Roughly one in five high school seniors said they used shisha tobacco at least once in the previous year, according to a multi-year study of more than 8,700 students published in the American Journal of Preventive Medicine.

Sustained use, defined as at least six times in the prior 12 months, was reported by 7.2 per cent of respondents, according to researchers at the University of Pittsburgh. Those reporting at least one-time use represented 18.8 per cent of 8,738 students interviewed from 2010 to 2013.
“Given the prevalence of sustained waterpipe tobacco smoking and indications of its increase over time, it should be included in efforts related to tobacco surveillance and intervention,” a study abstract concludes.