Quitting Shisha Smoking Among Young Adults in Germany: Insights From an Online Survey on Sociodemographic, Perceptual and Behavioural Economic Factors Associated With Quit Attempts.

Introduction: Shisha smoking is common among young adults despite well-documented health risks. Evidence on factors linked to quit attempts among shisha smokers is limited. We examined sociodemographic, consumption-related, harm-perception, and behavioural-economic correlates of quit attempts in Germany. Methods: We analysed baseline data from the SHISHA study (01/2024-12/2025), a pilot online survey of adults aged 18-40 years in Germany. Participants were recruited via social media, schools, and flyers. Associations with quit attempts were examined using univariable logistic regressions. Results: Of 1,134 respondents, 570 identified themselves as current shisha smokers, and 504 provided valid data on quit attempts. The median age was 24 years; 68.3% were male and 30.2% female. Overall, 14.6% (95% CI = 11.9-17.8) of current shisha smokers reported having ever attempted to quit. Perceived dependence was the only variable significantly associated with quit attempts: those rating it unlikely to be or become addicted had higher odds of having attempted to quit than those rating it likely (OR = 2.05, 95% CI: 1.26-3.32). No significant associations were observed for sociodemographic characteristics, consumption patterns, perceived health risk, or behavioural-economic measures; descriptively, quit attempters showed more risk-averse choices. Discussion: In Germany, people who smoke shisha are typically young adults and have never attempted to quit. The observed association between low perceived dependence and the absence of quit attempts leaves open whether perceived dependence drives cessation behaviour or whether previous quit attempts shape individuals' perception of their own dependence.