Trends and correlates of waterpipe use in the European Union, 2009-2017
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Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom
Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, Greece
European Network for Smoking and Tobacco Prevention (ENSP), Belgium
Publication date: 2018-06-13
Corresponding author
Filippos T Filippidis   

Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom
Tob. Prev. Cessation 2018;4(Supplement):A45
Aims and objective: To explore the trends and correlates of waterpipe use between 2009 and 2017 across the European Union (EU. Methods: We analysed data from waves 72.3 (2009, n=27,788); 77.1 (2012, n=26,751); 82.4 (2014, n=27,801); and 87.1 (2017, n=27,901) of the Eurobarometer survey in all 28 EU member states. Representative samples of EU residents aged ≥15 years were asked to report ever use of waterpipe. Regular waterpipe use, i.e. at least once a month was also assessed in 2017. We used multi-level logistic regression to assess associations of ever and current use with sociodemographic factors.

The prevalence of ever waterpipe use in the EU increased from 11.6% in 2009 to 16.3% in 2014, but dropped to 12.9% in 2017. Variation between EU member states was observed, ranging from 2.3% (Croatia, 2009) to 41.7% (Latvia, 2017). Regular waterpipe use was highest in Austria (3.6%), Latvia (2.5%) and Belgium (2.0%) in 2017. Those aged 15-24 years were 11.43 times more likely (95% Confidence Interval [CI]: 10.71-12.21) to have ever used waterpipe compared to respondents 55 years and older. Regular and ever waterpipe use were also more likely among current and former cigarette smokers. Males (adjusted Odds Ratio [aOR]=1.64; 95% CI: 1.58-1.70) and those living in urban areas (aOR=1.36; 95% CI: 1.30-1.42) were more likely to have ever used waterpipe.

A substantial proportion of EU citizens, especially young men, have tried waterpipe. Regular use is relatively limited, but more systematic surveillance is required to monitor trends across the EU.

This work was supported by a grant from the European Commission (Horizon2020 HCO-6-2015; EUREST-PLUS: 681109; Vardavas).

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