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Hookahs are waterpipes that are used to smoke specially made tobacco mixtures that come in a wide variety of flavors.


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Tweets by ETR. They said this repeatedly, even in the face of overwhelming evidence to the contrary from authorities all the way up to the U. Surgeon General. Over 20 years later, we have 20 more years worth of scientific evidence demonstrating that nicotine is addictive and harmful.

We know these products are killing people in all kinds of ways, from direct smoking, to secondhand smoke exposure and even thirdhand smoke the residual nicotine and other chemicals that remain on people and indoor surfaces—hair, skin, clothes, counters, furniture, drapes, bedding and more.

The very word brings a sense of excitement to the minds of many young adults. Not only can they sit around a table among friends and smoke, they can share this beautiful, ornate device that makes it an extra-special experience!

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What was once a cultural tradition dating back years in Middle East regions of the world has become a trend. I wanted to see what all the intrigue was about. A hookah lounge?

Facts about hookah

It seemed an odd thing for me to be doing. I was ed by a couple of my colleagues, also interested in the process, as well as two of my children.

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Our ages ranged from 18 to Before we entered the bar, we had to show our IDs—even the oldest of us! Once inside, we needed to choose which of the many flavors of hookah tobacco we wished to try. After much debate, we picked strawberry.

Hookah bowl let's smoke phunnel glaze

Then the fun began. We watched as the server brought the hookah pipe over to us and placed it in the middle of the table. He loaded our strawberry tobacco into the bowl, then set hot coals on top. What an elaborate and elegant ritual.

The history and meaning of hookah

We asked him if we were expected to share the tip. He told us if we wanted individual tips, we would have to pay an extra 25 cents each. That annoyed me. As we all proceeded to try the hookah pipe, it became very apparent to me that this was not the first time my daughter and son had done this.

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That alarmed me. I looked about and saw people smoking hookah indoors, which was clearly against the smoke-free workplace laws in California.

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That made me angry. The last straw was when a young man lit up a conventional cigarette. My daughter and I had a debate about whether he was smoking a cigarette.

The best drinks to enjoy with hookah

To this day I still say he was! By the end of this adventure, I could clearly say that hookahs were not for me. The craziest part about all of this was that my daughter and son are smarter than that!

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Even back then, they knew tobacco was harmful, yet they felt smoking hookah was not the same as smoking a cigarette. They believed it was safer, that it posed no threat.

The history and meaning of hookah

But I learned many years ago that if I wanted my daughter to do something, I would have to point her in the opposite direction. Make sense?

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I sent her on her way to the hookah bar, if not with my blessing, at least without my rage. Her interest fizzled out, much to my delight!

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Not every young person is so fortunate. Hookah use among teens and young adults in the U. Among high school seniors, almost 1 in 5 reports using hookah in the past year. Prevalence rates for university students in the U. Whatever hookah smokers may think and say, this is not a safe practice. Many of the same risks that face cigarette smokers also confront hookah smokers. The nicotine in hookahs is just as addictive as the nicotine in cigarettes, and the water in the device does not reduce the level of nicotine in the smoke. Hookah smoke is burned at higher temperatures than cigarettes and is at least as toxic as cigarette smoke.

It contains high levels of dangerous substances, including heavy metals, carbon monoxide, nicotine and other cancer-causing chemicals. Hookah smokers can actually absorb more toxins than cigarette smokers. A typical session might involve up to puffs over an hour or so of time, while a single cigarette takes about 20 puffs. Hookah smokers inhale to times as much smoke as someone smoking one cigarette.

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People smoking hookah may be at risk for some of the same conditions that threaten cigarette smokers, including reduced lung function, decreased fertility, heart disease and a whole range of cancers oral, lung, stomach, esophagus, bladder. The exhaled and sidestream smoke from hookahs creates additional risks for hookah users and non-users alike. Hanging around in a hookah bar is not a safe choice for anyone.

We need to develop a more successful conversation with young people about hookah use. We need to find ways to communicate the risks and dangers—to convince young people this behavior is not for them. We need to decrease their positive attitudes about hookah use. This is why the facts alone may not work. We need to change hearts, minds, peer attitudes and peer norms. Would a focus on the manipulations of the industry such as we saw in the Truth anti-tobacco campaign shift attitudes? How about social media campaigns? Powerful role models and spokespeople? Young people are very price sensitive.

The single most powerful intervention to reduce youth smoking is making cigarettes pricier. Because shisha is treated as a pipe tobacco, federal tax is about a tenth of the tax on cigarette tobacco. We have made impressive progress in tobacco prevention. We are turning things around, and we need to keep working toward our tobacco-free future. I simply do not want to see healthy lives destroyed by the deadly addiction of nicotine.

Halt the hookah! 4 practical steps to better prevention

We have a wide range of tobacco education and prevention products, and we distribute nationally and internationally. You can reach her at narinderd etr. Our e-newsletters bring you the best of our blog each month. So what are tobacco companies telling us now that e-cigarettes are on the scene?.

Halt the Hookah! The Exotic Experience A hookah lounge? Smart Kids?

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And we need to do this in the face of some pretty big obstacles: The natural allure of hookah use—its pleasant social nature, the ritual, the beautiful devices and sometimes exotic settings. Media and social media glamorization. Aggressive marketing to young people by hookah bars and wholesalers of hookah gear and shisha the mix of tobacco, sweeteners and flavors used in hookahs.

Get more young people involved in the conversation, at every level. Peers are convincing young people that hookahs are cool. Talk up the facts. We have plenty of data proving that hookah smoking is dangerous.

Hookah bowl let's smoke phunnel glaze

We need to use our public voice and organizational channels to keep that information on the airwaves. Get real about regulation. Policies and regulations can change this welcoming environment for hookahs. We can equalize tax rates, require warning labels and accurate product labeling, ban the use of flavorings as we do with cigarettes, and implement smoke-free laws in public spaces.

Never give up. What we now need is an increase in the tobacco tax, which will, in turn, lead to a decrease in use.

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However, when you pair the right hookah and drinks, you might as well boost the experience entirely.


Cleveland Clinic is a non-profit academic medical center.


Though hookah is the most widely spread and used name for this smoking device, it goes by many other different names around the world.


All manufacturing, flavoring and packaging, is done in-house.