Teens Hooked on Hookah
If you are a parent of a teenager and you’ve never heard of hookah, start educating yourself on the topic. Hookah is an ancient method of smoking that has been catching on in the U.S., and teenagers have been quick to pick up on this trend. Although cigarette smoking has declined due to education about the many health risks and more stringent laws regarding usage, hookah smoking is on the rise.
The Centers for Disease Control and Prevention reports, “In 2010, the Monitoring the Future survey found that among high school seniors in the U.S., about 1 in 5 boys (17 percent) and 1 in 6 girls (15 percent) had used a hookah in the past year.”
Unfortunately, there is a prevailing misconception that hookah smoking is a fairly safe alternative to cigarette smoking. Make no mistake, hookah smoking is detrimental to your health. It’s imperative that parents learn the truth about hookah and start talking to their teens about the dangers.
Hookah smoking was commonplace in ancient Persia and India. In recent years, there has been a resurgence of hookah use around the world, and it is becoming particularly popular among high school and college students who consider it a fun, social pastime.
Hookahs (or water pipes) are used to smoke specially made tobacco that comes in different flavors, such as apple, mint and cherry. Hookah smoking is typically done in groups, with the same mouthpiece passed from person to person.
Dr. Brian A. Primack, M.D., Ph.D., associate professor of medicine, pediatrics and clinical translation science at the University of Pittsburgh School of Medicine, explains that one of the reasons hookah has caught on so dramatically is due to its aesthetically pleasing tastes and environments.
“Hookah smoking is commonly done in ‘hookah lounges,’ which are often dimly lit and beautifully decorated.” He points out that the act itself is more aesthetic as well because the tobacco is flavored, sweetened and cooled by the water, which makes it less harsh than cigarette smoking. “I have a number of patients who would be horrified to smoke a cigarette, but they wholeheartedly embrace hookah tobacco smoking. They express disbelief when I show them data on what they are actually inhaling.”
Erin L. Sutfin, a developmental psychologist and assistant professor in the department of Social Sciences and Health Policy at the Wake Forest School of Medicine in Winston-Salem, agrees with Primack. “It is well documented that teens are attracted to flavored tobacco products and use them at much higher rates than adults,” she says.
“It takes a long time to do studies that accurately quantify health risks, and the hookah phenomenon is relatively young in the Western world,” Primack says. “That being said, we do have data that show that hookah smokers are heavily exposed to hazardous toxins.”
Primack reports that one hookah smoking session, which lasts about 45-60 minutes, exposes the user to about 100 times the smoke volume of a single cigarette. “It also seems to expose the user to about 40 times the tar, 10 times the carbon monoxide, and two times the nicotine.”
“Hookah smoking also carries the risk of infectious disease transmission, such as tuberculosis, influenza, and mononucleosis, due to the shared hoses and mouthpieces,” Sutfin warns.
The burning process itself poses risks as well. Dr. Dyan Hes, M.D., FAAP, medical director of Gramercy Pediatrics in New York City and clinical assistant professor of pediatrics at the Weill Medical College of Cornell University, says “There are as much or more carcinogens in hookah smoke, particularly since the tobacco is burned at a higher temperature than in a cigarette.”
Safe Hookah Products?
Some products boast that they are tobacco-free, hence safe.
“Smoking herbal shisha (a non-tobacco alternative) is still dangerous,” Sutfin says. “Although there is not the risk of addiction since there is no nicotine, there is still exposure to high levels of carbon monoxide and other toxins.”
“Most hookahs involve the lighting of a piece of charcoal in the hookah bowl,” Primack says. “Therefore, even if there are no other substances, the user will be exposed to the combustion products of the charcoal, which include carbon monoxide.” He reports that hookah smokers have landed in emergency rooms with carbon monoxide poisoning.
Besides carbon monoxide, the charcoal used to heat the products produces smoke containing metals and cancer-causing chemicals.
Laws have not caught up with this new trend. Although many states have enacted bans on smoking in enclosed public places, hookah lounges may be excluded from these laws because they claim to qualify for the same exemptions offered to cigar bars, retail tobacco shops and establishments that sell non-tobacco smoking products.
“Federal laws recently restricted youth-oriented flavorings in cigarettes [FDA regulation, 2009],” Primack says. “However, these laws do not apply to hookah tobacco.”
Knowledge is the Best Antidote
“Parents need to emphasize that hookah smoking, including using herbal products, carries many of the same health risks as cigarette smoking,” Sutfin urges.
“Parents should show their teens the statistics of the carcinogens found in hookah smoke,” Hes adds.
Myrna Beth Haskell is a feature writer, columnist and author of, LIONS and TIGERS and TEENS: Expert advice and support for the conscientious parent just like you. Learn more at myrnahaskell.com.