Hookah use: A new gateway drug to cigarette smoking

Background: Hookah (water pipe) smoking is increasingly popular in the United States. Hookah is by many laymen considered less hazardous to ones, although a typical hookah session exposes the person to up to 30 times more toxins. Of great concern is the apparent increase of hookah use among adolescents. Methods: We distributed a validated survey to a total of 955 of which 904 was returned with complete data The respondents represented 74 zip codes from Southeast MI. The average age was 35.94 (S.D. 14.82) . The ethnic make-up was: Chaldean, 39.0%, African, 11.2, and Arab, 49.8%. Different statistics were applied.

Results: The proportion of hookah smokers was highest among Arab (41.6%), followed by Chaldean (30.7), and African (10.9). Participants got hookah mainly from hookah stores . Smoking occurred mainly at t home (45%). Almost 50% smoked hookah with their family. Socialization was the most cited reason for smoking hookah (34.6%), while stress was (9.8%). 55% of respondents considered hookah less harmful than cigarettes, and 52% considered second-hand hookah smoke safe. Men were more likely to use hookah than women (OR=2.49; 95% CI 1.74-3.56). Arab were more likely to smoke hookah than Chaldean (OR=1.45; 95% CI 1.02-2.07).. 30% of all smokers had no intention of doing so.

Conclusions: People believe that Hookah smoke is less harmful than cigarettes. The favorable view of hookah and lax regulation and absence of public health anti-hookah smoking campaigns increases the risk for hookah to become a new gateway drug, especially among adolescents.