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This is a Cross-Sectional Study study.

September 21, 2025Nicotine & Tobacco ResearchOpen Access

Waterpipe and co-use of inhaled nicotine and tobacco products: findings from a population-based cross-sectional household survey in Germany

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Exclusive waterpipe use has decreased from 41.8% in 2019 to 26.3% in 2023, indicating a trend towards dual-use.
Dual-use of inhaled products among users has increased significantly from 49.3% to 62.3% over the same period.
In multivariable analysis, there is a significant decline in exclusive waterpipe use over time, with an odds ratio of 0.90 per year.
Rising dual-use and poly-use highlight the need for targeted public health interventions addressing combined product consumption.

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Cross-sectional survey reveals shifts in waterpipe use patterns in Germany, suggesting rising dual-use of products.

Klosterhalfen et al. (2025) studied this question.

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