Young adults who frequent bars are at least twice as likely to smoke as young adults in the general population, according to a study presented at the recent annual meeting of the American Public Health Association.

The researchers, from UCSF, reviewed survey data on over 6,000 participants ages 18 to 26 from Albuquerque, Los Angeles, Nashville, San Diego, San Francisco and Tucson and found that 30 to 50 percent of young adults who said they were frequent visitors to bars or night clubs smoked cigarettes; the national rate for that age group is about 15 percent.

Cigarettes were the most commonly used tobacco product, ranging from thirty percent (San Francisco) to fifty percent (San Francisco.) Hookah rates ranged from fourteen percent (Nashville) to 37 percent (New York City), and e-cigarette use which ranged from ten percent (Nashville) to 24 percent (Albuquerque). Men were more likely than women in all cities to use a combination of tobacco products and Latinos in New York and non-Hispanic blacks in San Diego were more likely than non-Hispanic whites to use multiple tobacco products. Survey participants who identified as lesbian, gay, bisexual or transgender, were more likely to be current tobacco users.

“These findings are important because young adulthood is a critical point in time to intervene on tobacco use: those who have never smoked by the age of 25 are much less likely to ever become smokers, and those who quit before the age of 30 avoid most of the long term health effects of smoking,” said Louisa Holmes, a postdoctoral fellow at UCSF and one of the study authors.