In the United States cigarette use is declining among young people, but according to a new study at the same time hookah smoking is gaining in popularity.
In fact, hookah bars are gaining popularity around the United States, particularly among college age individuals.
Right now, the majority of users are between the ages of 18 and 22, but is hookah smoking as dangerous as cigarette smoking? FOX 54 reveals the advantages and some dangers in our special report.
It has taken America by storm and it's a "smoking hot" sensation among young people.
A hookah is a water pipe used to smoke tobacco through cooled water. The tobacco is heated in the bowl at the top of the hookah and the smoke is filtered through the water in the base of the hookah.
This tradition, dating back at least 500 years, originated in the Middle East regions of the world.
Countries cited for the first use include Egypt, India, and Turkey.
But when it comes down to it, is hookah smoking just as dangerous as cigarette smoking?
"The way I understand, hookah smoking sorta takes place for a fairly long period of time, so they may actually get exposed to more context than if they were having a cigarette," said Dr. Clark Gillett with Family Medicine at Columbus Regional.
According to the University of Maryland's Health Center, there are myths and truths about hookah smoking. For example, hookah smoke is filtered through water so it filters out harmful ingredients.
That's a myth!
"The water is not a filter," Dr. Gillett said. "It doesn't change the smoke any meaningful way. It may humidify it a little at best."
There are two types of hookah's, those that contain tobacco and those that do not like this one at Spices Caribbean Restaurant.
Spices Caribbean Restaurant in Columbus is a popular spot among young local college students. But what's even more popular is the hookah smoking many of them do while there.
But what's makes this bar a little different is that the hookah pipes offered are tobacco free.
"Our hookah's is called Shisha, it's a natural herb that's made out of sugar and corn husk," said Earlisha Jones, manager at Spices Caribbean Restaurant.
While the non-tobacco hookah's at Spices is popular, most young people lean more towards the ones that contains tobacco.
"The good thing, I enjoyed about the tobacco was its flavor," said hookah smoker Stephen Cooper. "The bad was you don't understand how much tar you take in and you think you take in less tar than in a cigarette or a black because you feel it's all water vapor, but it's the same feeling, same results on your lungs."
"When I first started I think, I did have some concerns and once I tasted it, it was like the flavor, you don't have that care anymore," said hookah smoker Kae Jones.
Most national and state surveys of tobacco use do not track hookah smoking. As a result, the public health community must rely primarily on research conducted with college students and a limited number of state-based surveys to *ascertain* the extent of hookah use in the United States.
Despite these limitations, a troubling picture of this trend is emerging. Estimates of hookah use among college students over the past month and lifetime has skyrocketed from 9.5 percent to 20.4 percent.
"It's all a fixation where you have a fixation on having something in your mouth or doing something with your mouth," Cooper said. "So it's that sense of having something in your mouth or smoking something. Just being cool for a minute."
According to a study published in the 2012 issue of CDC's Preventing Chronic Disease, many hookah smokers believe that smoking a hookah carries less risk of tobacco-related disease than cigarette smoking.
However, hookah smoke contains many of the same harmful toxins as cigarette smoke and has been associated with lung cancer, respiratory illness, low birth weight, and periodontal disease.
According to a report from the World Health Organization, a hookah smoking session may expose the smoker to more smoke over a longer period of time than occurs when smoking a cigarette.
"A cigarette takes about three, four, or five minutes to finish," Dr. Gillett said. "These folks sit around for an hour or more passing the pipe around as it were. The thing I would really be concerned about if for the person who had managed to stop smoking and managed to beat the nicotine addiction and then gets invited to go to a hookah party and take in all that nicotine and gets hooked again."
Like cigarettes, hookah tobacco is illegal for those under the age of 18 in most states. Laws and regulations governing the use of hookahs in public places vary from state to state and sometimes from community to community.
While hookah smoking is most common in the United States among young adults ages 18 to 24, some studies suggest significant use among middle and high school students.
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