Waterpipe (shisha) smoking among adolescents in Germany: Results of the KiGGS study: first follow-up (KiGGS Wave 1)

Background: At the beginning of the 21st century, waterpipe (shisha) smoking has become a new and global youth trend in tobacco consumption. Despite the fact that this type of tobacco use can also lead to serious health problems, there are only a few studies on this topic in Germany.

Objective: The aim of this study was to determine the prevalence of waterpipe smoking among 12- to 17-year-old adolescents. Age- and sex-related differences were analyzed and, for the first time in Germany, the association between parental socioeconomic status and waterpipe use was examined.

Methods: Data were obtained from the first follow-up of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1), which was conducted from 2009 to 2012. Waterpipe smoking was assessed among adolescents aged 12 to 17 years using three items (n = 4,543). We calculated prevalence rates and age-adjusted odds ratios (OR) with 95 % confidence intervals (95 % CI).

Results: Lifetime prevalence of waterpipe use was 28.9 % (95 % CI: 26.9-31.0). Approximately one fifth (20.6 %; 95 % CI: 18.8-22.6) of the adolescents reported waterpipe use in the past 12 months, one tenth (10.0 %; 95 % CI: 8.6-11.6) reported current use (at least once during the past 30 days). In both sexes, prevalence increased with age. Waterpipe smoking rates were significantly higher among boys than girls, while no significant differences were found regarding parental socioeconomic status.

Conclusions: A considerable number of adolescents in Germany are at least occasional waterpipe (shisha) smokers. Because of waterpipe related health and addiction risks that are often underestimated by adolescents, specific health education and prevention measures are necessary.