BACKGROUND: Commercial waterpipe, or hookah, tobacco contains toxicants similar to cigarettes No studies to-date report rates for current U.S. hookah use since 2016. Research shows factors such as male gender, race and ethnic identity, age, college education, region, and other tobacco product use are associated with hookah use.
METHODS: The Tobacco Use Supplement to the Current Population Survey (TUS-CPS) provides nationally representative data among the adult (18+), civilian, noninstitutionalized U.S. population. We analyzed data from 2010–2011, 2014–2015, 2018–2019, and 2022-2023 to assess changes in prevalence of hookah use (current “some days/everyday”, former, never use) over time, and whether being a current or former hookah user (vs never user) was associated with characteristics (age, sex/gender, race/ethnicity, education, cigarette smoking, geographical region, and metropolitan status) using multinomial logistic regression for each of the seven sociodemographic variables accounting for changes in trends over time.
RESULTS: Between 2010 and 2023, the weighted percentage of adults in the U.S. who report lifetime hookah use (current or former users) increased, from 2.7% to 5.5%. Current hookah ranged from 0.3% to 0.6% across time periods. Current hookah use was positively predicted by being male (vs female), aged 25-34 or aged 35-44 (vs 18-24), non-Hispanic Black or Hispanic (vs Non-Hispanic White), and college educated (v. less than HS or HS). Former hookah use was positively predicted by being male, aged 25-34 or aged 35-44, in the West, college educated, and income above $75000 (v. Any lower income level. Current and former cigarette smoking was associated with increased odds of current and former hookah use (2.45 < OR < 5.11, p < .001).
CONCLUSIONS: Differences among never, former, and current hookah users during this period suggest value in further assessment to identify both risk factors for hookah use and groups needing tailored/targeted intervention.