Sixty percent of participants reported first-time water pipe use at or before age 18. About one-fifth of those surveyed reported daily use, and more than half of the users stated that they owned their own water pipe, usually ordered via the Internet. More than 40 percent of users smoked 60 minutes or more at one session.
Most users were confident that they could quit easily.
More ominously, the majority of users felt that water pipe use was safer than cigarettes because the smoke passes through water before being inhaled.
But neither belief has been proven.
In fact, because water pipe use involves a greater exposure to nicotine than cigarette smoking, the likelihood of regular hookah smokers to become addicted is higher.
Furthermore, prolonged exposure to water pipe smoke increases the likelihood of health effects that have been documented in scientific studies.
There is no safe exposure to tobacco smoke. Even secondhand smoke — such as sitting in a hookah bar without smoking — increases health risks.
The most famous example of the harm of secondhand smoke comes from the "natural experiment" that occurred in Helena, Mont., after that city passed an ordinance outlawing smoking in public places. Within six months of passage of this law, heart attack rates were cut in half in this community — and rebounded to pre-ordinance rates when the law was repealed.
Not to mention the bad breath, smelly clothes, tooth staining and premature wrinkles that go along with any tobacco smoke exposure.
Harmless hookah? Romantic smoking?
Dr. John Spangler is director of tobacco-intervention programs and a professor of family medicine at Wake Forest University School of Medicine.