Prevalence and characteristics of water-pipe smoking in Canada Peri Abdullah1, Christy Costanian1, Nazilla Khanlou2, Hala Tamim1 1 Kinesiology and Health Science, York University. 4100 Keele Street, Toronto ON, Canada. M3J 1P3 2 School of Nursing, York University. 4100 Keele Street, Toronto ON, Canada. M3J 1P3 BACKGROUND OBJECTIVE The purpose of this present study was to determine the prevalence and characteristics of ever and current water-pipe smoking in Canada. Water-pipe smoking (WPS) (a.k.a hookah, shisha, narghileh) is an ancient method of smoking practiced in multiple parts of the world including China, India and the eastern Mediterranean 1 (Fig. 1). WPS has been associated with multiple detrimental health effects including coronary artery disease, chronic bronchitis, emphysema and Chronic Obstructive Pulmonary Disease (COPD) and cancers including lung, gastric and esophageal 2. Little is known about the prevalence and characteristics of WPS in the Canadian population. Fig. 1: Parts of a water-pipe. Image from Centers for Disease control and Prevention (CDC). http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/ METHODS Survey Canadian Tobacco Use Monitoring Survey (CTUMS) cycles 2011 and 2012. CTUMS was an annual cross-sectional survey performed by statistics Canada examining tobacco use among Canadians aged 15 years or older in all 10 provinces. Outcome Variables Ever use of water-pipe asked by “Have you ever tried a tobacco water-pipe, also known as hookah, sheesha, nargeelay, hubble-bubble or gouza to smoke tobacco”. Current use of water-pipe asked by: “In the past 30 days, have you smoked a tobacco water-pipe’. Covariates Sociodemographic variables: Gender, age, Aboriginal status, province of residence, type of community (urban/rural), level of education, employment status, marital status and language spoken at home. Behavioural variables: Household smoking, cigarette smoking and marijuana use. Data Analysis Logistic regressions were performed to obtain Odds Ratios (ORs) and 95% Confidence Intervals (95%CI). Weighting and bootstrapping were performed. All analyses were performed in Stata Statistical Software: Release 13 (College Station, TX: StataCorp LP). RESULTS Results The weighted sample size was 28,513,934. The prevalence of Ever WPS was 8.9% and Current WPS was 0.8%. For Ever WPS, the most significant predictor (highest OR) was the 18-24 age group (OR=12.4, 95%CI=11.8-13.2) (Table 1). For Current WPS, the most significant predictor was the >18 age group (OR=47.9, 95%CI=38.0-60.3) (Table 1). Ever WPS was most prevalent in Quebec (11.3%) (Fig. 2). Current WPS was most prevalent in Alberta (1.2%) (Fig. 2). RESULTS (cont’d) REFERENCES CONCLUSION Maziak W, Ward KD, Afifi Soweid RA, Eissenberg T. Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tob Control. 2004;13(4):327-333. doi:10.1136/tc.2004.008169. Akl EA, Jawad M, Lam WY, Co CN, Obeid R, Irani J. Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review. Harm Reduct J. 2013;10:12. doi:10.1186/1477-7517-10-12. Age seems to be the most important predictor to consider, with the younger population showing higher ORs for ever and current WPS. In addition, WPS is associated with male gender and non-English non-French language use at home. These findings make it necessary to increase health promotion about WPS using age, gender and culturally sensitive approaches. Email: peri15@yorku.ca Table 1: Adjusted ORs and 95%CIs of Ever and Current WPS in Canada. conclusion ACKNOWLEDGEMENTS We express our gratitude to the team responsible for the Canadian Tobacco Use Monitoring Survey, Public Health Agency of Canada, and the staff at the Statistics Canada Research Data Centre – York Branch. The opinions expressed do not represent the views of Statistics Canada.  Email: peri15@yorku.ca