‘Oh my God! I used to smoke five packs of King Cools a day, who wouldn’t want to quit?’ Sitting in his Provincetown summer residence in the week that the MPAA (US film ratings board) have announced that films featuring smoking could now face an R rating (UK 15) and that films featuring children smoking will automatically receive the rating, this most cherished of underground US filmmakers is reminiscing. ‘I coughed so hard in the street strangers would ask if I was alright. So one day Robert Downey Sr took me to the Beverly Hills Clinic where they gave me shots in the neck and it seemed to work.’

Provincetown is a beautiful beach resort town located at the extreme tip of Cape Cod in Massachusetts, with a population of 3431. The nearest city, Boston, is 115 miles away. Waters has come to host the Provincetown Film Festival. ‘Every year we honour people,’ he says. ‘This year it’s Todd Solondz. Kathleen Turner and I are hosting a champagne reception at a drive-in cinema where they are showing a double bill of Serial Mom and The War of the Roses.’ Waters almost squeals with anticipation.

He is due to appear in Edinburgh to introduce and talk about This Filthy World, a film featuring but not made by him. It’s a concert film of Waters’ legendary stand-up routine, directed by Curb Your Enthusiasm’s Jeff Garlin (he plays Larry David’s put-upon agent Jeff in the show).

Waters is effusive about the project to the point of being almost maniacal: ‘I’ve been doing this one person spoken word act for 30 years now. I’m doing it tomorrow in New York where Bill Clinton is one of the other speakers.’ He stops to consider the booking. ‘That ought to be lush.’ He laughs at his own campness. ‘It all started in the real early days when I had no money to promote my movies. I would go out with the prints of my film with Divine and we would make appearances and I would come out and sort of dress like a hippy pimp and introduce “the most beautiful woman in the world” and Divine would come out pushing a shopping cart and throwing dead fish into the audience. Then we would hire the cutest hippy in each town who we dressed in a stolen police uniform and a short haired wig – he would come on stage and pretend to arrest us, and Divine would strangle him to death and then the movie would start. And so it grew from that . . . ’

At 61-years-old and with 16 films under his belt as filmmaker and innumerable projects as actor, producer and writer, I ask the pencil-moustached one if this could be his swansong. ‘No! I feel like it is my “position paper”. They say that I’m a cult leader so maybe it’s my manifesto. I entered the stage in film via a confessional so I suppose you could call this my vaudeville act. It’s a very good portrait of what makes me jump out of bed every morning in a good mood as I’m obsessed with human behaviour. Hopefully, it comes across as me convincing you to be obsessed with everything I’m obsessed with; I don’t think I do a bad job.’

Watching and listening for signs of vanity I ask him if he has seen the film yet. ‘Once. I can only watch myself so many times. I mean who else can I blame; I’m the only person on stage! Yes I’m happy, but to see yourself for 90 minutes, even for a narcissist, is some kind of torture.’

How John Samuel Walters Jr, the son of a middle class couple from Maryland got here is a colourful tale and one half-told in his wonderfully lurid 1981 autobiography Shock Value, the second part of which he promises will be written any day now. Yet some fans of the so called ‘Pope of Trash’ or ‘Prince of Puke’ have recently voiced their regret that the same man behind such deranged outré 70s gems as Pink Flamingos, Female Trouble and Desperate Living could allow his much-loved 1988 comedy Hairspray to be turned into a Broadway musical and then a multi million dollar remake starring John Travolta. Waters is blasé about such paradoxes: ‘I guess I would be the meanest critic of all but I think it’s a really good movie, really hilarious. I play the flasher in it. It was odd to go to Canada and see a $75m version of Baltimore.’

He is, however, quick to point out that his involvement with the new film is limited: ‘I’m not the producer. I call myself the “Grandfather of the second generation”. The studio asked me to write John Travolta a letter to talk him into it, which I did. And I gave all the creative staff a tour of the Baltimore locations where the original was filmed. But to be honest I have a very nice “passive income” from the whole phenomenon of Hairspray the musical and now the movie. And now Cry-Baby is coming to Broadway. I once asked for the rights to make Pink Flamingos into an opera. I mean, let’s get ‘em all working, let’s have Polyester On Ice!’

Besides touring and promoting This Filthy World, Waters has ‘a terribly wonderful children’s Christmas adventure’ called Fruitcake in production, while also promoting a compilation of songs he claims ‘I would seduce you by’ called A Date with John Waters which came out on Valentine’s Day. I note that he has the prolificacy that would stunt a man half his age. ‘I keep busy, yeah. I try to. I work for myself and people always say to me, “How can you be so organised and everything?” and I say “Because if I wasn’t I’d have to go work for someone else!”’

This Filthy World, Cineworld, Fountainpark, Dundee Street, 0131 228 2688, 16 Aug, 8.30pm, prices start from £6.50 (£4.55).