Uncovering Hookah
Hookah is primarily used by young adults 18 to 29 years of age in California.1 The Hispanic/Latino population makes up the largest proportion of young adult hookah users (51.4%).2 This suggests that hookah use is not only limited to a cultural and social practice among Middle Easterners, Indians, Armenians, and Persians, but rather that hookah use has become commercialized.
Hookah is an appealing social activity because it is smoked as a group, making it seem less dangerous. It’s hard to ignore that hookah cafes are commonly located near college campuses,3 4 making them the most common place to try hookah and where nearly 60 percent of college-age hookah users first starts.5 Hookah cafes typically advertise on social media, online, and in young adult newspapers and magazines to entice young adults.6 7
The popularity of hookah is due in part to the availability of flavors such as apple, peach, mint, strawberry, and cola,8 which mask the harsh taste of tobacco and makes it easier to inhale. Many people who use hookah think of it as less harmful and addictive than other types of tobacco.9 The truth is, using hookah pipes is not a safe alternative to cigarette smoking – hookah smoking increases the risk of esophageal and lung cancers as well as heart disease.10
Hookah tobacco contains the same chemicals found in all tobacco, including nicotine and cancer-causing chemicals. Many people that use hookah think that the water “filters” the tobacco, thus making it safer to use. Water only cools the tobacco, making it easier to inhale the toxic smoke. In addition, secondhand hookah smoke also contains the same cancer-causing chemicals found in cigarette smoke.11
- California Health Interview Survey. CHIS 2019-20 Adult Public Use Files. Los Angeles, CA: UCLA Center for Health Policy Research; September 2021.
- California Health Interview Survey. CHIS 2019-20 Adult Public Use Files. Los Angeles, CA: UCLA Center for Health Policy Research; September 2021.
- Kassem NO, Jackson SR, Boman-Davis M, et al. Hookah Smoking and Facilitators/Barriers to Lounge Use among Students at a US University. Am J Health Behav. 2015;39(6):832-848. doi:10.5993/AJHB.39.6.11
- Sutfin EL, McCoy TP, Reboussin BA, Wagoner KG, Spangler J, Wolfson M. Prevalence and correlates of waterpipe tobacco smoking by college students in North Carolina. Drug and alcohol dependence. 2011;115(1-2):131-136.
- Kassem NO, Jackson SR, Boman-Davis M, et al. Hookah Smoking and Facilitators/Barriers to Lounge Use among Students at a US University. Am J Health Behav. 2015;39(6):832-848. doi:10.5993/AJHB.39.6.11
- Kassem NO, Jackson SR, Boman-Davis M, et al. Hookah Smoking and Facilitators/Barriers to Lounge Use among Students at a US University. Am J Health Behav. 2015;39(6):832-848. doi:10.5993/AJHB.39.6.11
- Sterling KL, Fryer CS, Majeed B, Duong MM. Promotion of waterpipe tobacco use, its variants and accessories in young adult newspapers: a content analysis of message portrayal. Health education research. 2015;30(1):152-161.
- Centers for Disease Control and Prevention. Hookahs. cdc.gov. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm. Reviewed April 22, 2021. Accessed March 25, 2022.
- Smith-Simone S, Maziak W, Ward KD, Eissenberg T. Waterpipe tobacco smoking: knowledge, attitudes, beliefs, and behavior in two U.S. samples. Nicotine Tob Res. 2008;10(2):393-398. doi:10.1080/14622200701825023
- Qasim H, Alarabi AB, Alzoubi KH, Karim ZA, Alshbool FZ, Khasawneh FT. The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environ Health Prev Med. 2019;24(1):58. Published 2019 Sep 14. doi:10.1186/s12199-019-0811-y
