The Medical Press recently published an article on hookah smoking mentioning that it is “increasing in both prevalence and frequency” among high school students. What used to be a fad is now seeing 1 in 5 high school students using a hookah in the past year, with some using it “often enough to be considered regular users.” Some long-term surveillance reports monitoring the smoking habits of adolescents have not kept up with this trend which is a concern among researchers. As hookah’s popularity increases among teens, so do the public health concerns and here is why.
Hookah has become popular among youth because it is a shared social experience that’s slightly exotic. Most adolescents have heard about the dangers of cigarette smoking, but the truth among users about hookah is cloudy. The biggest myth is that the bubbling water at the base of the pipe removes the harmful toxins before reaching the smoker. In truth, the water does nothing more than cool the heat of the smoke, allowing the user to draw it deeper into their lungs. Tobacco used in hookah, called shisha, is different from cigarette tobacco as it is moist and mixed with fruit extracts, sweeteners, and other flavorings to make smoking smoother. Your hookah experience can be different each time by blending different flavors.
The long smoking sessions are another reason hookah is dangerous to health. A single cigarette can take about 20 puffs in about 10 minutes, and contains about 500-600 milliliters (ml) of inhaled smoke, while a hookah session can last up to an hour or longer, involve 200 puffs or about 90,000 ml or more of inhaled smoke. Hookah smokers are not only exposed to more smoke, they also inhale more nicotine, carbon monoxide, and “about 36 times the tar of one cigarette.”
Even though hookah use has been increasing nationwide, not all of the reporting studies and sites have kept up with gathering information. Here in our state, the Florida Youth Tobacco Survey has been asking teens about hookah use since 2008, and we have witnessed an increase. While the smoking rate is at 6.9% for high school cigarette use, a historic low, hookah use is at 11.6% of high school students who reported smoking from a hookah at least once during the past 30 days. That is an increase of 50.6% since 2008. The numbers are even higher, 22.5% for those high school students who reported that they ever tried hookah; that number has increased 66.7% since 2008.
The most shocking data is that it is not the high school students, but middle school students who have increased the most in the same time period. Since 2008 hookah use among middle school students increased 127.6%, from 2.9% to 6.6%. Middle school students who reported smoking hookah at least once during the past 30 days has increased by 84.2% since 2008, from 1.9% to 3.5% today.
Collecting and reporting figures for this tobacco trend is important, but so is getting the information to the parents and teachers so they can educate the students. Our Florida Tobacco Prevention Training for Educators online course provides information on hookah in our Alternatives chapter. Many of our participants taking the course are amazed at the dangers they did not know were present in hookah use. The tobacco epidemic among youth will decrease when education on the dangers of tobacco and tobacco alternative devices increases.