Researchers find 18 percent of high school seniors smoke hookah

July 7, 2014, New York University School of Medicine

While cigarette use is declining precipitously among youth, evidence indicates that American adolescents are turning to ethnically-linked alternative tobacco products, such as hookahs, cigars, and various smokeless tobacco products, according to a recent report from the Centers for Disease Control and Prevention (CDC).

Now a new study by researchers affiliated with New York University's Center for Drug Use and HIV Research (CDUHR), in the August 2014 edition of Pediatrics identifies how prevalent Hookah use is and which teens are most likely to be using it.

The study, "Hookah Use Among U.S. High School Seniors," published online July 7, used data from Monitoring the Future (MTF), a nation-wide ongoing annual study of the behaviors, attitudes, and values of American secondary school students. The MTF survey is administered in approximately 130 public and private schools throughout 48 states in the US. Roughly 15,000 seniors are assessed annually. This study examined data from the 5,540 students (modal age = 18) who were asked about Hookah use from 2010-2012. The researchers found the annual prevalence (use in the last 12 months) of use was nearly 1 in 5 .

"What we find most interesting is that students of higher socioeconomic status appear to be more likely to use hookah," said Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). "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."

Hookah, an ancient form of smoking, in which charcoal-heated tobacco or non-tobacco based shisha smoke is passed through water before inhalation, is rapidly gaining popularity among adolescents in the US. The researchers found those students who smoked cigarettes, and those who had ever used alcohol, marijuana or other illicit substances were more likely to use hookah.

"Tobacco use and exposure to secondhand smoke are the leading preventable causes of morbidity and mortality in the US," said a study co-author Michael Weitzman, MD, a professor of Pediatrics and of Environmental Medicine at the NYULMC. "Cigarette use has decreased by 33% in the past decade in the US, while the use of alternative such as hookahs has increased an alarming 123%. 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."

While the US is experiencing an alarming increase in hookah use among adolescents, Dr. Palamar does point out that "Use tends to be much different from traditional cigarette smoking. Right now it appears that a lot of hookah use is more ritualistic, used occasionally—for example, in hookah bars, and not everyone inhales."

"However, times are beginning to change," notes Dr. Palamar. "Now something called hookah pens, which are similar to e-cigarettes, are gaining popularity. While not all hookah pens contain nicotine, this new delivery method might normalize hookah use in everyday settings and bring use to a whole new level."

Researchers note that social stigma toward cigarette use appears to have played a large part in the recent decrease in rates of use, but they caution that it is doubtful these new hookah pens are frowned upon as much as cigarettes. Hookah pens also come in trendy designs and colors, which may be appealing to both adolescents and adults.

"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."

Researchers conclude increased normalization might lead to increases in use, and possibly adverse consequences associated with repeated use. "This portends a potential epidemic of a lethal habit growing among upper and middle class adolescents," said Dr. Weitzman. They stress that it is crucial for educators and public health officials to fill in the gaps in public understanding about the harm of hookah smoking.

Explore further: Students swayed by 'relaxing, fun' image of hookah smoking ignore health harms

Related Stories

Students swayed by 'relaxing, fun' image of hookah smoking ignore health harms

May 20, 2014
Educational campaigns meant to dissuade college students from initiating hookah tobacco smoking may be more successful if they combat positive perceptions of hookah use as attractive and romantic, rather than focusing solely ...

Toward understanding the health effects of waterpipe or 'hookah' smoking

September 8, 2013
With water pipes or hookahs gaining popularity in the United States and other countries, scientists today described a step toward establishing the health risks of what has been termed "the first new tobacco trend of the 21st ...

After tobacco, Turkey bans hookah in public places

January 28, 2013
After banning smoking in public places, the Turkish government has gone one step further by clamping down on an ancient tradition—the hookah, or water pipe.

Hookah smoking increasingly common among first-year college women

July 18, 2012
Nearly a quarter of college women try smoking tobacco with a hookah, or water pipe, for the first time during their freshman year, according to new research from The Miriam Hospital's Center for Behavioral and Preventive ...

Researchers alarmed at rise in hookah use among California youth

August 19, 2011
Hookah use among California youth ages 18 to 24 is rising rapidly according to a study conducted by researchers at University of California, San Diego School of Medicine. The study appears in the "First Look" online version ...

More smoke water pipes -- family habits significant

April 7, 2011
The number of people smoking water pipes is rising dramatically throughout the world. A large proportion of new users are young, and many believe – contrary to facts – that water pipe smoking is less dangerous than ...

Recommended for you

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

Teens likely to crave junk food after watching TV ads

January 15, 2018
Teenagers who watch more than three hours of commercial TV a day are more likely to eat hundreds of extra junk food snacks, according to a report by Cancer Research UK.

Can muesli help against arthritis?

January 15, 2018
It is well known that healthy eating increases a general sense of wellbeing. Researchers at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now discovered that a fibre-rich diet can have a positive influence ...

Your dishwasher is not as sterile as you think

January 13, 2018
(HealthDay)—Your dishwasher may get those plates spotless, but it is also probably teeming with bacteria and fungus, a new study suggests.

Study reveals what sleep talkers have to say

January 12, 2018
A team of researchers with members from several institutions in France has conducted a study regarding sleep talking and has found that most sleep talking is not only negative in nature, but involves a large amount of swearing. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.