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Waterpipe smoking is harmful and addictive and can be a gateway to cigarette smoking. This study examined the association between curiosity and susceptibility to cigarette smoking among cigarette-naïve US youth who smoke waterpipe using cross-sectional data from the National Youth Tobacco Survey, 2014. METHODS Susceptibility to cigarettes was assessed using a composite index of three questions: ‘Do you think you will smoke a cigarette in the next year?’, ‘Do you think that you will try a cigarette soon?’, and ‘If one of your best friends were to offer you a cigarette, would you smoke it?’. Curiosity was assessed by one question: ‘Have you ever been curious about smoking a cigarette?’. RESULTS Among current waterpipe smokers, 48.5% (95% CI: 43.1-53.9) were susceptible to cigarettes and 42.6% (95% CI: 36.5-48.9) were curious about cigarettes. Overall, 45.1% (95% CI: 38.9-51.4) and 46.5% (95% CI: 40.2-52.8) of those living with a waterpipe smoker were susceptible and curious about cigarettes, respectively. Current waterpipe smokers had significantly higher odds of susceptibility to cigarettes (aOR=1.5, 95% CI: 1.1-2.3, p<0.04), but not for curiosity about cigarettes (aOR=1.2, 95% CI: 0.83-1.70, p=0.3). CONCLUSIONS Initiation of cigarettes among adolescents who smoke waterpipe can be due to increasing susceptibility to cigarette smoking rather than increasing curiosity about cigarettes.

Curiosity and susceptibility to cigarette smoking among cigarette-naïve, waterpipe smoking US youth: National Youth Tobacco Survey, 2014