Abstract
Waterpipe (WP) use is popular among youth worldwide, but epidemiological data from Germany are scarce. We aimed to describe prevalence rates of WP use (current, last 12 months, ever) and analysed correlates and trends among 11- to 17-year-olds in Germany. Analyses were based on data from the “German Health Interview and Examination Survey for Children and Adolescents” study during 2014–2017 (n = 6599). Changes in WP use prevalence compared with 2009–2012 were used to describe trends. Associations with sociodemographic characteristics and cigarette smoking were assessed with multivariable logistic regression models. Prevalence of current WP use among adolescents was 8.5% (95% confidence interval (CI) = 7.5–9.6), use in the last 12 months was 19.7% (95% CI = 18.3–21.2), and ever use was 25.8% (95% CI = 24.2–27.5). High prevalence rates were particularly found among 16–17-year-olds. During 2009–2012, these prevalence rates were 9.0%, 18.5%, and 26.1%, respectively. WP use was associated with older age, male sex, migration background, lower educational level, and current smoking status. Among current WP users, 66.2% (95% CI = 60.0–71.9) identified themselves as non-smokers, and 38.1% (95% CI = 32.5–44.0) had used WP ≥ three times in the last month. WP consumption is popular among German youth, and prevalence rates have not changed over time. Specific prevention strategies to reduce harmful WP consumption among youth should be implemented.
Highlights
In recent decades, there has been a worldwide increase in the prevalence of waterpipe (WP) use among young people
The pattern of missing values showed a higher amount of missing values among boys with migration background, boys with lower socioeconomic status (SES) and lower education level, and among girls with lower SES and multivariable analyses showed that the odds of missing values are especially high among boys with a both-sided migration background
Concerning migration background, we found that boys with a one-sided migration background used WP more often than boys without a migration background (OR = 3.03, 95% confidence intervals (CIs) = 1.36–6.77)
Summary
There has been a worldwide increase in the prevalence of waterpipe (WP) use among young people. The popularity of WPs spread from India, across continents, until its consumption became accepted in the Western world as an alternative form of tobacco smoking. Regular consumption of WPs by broad sections of the population is a phenomenon that was not observed prior to the end of the 20th century [1,2,3]. Germany [Kinder- und Jugendgesundheitssurvey (KiGGS 2003–2006): Kinder und Jugendliche mit Migrationshintergrund in Deutschland]; Robert Koch-Institut: Berlin, Germany, 2008; p. The Drug Affinity of Young People in the Federal Republic of Germany 2015. Alcohol Consumption and Use of Illegal Drugs: Current Prevalence and Trends [Die Drogenaffinität Jugendlicher in der Bundesrepublik.
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