Waterpipe and Cigarette Smoking Among College Athletes in the United States

While tobacco use has declined over the past two decades, tobacco smoking using a waterpipe is an emerging trend among college students. A single waterpipe smoking session produces far more tar than a single cigarette (46 times) and more expired carbon dioxide (five times), as well as higher blood nicotine levels.

While college athletes generally are less prone to cigarette smoking, waterpipe tobacco smoking is gaining appeal with flavored tobaccos, and the mistaken belief that it is less harmful than cigarette smoking because water filters the smoke.

Using a subset of data from a national health survey of college students, participants included approximately 9,000 students from eight representative universities. Students were asked follow-up questions about waterpipe and cigarette tobacco smoking and their participation in organized sports.

Overall, 29.5 percent reported trying waterpipe smoking and 7.2 percent reported waterpipe tobacco smoking in the past 30 days.

The investigators were “surprised” that club and intramural athletes were at higher risk of waterpipe tobacco smoking than nonathletes. Among athletes, only varsity sport players had lower odds of waterpipe tobacco smoking; slightly lower than the rate for nonathletes.

These researchers recommend that public health prevention programs directed to college students need to emphasize that “tobacco is tobacco.”