SATURDAY, Dec. 4 (HealthDayNews) -- The practice of smoking
tobacco through elaborate water pipes called hookahs emerged
centuries ago, in the palaces and harems of the Middle East.
But experts say hookahs are now almost as popular in Denver
as they are in Damascus, with the current fad for water-pipe
use growing among U.S. college students.
Many young Americans may be attracted to hookahs because they
believe smoke that passes through water is somehow filtered
and safer, experts add.
Unfortunately, that's just not true.
"The data we have clearly shows that carbon monoxide is present
in large amounts in smoke from water pipes, as is nicotine
and the compounds we call 'tar,' " said Thomas Eissenberg,
a researcher at the Institute for Drug and Alcohol Studies
at Virginia Commonwealth University.
"In fact, carcinogen exposure in hookah smoke is equal to,
or more than, that found in cigarettes," said Eissenberg,
who has published research on the health dangers of the hookah
fad in numerous medical journals.
The hookah, also called nargile, is comprised of four parts
-- the head, where burning charcoal heats a bed of tobacco;
the body, through which inhaled smoke is drawn into the third
section, a water-filled bowl at the hookah's base, and the
hose, a flexible pipe through which the user inhales the smoke
after it has bubbled through the water.
"What you get, then, is smoke that has been cooled by the
water," Eissenberg said. Hookah use is, by its nature, a very
social act, with groups of users often sharing the same pipe.
"Water pipes have been around for centuries, but it looks
like they are making a real comeback," Eissenberg said. "They're
making a new appearance in the U.S., but they're also coming
back in the Middle East. They've also shown up in Germany
and Brazil, and in Thailand -- where they were recently outlawed."
The exact number of water-pipe users in America remains unknown,
he said, but new users typically discover hookahs in local
Middle Eastern restaurants or bars, where they can be rented
for short-term use.
"Then later they might say, 'Hey, this would be cool for me
to have in my dorm,' and go to the Internet and buy one. They
aren't expensive," Eissenberg said.
While traditional Middle Eastern hookah users tended to favor
harsher, dryer tobacco, American users prefer maassel -- sweetened
tobacco with tempting flavors like apple, watermelon, and
licorice.
"The upsurge in use of water pipes, here and in the Middle
East, is highly correlated with the mass-production of these
sweetened and flavored tobaccos," Eissenberg said.
He stressed that the U.S. hookah fad isn't restricted to fringe
populations in cities such as New York or San Francisco. "Washington
state, Louisiana, Tennessee, here in Virginia -- it's popping
up everywhere," he said.
While cigarette use has largely fallen out of favor with the
college crowd, the exotic allure of hookahs -- and the misperception
that hookah smoke is filtered and safer -- may be driving
the trend.
"We really need to counter this idea that, just because there's
water present, the smoke is safe," Eissenberg said. "We really
need to get that across to people."
Legal restrictions might be in order, too, he said. "I suspect
that we need to discourage the renting of water pipes, especially
to underage individuals. They should be controlled in the
same way that cigarettes are controlled."
The real danger, according to Eissenberg, is that hookahs
may be getting many young, new users hooked on nicotine.
"Water pipes aren't convenient to use," Eissenberg pointed
out. "So if somebody begins to find a water pipe and tobacco
pleasurable, but they don't have a lot of time, what are they
going to do? They're going to pick up cigarettes. So hookahs
are, unfortunately, a potential gateway to smoking for young
adults, and we certainly don't need a new gateway to tobacco
use."
Dr. Norman H. Edelman, director of scientific affairs for
the American Lung Association, said hookah users are taking
a big chance if they think water pipes are safe.
"I've seen no data to support that. They're really rolling
the dice when it comes to their health," he said.
Even if hookah smoke was somehow filtered, it probably wouldn't
make any difference in terms of the actual amount of carcinogens
inhaled per puff, Edelman said.
"We saw something similar with filtered cigarettes. Smoking
is really all about getting nicotine into the system. So,
with filtered cigarettes, people just dragged harder and longer
on the cigarette to get the same amount of nicotine," he said.
Eissenberg agreed, adding that the time is now to nip the
hookah craze in the bud.
"We don't want to get caught by surprise," he said. "I think
we need to be vigilant when it comes to any new tobacco use
method that comes into vogue."
