As fewer people puff away on cigarettes, a new smoking trend is gaining popularity among young North Americans.
A new survey, published in the journal Pediatrics, confirmed that as many as one-quarter of young people in North America have used a hookah, also known as a water pipe, shisha, narghile or hubble bubble, in the last year. And according to a study in the current issue of the American Journal of Health Behavior, hookah prevalence is on the rise worldwide.
Researchers believe the popularity of water pipes may be due in part to the perception that they are safer than cigarettes.
A hookah looks something like a lamp base, with the glass vase at the bottom that is filled with water. The top, called a “bowl” is filled with tobacco. When the tobacco heats up and the smoker sucks in through a connected hose, the tobacco smoke gets drawn down though a stem and pulled underwater before rising into an opening in the hose until it reaches the smoker’s mouth.
"It’s no longer kosher to smoke cigarettes in public," said Jennifer O’Loughlin, a professor at the University of Montreal Dept. of Social and Preventative Medicine and a scientist at the University of Montreal Hospital Research Center and senior researcher of the Pediatrics study. "However, water pipe smoke contains nicotine, carbon monoxide, carcinogens and may contain greater amounts of tar and heavy metals than cigarette smoke.”
Hookah use is growing in popularity, even in small towns, because the equipment and tobacco are easy to get off the Internet. O’Loughlin said that despite widespread bans on other smoking habits, hookahs and hookah tobacco are largely unregulated throughout North America.
“We need to ask ourselves, ‘Are we creating a new epidemic in the face of declining cigarette use?’ ” O’Loughlin said.
O’Loughlin and colleagues used questionnaires to survey 871 young adults, aged 18-24, who anonymously reported on their substance abuse habits. Of these, 201 had used a hookah in the previous year. While hookah use was higher among people who had used other tobacco products, one-third of water-pipe smokers said they steered clear of cigarettes entirely. The researchers interpreted the last finding as a possible indication that people too health conscious to smoke cigarettes were turning to hookahs as a "safe" alternative.
A 2009 study in the American Journal of Preventative Medicine found the average hookah use exposes the smoker to more smoke and carbon monoxide and similar amounts of nicotine as cigarettes. The study concluded the two practices likely share similar health risks, including lung cancer, heart disease, infectious diseases and pregnancy complications. The World Health Organization has said that hookah use is equivalent to smoking 100 cigarettes in a 200-puff session.
Among the study’s findings:
- Hookah use was markedly higher among people who had smoked cigarettes, used tobacco products, drank alcohol, or engaged in binge drinking.
- Water pipe use also was higher in people who had smoked marijuana or who had used illicit drugs in the past year.
- Hookah users may constitute an advantaged group of young people who have the leisure time, resources, and opportunity to smoke water pipes.
The authors note that at least one researcher reported that a single session of smoking a water pipe might be equivalent to smoking two cigarettes for a non-daily hookah user, or 10 cigarettes for a daily water pipe smoker.
“Little is known about the addictive nature or health risks of water pipe smoking, but it may be at least as harmful as cigarette smoking,” the authors wrote.
The study is published online in advance of the June print issue of the journal Pediatrics.
Source: “Waterpipe Smoking Among North American Youths,” Duglas, E. Cournoyer,D. O’Loughlin, J., Tremblay M., Low, N.; Pediatrics, June2010; vol 125: pp 1184-1189.
Lynette Summerill is an award-winning writer who lives in Scottsdale, Arizona. In addition to writing about cancer-related issues, she writes a blog, Nonsmoking Nation, which follows global tobacco news and events.