While cigarette smoking is on the decline nationwide, it is quickly being replaced by a growing trend - hookah smoking. Hookah is becoming increasingly popular among young people, ages 18-24, and is often a means of social interaction because it is typically used in groups. While hookah bars are common in parts of New York City, several are now popping up in Westchester County. Patrons who never considered themselves smokers are participating in this social movement unaware of the dangers it can cause their bodies, even if they refrain from traditional tobacco use, namely cigarettes. Hookah smoking
is falsely perceived as being “less harmful” than cigarettes.
Hookah smoking has its origins in India and Persia, where it remains a cultural staple. Hookah was introduced to the U.S. in the 1960’s and 70’s, but its mainstream use and marketing towards young people today is much more concerning. Personal hookah systems are accessible to middle and high school age students from local smoke shops, despite the fact that the legal age to purchase tobacco is 18. Some businesses that sell hookah are exempt from smoking ban policies. Additionally, small hookah cafes are on the rise nationwide.
The tobacco used in a hookah device (sometimes referred to as shisha, boory,
narghile, goza, arghileh, or hubble bubble) comes in flavors such as cherry, chocolate, or grape - that are used to mask the harshness of the tobacco, allowing harder and longer hits. Tobacco contains the addictive ingredient nicotine, which can lead to dependence. The water pipe is used to smoke specially-made tobacco by indirectly heating the tobacco, usually with burning embers or charcoal. The smoke is then filtered through a bowl of water (sometimes mixed with other liquids such as wine) and then drawn through a rubber hose to a mouthpiece. 1
While research on hookah smoking in the U.S. is still emerging, it has become evident that participating in hookah activities creates dangerous risks surpassing
those from cigarette smoking. “Young people are engaging in the behavior
without education as to how it can damage their bodies,” said Leilani Lockett,
Education and Outreach Specialist for the POW’R Cessation Center. Due to the longer smoking sessions, chemicals are inhaled into the lungs and have a more severe impact on the body. A 45 to 60 minute hookah session exposes the smoker to approximately the same amount of tar and nicotine as one pack of cigarettes. 2 There are also higher levels of cancer causing chemicals - arsenic, lead, nickel, and carbon monoxide - associated with hookah smoking.
The charcoal from the instrument creates its own health risks apart from the standard tobacco risks. Secondhand smoke from hookahs poses a serious risk for
nonsmokers, particularly because it contains smoke not only from the tobacco
but also from the heat source (charcoal) used in the hookah.1,3
Hookah smoking is a silent public health threat that keeps growing. If not properly
regulated, this deadly trend could possibly lead to an increase of overall
tobacco use (cigarettes included). “This growing public health trend may lead to an increase in tobacco related illness,” said Makeda James, Westchester County Coalition Coordinator for POW’R Against Tobacco. “Furthermore, hookah establishments should also provide education on the practice in efforts
to increase awareness.” Like cigarettes, hookah access should be limited
and individuals’ should be educated on the dangers of hookah before they start.
For all who are interested in making a Quit Smoking attempt they should talk with their doctors. For more information, call the New York Smoker’s Quitline at 1 (866) NY-Quits (1 866 697-8487) or visit POW’R Cessation’s Website at
American Lung Association. An Emerging Deadly Trend: Waterpipe
Tobacco Use . (PDF–222KB) Washington: American Lung
2) Mayo Clinic staff. Hookah smoking: Is it safer than smoking cigarettes? (February 7, 2006)
3) World Health Organization. Tobacco Regulation Advisory Note. Water Pipe Tobacco Smoking: Health Effects,Research Needs and Recommended Actions by Regulators . (PDF–550KB) Geneva: World Health Organization,Tobacco Free Initiative, 2005
Cessation Center located in White Plains, NY, serves; Putnam, Orange,
Westchester and Rockland counties. It is a grant program of the American Lung Association of the Northeast, funded by the NYS Department of Health Tobacco Control Program. Using the evidence-based Model for Treating Tobacco Use and Dependence, they offer healthcare providers free education and resources to assist them in helping their patients to quit smoking. Healthcare
providers interested in contacting POW’R should call 914-407-2214 or go to www.powrcessationcenter.org.