Water-pipe smoked tobacco has become increasingly prevalent among youth, exposing them early to a habit that can bring substantial harm to health and increase the likelihood of nicotine addiction. It is important to focus attention on this growing public health threat.

More U.S. college students and younger adolescents are using water pipes to smoke tobacco. Water-pipe smoke, which contains many of the same toxicants as cigarette smoke, has been associated with cancer, cardiovascular disease, decreased pulmonary function and nicotine dependence. This study of Arizona middle and high school students examined the prevalence of water-pipe tobacco smoking and compared water-pipe smoking with other forms of tobacco use. Outcomes of interest were: ever use of water pipe to smoke tobacco and water-pipe tobacco smoking in the previous 30 days. To obtain data, researchers supplemented Arizona’s 2005 Youth Tobacco Survey, a statewide sample of high school students.

Key Findings:

• Among middle school students, 2.1 percent had ever smoked water-pipe tobacco; 1.4 percent within previous 30 days.
• Among high school students, 10.3 percent had ever smoked from a water pipe; 5.4 percent within previous 30 days.
• Ever smoking of water-pipe tobacco was associated with older age, Asian race, white race, charter school attendance and lack of plans to attend college.

Among Arizona youth, water pipe is the third most common source of tobacco after cigarettes and cigars, with higher uptake among higher-risk youth. Increased national surveillance, water-pipe-specific prevention efforts and additional research may help address this public health concern.