If you are a parent of a teenager and you’ve never heard of hookah, you need to start educating yourself on the topic. Hookah is an ancient method of smoking that has been catching on in the US, and teenagers have been quick to pick up on this new trend. Although cigarette smoking has declined due to education about the many health risks and more stringent laws regarding usage, hookah smoking is on the rise.
The Centers for Disease Control and Prevention (CDC) reports, “In 2010, the Monitoring the Future survey found that among high school seniors in the United States, about 1 in 5 boys (17%) and 1 in 6 girls (15%) had used a hookah in the past year.”
Unfortunately, there is a prevailing misconception that hookah smoking is a fairly safe alternative to cigarette smoking. Make no mistake, hookah smoking is detrimental to your health. Therefore, it’s imperative that parents learn the truth about hookah and start talking to their teens about the dangers.
Tips for You and Your Teen
Tips are provided by Alexander V. Prokhorov, MD, PhD, professor of behavioral science at The University of Texas MD Anderson Cancer Center.
* Do not use tobacco products yourself. Kids model their behaviors and lifestyle after their parents.
* Create a tobacco-free policy in your household. Make sure that relatives and guests don’t feel free to use tobacco products around your children.
* Hookah is not a safe tobacco product. It generates a very large amount of smoke that contains toxic chemicals, just like the smoke from cigarettes and other combusted forms of tobacco.
* If you learn that your teen uses tobacco, show that you are disheartened by your teen’s tobacco use. If you have a story about a relative or friend who suffered or died from tobacco-related disease, tell your child this story.
* Refer your child to reputable resources which help young people adopt tobacco-free lifestyles. One such program is ASPIRE (A Smoking Prevention Interactive Experience). Find out more about it at www.mdanderson.org. Free apps, including the Tobacco Free Teens app developed by experts at MD Anderson, are also available.
Why Hookah?
Hookah smoking was commonplace in ancient Persia and India. In recent years, there has been a resurgence of hookah use around the world, and it is becoming particularly popular among high school and college students who consider it a fun, social pastime.
Hookahs (or water pipes) are used to smoke specially-made tobacco that comes in different flavors, such as apple, mint, and cherry. Hookah smoking is typically done in groups, with the same mouthpiece passed from person to person.
Brian A. Primack, MD, PhD, associate professor of medicine, pediatrics and clinical translation science at the University of Pittsburgh School of Medicine, explains that one of the reasons hookah has caught on so dramatically is due to its aesthetically pleasing tastes and environments. “Hookah smoking is commonly done in ‘hookah lounges,’ which are often dimly lit and beautifully decorated.” He points out that the act itself is more aesthetic as well because the tobacco is flavored, sweetened, and cooled by the water, which makes it less harsh than cigarette smoking. “I have a number of patients who would be horrified to smoke a cigarette, but they wholeheartedly embrace hookah tobacco smoking. They express disbelief when I show them data on what they are actually inhaling.”
Erin L. Sutfin, PhD, a developmental psychologist and assistant professor in the department of Social Sciences and Health Policy at the Wake Forest School of Medicine in Winston-Salem, NC, agrees with Dr. Primack. “It is well documented that teens are attracted to flavored tobacco products and use them at much higher rates than adults,” she says.
The Risks
“It takes a long time to do studies that accurately quantify health risks, and the hookah phenomenon is relatively young in the Western world,” explains Primack. “That being said, we do have data that show that hookah smokers are heavily exposed to hazardous toxins.”
Dr. Primack reports that one hookah smoking session, which lasts about forty-five to sixty minutes, exposes the user to about 100 times the smoke volume of a single cigarette. “It also seems to expose the user to about forty times the tar, ten times the carbon monoxide, and two times the nicotine.”
Sutfin warns, “Hookah smoking also carries the risk of infectious disease transmission, such as tuberculosis, influenza, and mononucleosis, due to the shared hoses and mouthpieces.”The burning process itself poses risks as well. Dyan Hes, MD, FAAP, medical director of Gramercy Pediatrics in Manhattan and clinical assistant professor of pediatrics at the Weill Medical College of Cornell University, explains, “There are as much or more carcinogens in hookah smoke, particularly since the tobacco is burned at a higher temperature than in a cigarette.”
Safe Hookah Products?
Some products boast that they are tobacco-free, hence safe. Sutfin informs, “Smoking herbal shisha (a non-tobacco alternative) is still dangerous. Although there is not the risk of addiction since there is no nicotine, there is still exposure to high levels of carbon monoxide and other toxins.”
“Most hookahs involve the lighting of a piece of charcoal in the hookah bowl,” Primack describes. “Therefore, even if there are no other substances, the user will be exposed to the combustion products of the charcoal, which include carbon monoxide.” He reports that hookah smokers have landed in emergency rooms with carbon monoxide poisoning.Besides carbon monoxide, the charcoal used to heat the products produces smoke containing metals and cancer-causing chemicals.
The Law
Laws have not caught up with this new trend. Although many states have enacted bans on smoking in enclosed public places (e.g. New York’s Clean Indoor Air Act – CIAA), hookah lounges may be excluded from these laws because they claim to qualify for the same exemptions offered to cigar bars, retail tobacco shops, and establishments that sell non-tobacco smoking products.
Dr. Primack states, “Federal laws recently restricted youth-oriented flavorings in cigarettes [FDA regulation, 2009]. However, these laws do not apply to hookah tobacco.”
Knowledge is the Best Antidote
“Parents need to emphasize that hookah smoking, including using herbal products, carries many of the same health risks as cigarette smoking,” urges Sutfin.
“Parents should show their teens the statistics of the carcinogens found in hookah smoke,” adds Hes.
Myrna Beth Haskell is a freelance writer and monthly contributor to Rochester & Genesee Valley Parent Magazine who lives in Salt Point, NY. She is the author of LIONS and TIGERS and TEENS: Expert advice and support for the conscientious parent just like you (Unlimited Publishing LLC). Visit www.myrnahaskell.com.
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