Clearing the smoke over hookah usage

You are a good kid. You get good grades, take AP classes and get along with your parents. You never drink alcohol, smoke cigarettes or do any drugs. But every so often, you smoke hookah, because your friends do and it’s fun.

What you don’t realize is that hookah is not only harmful but illegal for minors.

Hookahs, also known as nargila, are Middle Eastern water pipes used for smoking a mixture of tobacco, molasses and flavoring. Over the past five years, they have become increasingly popular in America. Many hookah bars are opening nationwide, and are becoming social hotspots. Smoking hookahs is particularly popular among high school and college students, according to public health authorities.

But most teens don’t know that it’s harmful. For example, at Shalhevet, a Modern Orthodox high school in Los Angeles, 79 percent of seniors, 67 percent of juniors, 88 percent sophomores and 89 percent of freshmen thought that hookah was legal for minors, according to a survey by the Boiling Point, the school newspaper. And fully 92 percent of Shalhevet students thought hookahs were not as harmful as cigarettes.

In reality, serving tobacco to minors is illegal for the cafe, and it’s a misdemeanor for the students, punishable with fines and community service.
And while hookahs have not been studied as cigarettes have, health officials are certain that it carries the same medical risks as any other form of tobacco.

During a hookah smoking session, smokers may inhale 100 to 200 times more smoke than they do smoking a cigarette. That’s because while smoking a cigarette takes approximately five minutes, hookah smoking sessions take anywhere from 40 to 90 minutes.

“Preliminary research on the patterns of smoking, the chemistry of the smoke that is inhaled, and the health effects supports the idea that waterpipe smoking is associated with many of the same risks as cigarette smoking, and may in fact involve some unique risks,” states a 2005 report by the World Health Organization.

The report, which was published in English and in Arabic, said hookah use was spreading from the Middle East to teens and college students in the West and called it “an emerging health threat.”

Students say the appeal of smoking a hookah is not the smoke itself, but rather the atmosphere in the cafes. Hookahs, it is said, does not cause users to get a high; rather, they are a way to pass the time.

While this article, which originally appeared in the Boiling Point, focuses on Shalhevet students, hookah smoking is growing in popularity at nearly all Jewish and non-Jewish high schools.

“Hookah is a very social activity, it’s just fun to sit there in a dark room and smoke hookah with your friends,” says an anonymous Shalhevet junior.

“There are always other teenagers smoking hookah, so it’s a great place to go if you have nothing to do,” said a Beverly Hills High School junior.

On a typical weekend evening, hookah bars are buzzing with college and high school students, talking and relaxing as they eat and enjoy the long releases of smoke that come from hookah pipes, often taking pictures and giggling at the excitement of the activity.

While it is illegal for minors to be served tobacco, according to California’s Unruh Civil Rights Law, hookah cafe owners cannot legally exclude anyone underage from coming into the cafe.

“[My hookah cafe] is a place to come and hang out, there’s no need to smoke hookah,” says Jeremy Bechor, owner of the Chit Chat Hookah Cafe on National Boulevard. “We also have computers to come and check your e-mail. It is just a fun place to be.”

“Everyone goes to hookah bars, whether you’re smoking or not,” Shalhevet junior Yoni Avraham says. “It’s really a fun place to be.”

“Cigarettes are much worse, and hookahs [are] not addictive,” said a Shalhevet senior who did not wish to be named.

But in addition to the higher quantity of smoke inhaled, the WHO report cites other risks:

  • The way the tobacco is burned, usually over charcoal or wood cinders, lets off chemicals such as carbon monoxide, or other chemicals that can cause cancer, and metals which are also inhaled.
  • There is a large risk of second-hand hookah smoke from both the tobacco and the fuels used.
  • Although the water does absorb a little bit of the addictive nicotine, scientists believe that means the smoke contains more of other dangerous chemicals like tar, causing both hookah smokers and secondhand smokers to be at higher risks for all the usual tobacco evils: coronary heart disease; lip, tongue and bladder cancers, and lung cancer and lung diseases.
  • The way a hookah is smoked — through a mouthpiece, which is usually shared by multiple users — often leads to the spread of bacterial diseases and infections.

But the report says more research needs to be done.

“There are very few solid U.S. studies that have been done on the effects of hookah smoke,” agrees Dr. Herman Kattlove, a medical editor at the American Cancer Society, on a Web site affiliated with the National Lung Association. In California, smoking — and that includes any type of tobacco product or paraphernalia — under the age of 18 is illegal, punishable by a fine of $75 and 30 hours of community service.

The hookah may seem safe to teenagers because of the water in the pipe that makes the smoke cool, but until further scientific research, kids may want to put hookah on the not-to-do list along with smoking cigarettes or drinking alcohol.

Otherwise, it may cost you $75, 30 hours of community service, your clean record with the police — and your health.

For more information on the report, visit