Prevalence of Waterpipe (Shisha, Narghille, Hookah) Use Among Adults in Great Britain and Factors Associated With Waterpipe Use: Data From Cross-sectional Online Surveys in 2012 and 2013

Introduction: We assessed the prevalence and frequency of waterpipe smoking among adults (aged 18+ years) in Great Britain (GB) and determined demographic factors associated with use. Methods: We used cross-sectional representative population surveys conducted online in 2012 and 2013. A total of 12,436 adults in 2012 and 12,171 in 2013 were recruited from a commercial online survey panel. Results: The prevalence of ever use of waterpipe across both survey years combined was 11.6% (95% confidence interval [CI] = 11.0-12.1). Frequent use (at least once or twice a month) was 1.0% (95% CI = 0.8-1.2) and was similar in both 2012 and 2013. There was some suggestion of increased ever but not frequent use among 18-24-year-olds between survey years. After adjustment for covariates, females had lower odds of ever waterpipe use than males (odds ratio [OR] = 0.71, 95% CI = 0.63-0.79), those in the lowest social grade had lower odds of use compared to those in the highest social grade (OR = 0.43, 95% CI = 0.35-0.54), older people were at much lower odds of ever use than younger people, ever having smoked cigarettes increased odds of ever waterpipe use, and being Asian (OR = 1.84, 95% CI = 1.39-2.45) or of mixed ethnicity (OR = 2.36, 95% CI = 1.64-3.40) increased likelihood of ever use compared to White ethnicity. Conclusions: Frequent waterpipe smoking was relatively rare in these representative samples of the GB adult population, and prevalence was similar between 2012 and 2013. Continued monitoring and targeted interventions are appropriate.