INTRODUCTION

Waterpipe tobacco smoking among university students in the Western Cape

Province of South Africa: Differences and similarities with

cigarette smoking

The Main Results

• Waterpipe smoking is very prevalent among the university students

• Waterpipe smokers differ greatly to cigarette smokers

Some background

• Why?• How?

The responseUniversities N % N n % n Response Rate

UCT 25865 24% 1583 35% 6.12%UWC 19500 18% 582 13% 2.98%SUN 28156 26% 2090 46% 7.42%CPUT 33562 31% 323 7% .96%

107083 100% 4578 100% 4.28%

% N % n % N % n % N % n % N % n % N % nGender

Male 48% 42% 41% 39% 49% 45% 54% 56% 48% 44%Female 52% 58% 59% 61% 51% 55% 46% 44% 52% 56%

RaceAfrican 23% 28% 41% 42% 16% 11% 58% 76% 35% 25%White 34% 44% 5% 7% 65% 72% 13% 5% 30% 49%Coloured 14% 12% 47% 42% 16% 9% 28% 17% 25% 15%Indian 7% 9% 7% 5% 2% 3% 1% 1% 4% 5%Missing 22% 6% 0% 3% 0% 5% 0% 1% 5% 5%

YearUndergraduate 68% 76% 77% 77% 64% 67% 96% 94% 76% 73%Postgraduate 32% 24% 23% 23% 36% 33% 5% 6% 24% 27%

Total UCT UWC SUN CPUT

Prevalence

Current use

Waterpipe Cigarettes

10.6 (n=484) 17.3 (n=794)

Ever use

Waterpipe Cigarettes

67.7 (3101) 62.0 (n=2838)

DifferenceFigure 2a: A Venn diagram illustrating the use distribution of manufactured and roll-

your-own cigarettes Figure 2b: A Venn diagram illustrating the use distribution of cigarettes (as

determined in Figure 2a), waterpipe and cigars Figure 2a: Figure 2b:

Age of initiation

Correlates worthy discussingWaterpipe Cigarettes

Age Gender

Coloured* Coloured

(Indian) English*

SUN No affiliation*

Med Muslim*Undergrad MedDrinking quantity* R300+*

Binge*Drinking quantity*

Others..* CAGE*Perceptions* Others*

Social perception*

Convinced?

• Waterpipe smoking is very prevalent among the university students

• Waterpipe smokers differ greatly to cigarette smokers

Table 8: Socio-demographic and behavioural characteristics by current waterpipe and cigarette users

Characteristics (n)% n % n % n % n

GenderMale (2018) 70.0 (1413) 11.6 (233) 64.9 (1310) 20.6 (416)Female (2560) 65.9 (1688) 9.8 (251) 59.7 (1528) 14.8 (378)p-value 0.003 0.057 <0.001 <0.001

RaceAfrican (1163) 42.1 (490) 6.9 (80) 48.6 (565) 11.3 (131)Coloured (689) 79.7 (549) 16.8 (116) 74.2 (511) 23.5 (162)White (2263) 77.0 (1742) 10.2 (132) 65.6 (1484) 19.0 (429)Indian (223) 76.2 (170) 14.4 (32) 61.9 (138) 14.4 (32)Other/prefer not to say (240) 62.5 (150) 10.4 (25) 58.3 (140) 16.7 (40)p-value <0.001 <0.001 <0.001 <0.001

UniversityUCT (1583) 68.9 (1090) 9.9 (157) 60.7 (961) 15.9 (252)SUN (2090) 73.2 (1529) 12.0 (251) 63.6 (1329) 18.8 (392)UWC (582) 58.1 (338) 9.6 (56) 63.2 (368) 16.8 (98)CPUT (323) 44.6 (144) 6.2 (20) 55.7 (180) 16.1 (52)p-value <0.001 0.006 0.028 0.133

ReligionNo Affiliation (813) 83.8 (681) 10.8 (88) 76.8 (624) 30.4 (247)Christian (3148) 61.9 (1949) 9.9 (311) 57.0 (1793) 13.5 (426)Hindu (80) 76.3 (61) 15 (12) 67.5 (54) 17.5 (14)Muslim (270) 81.9 (221) 14.8 (40) 70.7 (191) 19.6 (53)Jewish (53) 79.3 (42) 13.2 (7) 64.2 (34) 11.3 (6)Other/prefer not to say (214) 68.7 (147) 12.2 (26) 66.4 142/214 22.4 (48)p-value <0.001 0.101 <0.001 <0.001

Year of studyFirst (764) 66.4 (507) 13.5 (103) 56.9 (435) 17.2 (131)Second (1011) 63.8 (645) 12.5 (126) 59.1 (597) 17.6 (178)Third (949) 69.3 (658) 13.6 (129) 62.5 (593) 18.9 (179)Four + undergrad (633) 75.4 (477) 9.2 (58) 66.4 (420) 17.5 (111)Postgrad (1221) 66.7 (814) 5.6 (68) 35.0 (793) 15.7 (195)p-value <0.001 <0.001 <0.001 0.522

FacultyHealth faculty (3973) 63.0 (381) 6.8 (41) 54.9 (332) 11.4 (69)Other (605) 68.5 (2720) 11.2 (443) 63.8 (2506) 18.3 (725)p-value 0.007 0.001 <0.001 <0.001

Weekly spend<R100 (1484) 54.3 (805) 6.5 (97) 49.9 (733) 9.0 (134)R100-R199 (1310) 67.3 (881) 10.5 (138) 59.6 (781) 15.0 (196)R200 - R299 (711) 77.8 (553) 14.2 (101) 68.4 (486) 21.1 (150)>R300 (1073) 80.3 (862) 13.8 (148) 78.1 (838) 29.3 (314)p-value <0.001 <0.001 <0.001 <0.001

Fees funded byParents (1945) 75.8 (1475) 13.5 (263) 64.1 (1246) 19.6 (382)Academic bursary (1068) 64.0 (683) 8.8 (94) 56.4 (602) 14.1 (151)Financial Bursary (479) 57.2 (274) 7.3 (35) 60.5 (290) 14.8 (71)Student Loan (607) 62.3 (378) 11.2 (68) 63.1 (383) 17.8 (108)Self-funded (375) 60.5 (227) 4.8 (18) 67.7 (254) 18.1 (68)Other (104) 61.5 (64) 5.8 (6) 60.6 (63) 13.5 (14)p-value <0.001 <0.001 <0.001 0.003

Days activeNo days (311) 65.3 (203) 11.3 (35) 65.0 (202) 20.9 (65)1 day (1265) 67.0 (848) 11.7 (148) 61.6 (779) 19.1 (242)2 days (1228) 67.5 (829) 9.8 (120) 61.0 (749) 17.1 (210)3 to 4 days (1258) 68.3 (878) 9.8 (126) 62.1 (798) 16.1 (207)5 to 7 day (489) 70.1 (343) 11.3 (55) 63.4 (310) 14.3 (70)p-value 0.613 0.445 0.702 0.039

CAGENon-drinker (current/ever) (502) 37.9 (190) 6.0 (30) 33.5 (168) 6.6 (33)Non-problem drinker (3026) 69.6 (2107) 10.0 (303) 61.5 (1860) 15.1 (457)Problem drinker (1050) 76.6 (804) 14.4 (151) 77.1 (810) 29.0 (304)

<0.001 <0.001 <0.001 <0.001Parents smoke cigarettes

Yes (1737) 73.2 (1271) 12.7 (221) 70.6 (1227) 22.3 (387)No (2841) 64.1 (1830) 9.3 (263) 56.7 (1611) 14.3 (407)p-value <0.001 <0.001 <0.001 <0.001

Total 67.7 (3101) 10.6 (484) 62.0 (2838) 17.3 (794)

CurrentEverWaterpipe smoking Cigarette smoking

Ever Current

Table 4: Socio-demographic characteristics of the study groupGroups n %

Age (years) (mean ± SD)

GenderMale 2018 (44.1%)Female 2560 (55.9%)

RaceBlack 1163 (25.4%)Coloured 689 (15.1%)White 2263 (49.4%)Indian 223 (4.9%)Other/Prefer not to say 240 (5.2%)

ReligionNo Affiliation 813 (17.8%)Christian 3148 (68.8%)Hindu 80 (1.8%)Muslim 270 (5.9%)Jewish 53 (1.2%)Other 95 (2.1%)Prefer not to say 119 (2.6%)

NationalitySouth African 3993 (87.2%)Zimbabwe 142 (3.1%)Nambia 71 (1.6%)Other 372 (8.1%)

Home LanguageAfrikaans 1229 (26.9%)English 2221 (48.5%)isiXhosa 459 (14.4%)Other/missing 669 (10.3%)

UniversityCPUT 323 (7.1%)SUN 2090 (45.7%)UCT 1583 (34.6%)UWC 582 (12.7%)

Year of studyFirst year 764 (16.7%)Second year 1011 (22.1%)Third year 949 (20.7%)Four+ undergrad 633 (13.8%)Postgrad 1221 (26.7%)

Weekly spendingR0 - R99 1484 (32.4%)R100 - R199 1310 (28.6%)R200 - R299 711 (15.5%)R300+ 1073 (23.4%)

How are fees fundedParents 1945 (42.5%)Academic bursary 1068 (23.3%)Financial bursary 479 (10.5%)Student loan 607 (13.3%)Self-funded 375 (8.2%)Other 104 (2.3%)

Total 4578 (100.0%)

22.6 ± 4.2

Table 5: Health characteristics of the study groupGroups n %

Average days active per weekLess than 1 day 311 (6.8%)1 day 1265 (27.6%)2 days 1228 (26.8%)3 -4 days 1285 (28.1%)5 - 7 days 489 (10.7%)

Average time active per dayless than 3 minutes 375 (8.2%)less than 15 minutes but more than 3 minutes 1196 (26.1%)15 mins or more but less than half an hour 1144 (25.0%)30 minutes or more but less than 1 hour 1320 (28.8%)an hour or more 543 (11.9%)

Number of days drinking in past yearNever 552 (12.1%)Not in past year 266 (5.8%)1 or 2 times per year 353 (7.7%)3-11 times per year 520 (11.4%)Once a month 414 (9.0%)2-3 times a month 730 (16.0%)Once a week 638 (13.9%)Twice a week 698 (15.3%)3-4 times a week 294 (6.4%)5-6 times a week 78 (1.7%)Everyday 35 (0.8%)

Quantity drunk per drinking dayDid not drink in past year/ever 818 (17.9%)1 drink 715 (15.6%)2 drinks 952 (20.8%)3 - 4 drinks 1104 (24.1%)5 - 6 drinks 559 (12.2%)7 - 8 drinks 218 (4.8%)9 or more drinks 212 (4.6%)

How often do you binge drinkDid not drink in past year/ever 818 (17.9%)Not in past year 873 (19.1%)Less than once a month 1561 (34.1%)Monthly 766 (16.7%)Once a week 285 (6.2%)Twice a week 194 (4.2%)3 - 4 times a week 60 (1.3%)5 or more times a week 21 (0.5%)

CAGEAll no 2509 (54.8%)One yes 1019 (22.3%)Two yes 648 (14.2%)Three yes 313 (6.8%)Four yes 89 (1.9%)

Total 4578 (100.0%)