Hookah Use Increasing in Teens

Though cigarette smoking in teens is declining, use of other forms of tobacco products is on the rise — including the ancient practice of smoking special flavored tobacco from a hookah.

A new study, "Hookah Use Among U.S. High School Seniors," published online July 7 in the journal Pediatrics, examined data from Monitoring the Future, a nationwide ongoing annual study of the behaviors, attitudes and values of about 15,000 U.S. high school seniors annually.

Researchers evaluated data from 5,540 students who were asked about hookah use from 2010-2012. They found that nearly 1 in 5 high school seniors had smoked using a hookah at least once in the previous 12 months. Students who smoked cigarettes, and those who had ever used alcohol, marijuana or other illicit substances were more likely to use hookah.

"What we find most interesting is that students of higher socioeconomic status appear to be more likely to use hookah," said Joseph J. Palamar, Ph.D., M.P.H., a researcher and an assistant professor of Population Health at NYU Langone Medical Center. "Surprisingly, students with more educated parents or higher personal income are at high risk for use. We also found that hookah use is more common in cities, especially big cities. So hookah use is much different from cigarette use, which is more common in non-urban areas."

"Cigarette use has decreased by 33 percent in the past decade in the U.S., while the use of alternative tobacco products such as hookahs has increased an alarming 123 percent," said study co-author Michael Weitzman, M.D., a professor of Pediatrics and of Environmental Medicine at the NYULMC. "This is especially worrisome given the public misperception that hookahs are a safe alternative to cigarettes whereas evidence suggests that they are even more damaging to health than are cigarettes."
And as the practice of using a hookah gains popularity in younger people, steam stones and hookah pens — varieties of electronic hookahs similar to e-cigarettes — are hitting the market.

"These nifty little devices are likely to attract curious consumers, possibly even non-cigarette smokers," said Dr. Palamar. "And unlike cigarettes, hookah comes in a variety of flavors and is less likely to leave users smelling like cigarette smoke after use. This may allow some users to better conceal their use from their parents or peers."
According to the Centers for Disease Control and Prevention, using a hookah to smoke tobacco can be as dangerous as smoking cigarettes, as users have are exposed to several toxic agents known to cause lung, bladder, and oral cancers.
Other risks include heart disease and infections caused by sharing a hookah with other smokers. Visit the CDC website (http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/) for more details on the health risks of hookah use.

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