Water Pipe Steam Stones: Familiarity and Use Among US Young Adults

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Water pipe tobacco smoking (WTS) is associated with substantial toxicant exposure. Water pipe steam stones (WSS) are marketed as a healthier alternative. The purpose of this study was to determine, in a nationally representative sample, young adults’ familiarity with, perceptions regarding, and use of WSS.


A survey about WTS was completed by 3,253 members of an online nonvolunteer access panel. Four items specifically addressed WSS.


Of the 228 individuals who had heard of WSS, 17% (n = 41) reported using them. Use was associated with ever (adjusted odds ratio [AOR] = 7.7, 95% confidence interval [CI] = 2.7-21.8) and current (AOR = 16.1, 95% CI = 5.1-51.5) WTS. Compared with those who thought that WSS had about the same harm as WTS, those who thought that WSS was “a lot less harmful” to a person’s health had substantially higher odds of having tried WSS (AOR = 6.8, 95% CI = 2.0-23.1).


Approximately 1 in 6 young adults who have heard of WSS used them. WSS use is associated with the perception of reduced harm.

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