Int. J. Environ. Res. Public Health 2011, 8 566 was estimated to be 8.6 billion gallons, or 27.6 gallons per person [2]. Despite the common belief that bottled water is safer to drink and has better taste than tap water, scientific studies have shown that the belief is not necessarily true [3,4]. Research also shows that the sales and consumption of bottled water can have environmental and social impacts whose consequences are yet to be fully understood [5-7]. After years of substantial growth in sales, the U.S. bottled water market is recently slowing down. The current economic downturn may have played a part in the drop; however, environmental concern is also an important factor. Some research has found that environmental awareness campaigns may have curbed consumer demand [8-10]. Previous studies about bottled water have focused on its production, regulation, sales and consumption, and criticism and concerns. However, few researchers have examined the relationship between consumer use of bottled water and perceptions of drinking water quality. In this article, the authors explore the demographic and social factors associated with bottled water users in the U.S. and the relationship between bottled water use and perceptions of the quality of local water supply. A brief discussion of bottled water and tap water and bottled water consumers is used to develop several hypotheses. These hypotheses are tested using a national dataset representing twenty-one U.S. states. Results and discussion are followed by implications directed toward educators and public policy makers as they fund and develop programs that promote knowledge about health and local drinking water. 1.1. Bottled Water vs. Tap Water Bottled water has been used in place of tap water for its convenience, better taste, and perceived purity [1,3,11]. Perceptions of bottled water being of higher quality, however, are challenged by the increasing number of water quality incidents with bottled water [12]. A study showed that only five percent of the bottled water purchased in Cleveland, Ohio had the required fluoride recommended by the state, whereas the sampled tap water 100% met this requirement [3]. The same experiment also conducted bacteria count on both bottled water and tap water samples. The result showed that all of the tap water samples had a bacterial content under 3 CFUs/mL (colony-forming unit, a measure of viable bacterial or fungal numbers) and the bottled water samples' bacterial content ranged from 0.01–4,900 CFUs/mL. Although most of the water bottle samples were under 1 CFU/mL, there were 15 water bottle samples containing 6–4,900 CFUs/mL [3]. Another study focusing on the temperature and duration of storage for bottle water found that the bacterial growth in bottled water was markedly higher than that in tap water, especially at higher temperatures [4]. Many scientific reports on bottled water urge increased public awareness and development of guidelines/regulations on the industry of bottled water [1]. Incidents with bottled water quality are largely reported as associated with lenient regulations on bottled water. Bottled water plants are subject to the U.S. Food and Drug Administration (FDA) monitoring and inspection. Despite specific inspection requirements, bottled water plants are given low priority for safety inspection compared with other food plants because of FDA’s staffing and financial constraints [13]. The “Nutrition Facts” label on bottled water usually shows only limited information about the water [1]. Despite the popularity of bottled water in the U.S., there are a number of environmental and social concerns. Plastic bottles are a waste problem adding to landfill overload when not recycled. Water bottling plants have impacts on local groundwater aquifers and streams [5]. Taking too much water can