Nearly 1 in 5 high school seniors has used a hookah

Imad Marouf smokes a lemon and mint hookah in his specialty shop called Hookah Mocha in Monroe, Michigan on April 21, 2010.

Nearly one in five U.S. high school seniors has used a hookah, according to a new study published in Pediatrics. These water pipes have been used for centuries in the Middle East and are an increasingly popular method of tobacco delivery in the United States. Bars and restaurants — even in many states where smoking cigarettes indoors would be illegal — offer the pipes for tables to share. In an era when cigarettes are no longer cool, hookah seems to be a smoking method with less stigma.

But according to another study released last week, this one in Nursing Research, many young people who smoke hookahs are under the false impression that it’s safe. But don’t go smashing the water pipes just yet: The Food and Drug Administration may soon place regulations on hookah use.

Hookah smoke isn’t great for you. It contains the same carcinogens and contaminants (such as tar and carbon monoxide) as cigarette smoke, and it delivers nicotine. Mary Rezk-Hanna, a UCLA nursing doctoral student and lead author of the Nursing Research study, said that 16 percent of 91 hookah-bar patrons she surveyed (all between 18 and 30 years old) thought that hookah smoke lacked nicotine and wasn’t addictive. And 56 percent said that hookah use wasn’t harmful to their health at all. Around half thought that the pipes, which generally have several feet of hose for the smoke to travel through, somehow “filtered out” the toxic components with air and water. Some even thought that the flavors given to hookah smoke, which can be fruity, made them less toxic.

According to Joseph Palamar, an assistant professor of population health at NYU Langone Medical Center and lead author of the Pediatrics study, white, wealthier young men are more likely than people in other demographic groups to use hookahs. But he acknowledges that it’s likely many teens do so quite infrequently, on special occasions. However, one session of hookah is certainly worse than one cigarette, with hookah sessions taking up to two hours and involving much more inhalation.

“It’s bad for you regardless,” he said, “but certainly not as bad as doing it every day.”

The FDA recently announced that it would create more regulations for consuming nicotine, though it’s expected that the focus will be electronic cigarettes. Cheaper and more convenient than a water pipe but with the same flavors and misconceptions about healthfulness, e-cigarettes are seen by some health experts as posing a more immediate threat to the health of U.S. teens.