A multiyear survey of waterpipe and cigarette smoking on a US university campus.

Objectives: To examine the prevalence and characteristics of dual users of cigarettes and waterpipes by comparing them with individuals who use either product exclusively.

Participants: Cross-sections of undergraduate students at a public university recruited each spring semester from 2006 to 2011 (total N = 2,998).

Methods: Participants completed an Internet survey that assessed demographics, tobacco use, perceptions, and norms concerning various tobacco products. Individuals who reported exclusive cigarette, exclusive waterpipe, and dual (waterpipe + cigarette) use were examined.

Results: Across years, 22% reported exclusive cigarette, 6.1% exclusive waterpipe, and 9.3% dual cigarette and waterpipe use. Dual users differed in demographics and social influences from their exclusive counterparts.

Conclusions: Findings suggest that dual waterpipe and cigarette use was more prevalent than exclusive waterpipe use, and dual users may differ from individuals who use either product alone. These results warrant the inclusion of waterpipe-specific content in state and national surveys as well as tobacco prevention and intervention efforts.