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Hookahs an Unhealthy Hit Among Privileged Young Adults

Number of users nearly tripled in one year, study finds

MONDAY, May 10 (HealthDay News) -- Smoking tobacco with a water pipe is gaining popularity in western countries, and those most likely to indulge are privileged young men who live apart from their parents, a new study finds.

Young adults in Montreal who use water pipes, or hookahs, are typically 18- to 20-year-old, English-speaking males who live away from their parents and have a higher household income than non-users, University of Montreal researchers report. Water pipe smokers are also more likely to use other psychoactive drugs, such as marijuana, the study found.

"These are young men who are living away from home for the first time and who have disposable cash, and so they have lots of freedom and leisure time to try out new things," said study co-author Jennifer O'Loughlin, a professor in the department of social and preventive medicine.

Hookah bars are cropping up in U.S. and Canadian cities and college towns, where young people often gather to smoke sweetened, flavored tobacco, she added. "With the increasing restrictions on tobacco use in public places, I'm afraid that young adults wanting to smoke in social situations may be choosing hookah bars," said O'Loughlin.

For their study, published online May 10 in the journal Pediatrics, the researchers analyzed questionnaires filled out by 871 people aged 18 to 24 in 2007. According to the study, 23 percent of those surveyed had used a hookah during the previous year, which was almost three times the number identified in a similar survey conducted just the year before.

Wasim Maziak, an associate professor at the University of Memphis School of Public Health who studies water pipes in the United States and the Middle East, said these findings are consistent with a review of the literature that he and his colleagues recently published in the American Journal of Health Behavior, which estimated that 10 percent to 20 percent of some young adult populations in the United States are water pipe users.

"Looking at today vs. where we were about seven or eight years ago, the trend in water pipe popularity in the U.S. has surpassed my worst expectations," said Maziak. "Cigarette smoking is actually declining all over the world, but other tobacco use is increasing and that's mostly due to the water pipe."

One reason why water pipes have become so popular among young people is because "they believe that it's safer than smoking cigarettes because the smoke is filtered through water, and so it's therefore less toxic," said study author Erika Dugas, a research assistant at the University of Montreal Hospital Research Center. Also, the smoke that's inhaled has a smoother texture than cigarette smoke, and the flavored tobacco often masks the nicotine taste, she added.

But water pipe smoking is no safer than cigarettes, recent studies show. One study, which Maziak co-wrote, revealed that water pipe smokers inhale about 48 times more smoke than they would through a cigarette. Another recent study showed that leisurely puffing on a hookah for an hour exposes the smoker to as much carbon monoxide as a pack-a-day cigarette habit would. A few cases of carbon monoxide poisoning associated with water pipe smoking have been reported, Maziak said.

The study authors conclude that more research is needed to understand the health effects of water pipes. But in the meantime, "people who've used or have considered using a water pipe should do some investigation in terms of the potential health effects," said O'Loughlin. "They shouldn't just sit back and think it's an innocuous behavior that has no impact."

More information

There's more on water pipes at the American Lung Association.

SOURCES: Jennifer O'Loughlin, Ph.D., professor, department of social and preventive medicine, University of Montreal; Wasim Maziak, Ph.D., associate professor, University of Memphis School of Public Health, Tennessee; Erika Dugas, M.Sc., research assistant, University of Montreal Hospital Research Center; May 10, 2010, Pediatrics, online

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