Waterpipe and Cigarette Smoking Among College Athletes in the United States

Primack, Brian A.; Fertman, Carl I.; Rice, Kristen R.; Adachi-Mejia, Anna M.; Fine, Michael J.

doi:10.1016/j.jadohealth.2009.05.004

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Volume 46, Issue 1 , Pages 45-51, January 2010

Waterpipe and Cigarette Smoking Among College Athletes in the United States

Brian A. Primack, M.D., Ed.M., M.S.
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Address correspondence to: Brian A. Primack, M.D., Ed.M., M.S., Center for Research on Health Care, 230 McKee Place Suite 600, Pittsburgh, PA 15213.
Carl I. Fertman, Ph.D., M.B.A., C.H.E.S.
- Department of Health and Physical Activity, School of Education, University of Pittsburgh, Pittsburgh, Pennsylvania
Kristen R. Rice, M.P.H.
- Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Anna M. Adachi-Mejia, Ph.D.
- Hood Center for Children and Families, Department of Pediatrics, Dartmouth Medical School, Hanover, New Hampshire
Michael J. Fine, M.D., M.Sc.
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Center for Health Equity Research and Promotion, VA Healthcare System, Pittsburgh, Pennsylvania

Received 15 January 2009; accepted 20 May 2009. published online 08 July 2009.

Abstract

Purpose

Tobacco use using a waterpipe is an emerging trend among college students. Although cigarette smoking is low among college athletes, waterpipe tobacco smoking may appeal to this population. The purpose of this study was to compare cigarette and waterpipe tobacco smoking in terms of their associations with organized sport participation.

Methods

In the spring of 2008, we conducted an online survey of 8,745 college students at eight institutions as part of the revised National College Health Assessment. We used multivariable regression models to assess the associations between tobacco use (cigarette and waterpipe) and organized sports participation.

Results

Participants reported participation in varsity (5.2%), club (11.9%), and intramural (24.9%) athletics. Varsity athletes and individuals who were not varsity athletes had similar rates of waterpipe tobacco smoking (27.6% vs. 29.5%, p=.41). However, other types of athletes were more likely than their counterparts to have smoked waterpipe tobacco (35.1% vs. 28.7%, p < .001 for club sports and 34.8% vs. 27.7%, p < .001 for intramural sports). In fully-adjusted multivariable models, sports participants of any type had lower odds of having smoked cigarettes, whereas participants who played intramural sports (odds ratio=1.15, 95% confidence interval=1.03, 1.29) or club sports (odds ratio=1.15, 95% confidence interval=1.001, 1.33) had significantly higher odds of having smoked waterpipe tobacco.

Conclusions

College athletes are susceptible to waterpipe tobacco use. In fact, compared with their nonathletic counterparts, club sports participants and intramural sports participants generally had higher odds of waterpipe tobacco smoking. Allure for waterpipe tobacco smoking may exist even for individuals who are traditionally considered at low risk for tobacco use.

Keywords: Athletes, Waterpipe, Hookah, Tobacco, Team sports, Club sports, Intramural sports, Varsity sports, Organized sports, College