What is Hookah?

Hookah - also called narghile, shisha, goza, and hubbly-bubbly is a water pipe used to smoke specially made tobacco by indirectly heating the tobacco, usually with burning embers or charcoal. The waterpipe generally consists of four main parts:

  • The bowl where the tobacco is heated;
  • The base filled with water or other liquids;
  • The pipe, which connects the bowl to the base; and
  • The rubber hose and mouthpiece through which smoke is drawn.

Hookah smoking is a relatively new activity in the United States and is a popular social activity among teens and young adults who generally sit together and share a pipe. Hookah smoke can be served in a variety of flavors like strawberry, mint, and chocolate. The device has been used for centuries in the Middle East and Asia to smoke tobacco. Now, hookah bars and cafes are popping up across the United States -fueled by the growing popularity of hookah smoking among teens and young adults.

What Parents Can Do:

Talk to your teen about the risks of hookah smoking. There is a misperception among youth that hookah smoking is somehow safer than smoking a cigarette because the smoke is filtered through water. This is not true. Waterpipe smoking carries the same serious health effects as smoking cigarettes. In addition to causing lung cancer, there is an increased incidence of cancers of the lower lip, esophagus, and stomach from waterpipe use. Another potential problem is that commonly used heat sources that are applied to burn the tobacco, such as wood cinders or charcoal, are likely to increase the health risks from waterpipe use because when burned on their own these heat sources release high levels of potentially dangerous chemicals, including carbon monoxide and heavy metals. There is also the risk of spreading infectious diseases, like tuberculosis, and viruses such as hepatitis and herpes by sharing the tube.

Talk to your teen about the myths of hookah smoking

  • It is not safer than smoking cigarettes. Hookah smokers are exposed to cancer-causing chemicals and hazardous gases such as carbon monoxide. Hookah is linked to lung, oral and bladder cancer, as well as clogged arteries and heart disease.
  • Hookah is addictive. People ingest higher nicotine levels than with cigarettes, which could increase the risk of addiction since nicotine is the drug that causes addiction.
  • The water pipe does not filter out the "bad stuff". The water-filtration and extended hose does not filter out the nicotine, tar, cancer-causing chemicals and dangerous heavy metals.
  • Smokers who share a water pipe are at risk for infectious diseases, such as tuberculosis, and viruses such as hepatitis and herpes. Shared mouthpieces may enhance the opportunity for such diseases to spread.

Know if your teen's friends use hookah. Talk about ways to refuse it.

Look out for hookah (waterpipes) and supplies associated with it. The waterpipe and tobacco can be bought in specialized shops and online, so some youth are buying their own hookah pipes. Some also smoke marijuana using the hookah pipe.

Talk to other parents. Talk to the parents of your teen's friends. Make sure they are aware of this trend and its dangers.

Advocate changing current smoke free air laws by contacting your local representative or senator. In Rhode Island and Massachusetts there are exemptions to restaurant and bar smoking laws. Smoking under the current law is allowed in smoking bars primarily devoted to selling tobacco products for consumption on the premises. Ensure new smoke free air laws include hookahs and the places hookahs are smoked, and remove loopholes from existing laws that make hookahs popular and accessible.

Tobacco producers who need a continuing source of new tobacco users are targeting young people. Hookah bars are showing up in college neighborhoods where older teens and college age youth can frequent them. Hookah cafes are marketed to young people and hookah is being promoted on websites and computer chat boards. Even though tobacco products may not be sold to persons under age 18, hookah smoking is available to younger teens.


American Lung Association, Tobacco Policy Alert, An Emerging Deadly Trend: Waterpipe Tobacco Use, February 2007.