While much attention has been paid to the dangers of e-cigarette use among teens, new research shows that more than half of all tobacco smoked by young people comes from hookah.
The researchers warned that smoking cessation strategies should include these water pipes, which are gaining popularity in this age group.
"Most hookah smokers in the US are not daily users, whereas many cigarette smokers smoke multiple times a day, so it may seem that the vast majority of public health and policy-related interventions should be directed at cigarette smoking," said study author Dr Brian Primack. He directs the University of Pittsburgh's Center for Research on Media, Technology and Health.
Hookah needs to be addressed
"What our research shows is that hookah smoking contributes significantly to the burden of tobacco smoke-related toxicants inhaled by our young people," Primack said in a university news release.
"Therefore, public health and policy efforts should explicitly address hookah smoking in addition to cigarette smoking," he added.
For the survey, the researchers examined the responses of over 3 200 adults aged 18 to 30 who completed questionnaires about their tobacco use. Nearly two-thirds of the participants were women. Of the entire group, about 18% were Hispanic, and roughly 10% were black.
The study, funded by the US National Cancer Institute, found that roughly one in 20 participants said they had used a hookah in the month leading up to the survey, while 23% said they had smoked cigarettes.
Only about 3% reported smoking both cigarettes and hookahs in the past 30 days, according to the report, which was published in the journal Tobacco Control.
Flavoured and sweetened
The researchers pointed out that it takes about 10 to 12 puffs to smoke one cigarette, which contains about 50ml of smoke. In contrast, one 45- to 60-minute hookah session can involve up to 100 inhalations of about 500ml of smoke. As a result, hookahs can be harmful even when used less often.
The study found that hookahs accounted for 55% of the smoke inhaled by young smokers. These water pipes also accounted for nearly 21% of the tar, about 10% of the carbon monoxide and 2.4% of nicotine the survey participants consumed over the past 30 days.
"Smoking tobacco from a water pipe attracts young users because it is flavoured and sweetened, done in a social setting and is often less irritating compared to cigarette smoking," Primack said.
But, "besides being a direct source of toxicants itself, hookah smoking has been linked to transition to cigarette smoking," he added.
"All of this, combined with our new findings around the volume of hookah smoke consumed, should guide future efforts to prevent young adults from becoming hookah smokers," Primack said. Hookahs expose users to lower, but still significant, levels of nicotine, tar and carbon monoxide, the researchers found.
Image credit: iStock