Hookah Smoking ~ An Unexpected Epidemic?

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Are we ignoring a resurgence in tobacco use in our youth and college age students? A study published in the January, 2013 issue of Nicotine & Tobacco Research (first published online in 2012) reports on the emerging increase in waterpipe (or hookah) usage among college students. In this study, researchers at the University of Pittsburgh School of Medicine assessed over 100,000 students from 152 colleges and universities and found almost one-third (30.5%) of the study participants reported smoking tobacco through a hookah.¹

I was surprised to read this, as I knew that cigarette use is declining. A tobacco trend report published by the American Lung Association states "current smoking prevalence among young adults was 52.0% lower in 2009 (21.8%) than in 1965 (45.4%)."²  

Why do we see this increasing trend? Is it due to the social nature of hookah lounges? Or, is it due to the commonly held misperception that waterpipe tobacco is safer than cigarette smoking? Perhaps it is a mix of both of these two reasons. Regardless, if steps aren’t taken to educate our youth, we may be facing an increase in future tobacco-related illnesses, cancer, heart disease, and subsequent an increase in early, preventable deaths.


1. Primack, B. A., Shensa, A., Kim, K. H., Carroll, M. V., Hoban, M. T., Leino, E. V., … & Fine, M. J. (2013). Waterpipe smoking among US university students. Nicotine & Tobacco Research, 15(1), 29-35.

2. American Lung Association. (2011). Trends in tobacco use. American Lung Association Epidemiology and Statistics Unit, Research and Program Services.

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