Reduction of hookah bars and lounges through enforcement: A case study in San Francisco

Despite scientific reports and education efforts by national and local public health officials regarding the dangers of smoking and exposure to second hand smoke, hookah tobacco smoking is gaining popularity nationwide, especially among urban youth, college students, and young professionals. California Department of Public Health states that the proliferation of hookah bars and lounges is leading to a growing acceptance of smoking which threatens to setback twenty years of progress in reducing tobacco related death and disease.

In 2009, San Francisco public health officials identified five establishments that were engaged in smoking hookah. By 2010, the number of operating hookah bars and lounges in San Francisco increased to 20 establishments. During the same year, San Francisco Office of Small Business reported receiving about 200 inquiries requesting information on opening a new hookah business.

With the passing of a newly amended local smoke free ordinance and in order to prevent new hookah establishments from opening, San Francisco public health officials commenced enforcement action in June 2011 against existing hookah bars and lounges by using state and local smoke free laws, state food code, and the local tobacco permit requirements. By utilizing the combination of these laws, to date, approximately 75% of the existing hookah establishments have ceased smoking inside their premise and no new hookah bars or lounges have opened in San Francisco.