Smoking tobacco from hookahs or water pipes has become an unhealthy habit among some young adults, Quebec researchers suggest.
Hookahs are large communal water pipes designed to burn fragrant blends of tobacco. Hookah smoking may evoke images of the Mideast, where it has been practised for centuries.
The study, published Monday in the journal Pediatrics, showed about 23 per cent of 871 youth aged 18 to 24 reported smoking a water pipe, also known as shishas, at least once in the previous year. Most reported smoking only on rare occasions, but five per cent had used water pipes one or more times in the past month.
"The popularity of water pipes may be due in part to perceptions that they are safer than cigarettes," warned senior investigator Jennifer O'Loughlin, a professor at the University of Montreal department of social and preventive medicine and a scientist at the University of Montreal Hospital Research Center.
"However, water pipe smoke contains nicotine, carbon monoxide, carcinogens and may contain greater amounts of tar and heavy metals than cigarette smoke."
In some places, laws aimed to keep bars and restaurants cigarette-free don't ban the aromatic smoke swirling from water pipes.
Hookahs: Should they be permitted indoors?
"From a public health standpoint, we really do need to nip this in the bud before we've got a hookah lounge on every corner," says Pippa Beck, a policy analyst with the Non-Smokers Rights Association.
Beck notes that the city of Ottawa, where she is based, has issued at least 15 licences to restaurants or bars that offer hookahs.
Tobacco content varies
Some of the products contain no tobacco, but it's impossible to tell without laboratory testing, Beck said. The labels on smoking materials are often minimal to non-existent and may be Arabic, she said.
Hookah use is also on the rise throughout the United States and elsewhere, said Dr. Wasim Maziak, an epidemiologist who studies tobacco addiction at the University of Memphis in Tennessee.
"It's still under the radar currently. But I think there's a kind of major awakening," Maziak says, pointing to the fact that the U.S. National Institutes of Health have started funding research into hookah use.
"This is spreading so fast.… People now understand it's really a major public health threat."
Student Sarah Bergman of Concordia University in Montreal said smoking hookah offers an illusion it's not bad for you.
"It's not like cigarettes at all," said Bergman, who described a sweet flavour from inhaling the smoke. "In a way, people want to do it more often, and they think it is better for them."
"Water pipe users may represent an advantaged group of young people with the leisure time, resources, and opportunity to use water pipes. Evidence-based public health and policy interventions are required to equip the public to make informed decisions about water pipe use," the study's authors concluded.
Hookah users were more likely to report also using cigarettes, marijuana, illicit drugs and alcohol, the researchers found.