1 in 3 college students has smoked hookah
June 7th, 2012
03:01 PM ET

1 in 3 college students has smoked hookah

The problem, Dr. Brian Primack says, is that hookah smoking is a beautiful thing.

Polished brass, woven rugs and intricate carvings create a culturally-rich atmosphere where friends can relax and socialize.

Unfortunately, smoking hookah delivers the same chemical compounds as smoking a cigarette. In fact, one session (usually about 45 to 60 minutes) delivers approximately 100 times the smoke as a single cigarette, with 40 times the tar and 10 times the carbon monoxide.

A hookah is a water pipe with a smoke chamber, bowl and a hose. The flavored smoke is created with three ingredients – heated tobacco, molasses and fruit. The smoke passes through water and into the mouthpiece, allowing consumers to inhale more deeply than they would when inhaling the dry air of a cigarette.

Hookah bars have been popping up around the country for the last decade.

“We normally cater to 18 to 20-year-olds,” says Lance Freeman of The Egyptian Café & Hooka Bar in Indianapolis, Indiana. “We are a place to come to for people who can’t go to bars.”

Primack’s latest study, published in the June issue of the journal Nicotine and Tobacco Research, finds that 1 in 3 current college students has smoked hookah at some point; more than 50% of those students were not cigarette smokers.

“In my opinion [hookah] is a lot better,” Freeman says. “There’s more flavor, it’s more mellow, it gives this tickle in your throat… it’s very relaxing.”

Primack was giving a lecture on the dangers of smoking at the University of Pittsburgh School of Medicine when a student interrupted him. “He said, ‘No offense, but nobody really smokes anymore – we all do this hookah thing instead.”

That moment launched Primack’s research into the hookah world. “It’s a very interesting public health puzzle. The same chemicals - in one form [are] reviled by many people, but the same people will go across the street and take it in this different format.”

Better education is needed, Primack says, to show the similarities between hookah smoking and cigarette smoking. In a previous study the researcher found 92% of videos on YouTube showed hookah in positive light, compared to just 24% of cigarette videos. And only 26% of hookah bars use the word “tobacco” at all on the first page of their websites.

Primack and his colleagues analyzed the survey responses of 105,012 students at 152 universities across the country for their most recent study. The population that participates in hookah smoking tends to be younger, male and white, but is found across all characteristics.

The researchers don’t know yet if hookah is addictive. Smokers inhale twice the amount of nicotine in one hookah session as they do with a single cigarette, but long-term studies need to be done to see if it interferes with their life in the same way.

soundoff (428 Responses)
  1. rob

    wait.. people smoke tobacco from a hooka? who knew!!?

    If you're putting tobacco in your hooka, you're smoking nicotine, yes stoopid, nicotine is addictive. Have fun with that.

    June 7, 2012 at 17:22 | Report abuse | Reply
    • TinKnight

      rob, a lot of people DON'T know that hookah contains tobacco.

      I was actually at a Turkish restaurant a few weeks ago, and nowhere on the menu or in any of their advertising does it even mention tobacco...they just say "Oh, you're smoking fruit!"

      My question is, how is this legal? I mean, I thought tobacco and nicotine had to be advertised in whatever they might be located, just due to the obvious and well-known effects of tobacco smoking of any kind?

      June 7, 2012 at 17:49 | Report abuse |
    • eric

      Just because you have ingested something that is addictive, it doesn't instantly turn you into an addict. Most of these kids are only smoking when they go out, unlike cigarette smokers who smoke from the time the wake up to the time they go to sleep. Most students don't throw a hooka in their backpack to grab a quick smoke between classes like they would with a pack of cigarettes. You need to accept the fact that the majority of college students are going to experiment. It's a rite of passage when you leaqve the authority of your parents. Nobody wants their kid taking hallucinogenics, but many of them will. If they're going to experiment with tobacco, I'd rather my kids go to a Hooka Bar once or twice a week, instead of buying a pack of cigarettes every day. Most people who buy a hooka don't smoke tobacco...but that's another subject all together.

      If they could drink alcohol at 18, these Hooka Bars would be out of business.

      June 7, 2012 at 18:08 | Report abuse |
    • rmtaks

      "one session (usually about 45 to 60 minutes) delivers approximately 100 times the smoke as a single cigarette..."

      You don't sit there and hammer it for an hour straight. You pass it around and probably spend 5-10 of those minutes actually smoking it.

      June 7, 2012 at 18:29 | Report abuse |
    • MarkGlicker

      Problem though is the 44 ounce slurpy.

      June 7, 2012 at 19:06 | Report abuse |
    • Nat

      @TinKnight what is your source for saying that a lot of people don't know that it is tobacco that they are smoking? I am a white, 20 year-old male who smokes hookah about once a month. I'm the exact demographic that this study shows. I've never smoked with a person who DIDN'T know that they were smoking tobacco. This is completely legal and i'm not addicted to smoking hookah, nor know anyone who is. Just thought I would just give my opinion as well.

      June 7, 2012 at 19:41 | Report abuse |
    • Marissa

      Most shisha does not contain nicotine.

      June 7, 2012 at 20:25 | Report abuse |
    • HookahSuckersAnnon

      I think there are too many thinkers on this. Sarcasim aside tell me of all the substances that are avaiable to smoke then remove the illegal ones and then ask the person loading the bowl "Hey what is that?" I think you are all intelligent enough to realize that smoking most fruits are going to give you a headache; most of you most likely know this as teenagers trying to score your first bag of weed and trying to inhale oregano because hey we were mostlky all stupid teenagers. I think you are al intelligent enough to deduct that there is tobacco in the bowl. Oh and hey if you arn't able to figure that out try to google it, google know all>|)

      June 7, 2012 at 20:30 | Report abuse |
  2. TSimon

    Ok, let me get this straight. According to the research in the article, one hookah session is equal to 100 times the smoke as a single cigarette (that would be 100 cigarettes or 5 packs of cigs), with 40 times the tar (that would be 2 packs of cigs) in one single 45-60 minute hookah session.
    I don't see how that is any more healthy. Let's face it..if you're going to smoke ANYTHING there is a risk. Just admit it and assume the risk. Don't try and BS your way out of it.
    I smoked for 33 years. I knew what I was doing. If I am diagnosed with lung cancer tomorrow...I promise I won't act surprised.
    And to the guy that mentioned how we all pay for smokers because the health care costs affect us all.....I'd tend to shed a tear for you people...but I'm too busy paying for the health care costs of obese americans. Stop blaming the smokers for everything. Get off your butts and take a walk...and preferably not down to McD's for a supersized meal.

    June 7, 2012 at 17:22 | Report abuse | Reply
    • Lenny

      I despise both the fat fcuks and the more onic smokers.

      June 7, 2012 at 17:51 | Report abuse |
    • More onic

      @Lenny How do they get this excess onic? Can I have some of their onic? Am I allowed to buy more onic?

      June 7, 2012 at 18:30 | Report abuse |
  3. Gurgi

    A bong is a bong is a bong. A "hooka" only has one purpose, and always has.

    June 7, 2012 at 17:23 | Report abuse | Reply
    • Weeniewagon

      That's actually COMPLETELY untrue.

      June 7, 2012 at 18:56 | Report abuse |
    • nepawoods

      A bong is a bong is a bong is not a hookah.

      June 7, 2012 at 19:54 | Report abuse |
  4. The Good Stuff

    I don't use cigarettes but every now and then I light up a good cigar on special occasions. I never inhale. This hookah thing is nothing to worry about unless it is done continually. You can die from drinking too much water and we need that to live. I hardly see young people smoking cigarettes. Less people do cigars. I've never done a hookah.

    June 7, 2012 at 17:24 | Report abuse | Reply
    • MIke

      Except you DO inhale hookah and people do this everyday. I know here in south florida we have many hookah bars called "Off the Hookah" (clever name) They cater to anyone 21+ and the place is always packed

      June 7, 2012 at 17:28 | Report abuse |
  5. Leucadia Bob


    June 7, 2012 at 17:24 | Report abuse | Reply
  6. MIke

    If you didnt know hookah was tobacoo you didnt need your health anyway. Darwin is going to catch up with those folks soon enough.

    June 7, 2012 at 17:25 | Report abuse | Reply
    • killallthewhiteman

      Wrong, he died a long time ago.

      June 7, 2012 at 17:50 | Report abuse |
    • Johdar

      A hookah is the water pipe that shisha is smoked from. Shisha is your fruit flavored tobacco.

      June 7, 2012 at 19:36 | Report abuse |
  7. Saeed

    Are you serious a lot of political Ass holes don't want this Hookah stuff to become a trend in America....

    June 7, 2012 at 17:26 | Report abuse | Reply
    • DarqueSide

      LOL! Too late! It's here and we like it!

      June 7, 2012 at 22:49 | Report abuse |
  8. Emm

    A hookah is the device (the water bong) used to smoke. Shisha or Mu‘assel is the name of the tabacco product which is smoked using a hookah. So to say that "The researchers don’t know yet if hookah is addictive", as per this article, is a bit of an odd statement.

    June 7, 2012 at 17:27 | Report abuse | Reply
  9. ADJCB

    This research says that one bowl/session = 40 times the tar of a single cigarette, but you have to also consider that most people smoke hookahs socially, so that one bowl is shared between multiple people. If 5 people are sharing a bowl, then each person is smoking the equivalent of 8 cigarettes. And if that same group of 5 people only smokes once a month, that equates to only 8 cigarettes a month. No one is arguing that hookah isn't bad for you, but 8 cig's a month is leaps and bounds better for you than a pack-a-day.

    Comparing a cigarette to a hookah session is misleading. You have to compare puff-for-puff.

    June 7, 2012 at 17:33 | Report abuse | Reply
    • yep

      This is almost exactly the point I came down to the comments to make.

      Of course not smoking at all is better for you thank smoking hookah, but if you smoke hookah with some friends once or twice a month, you're still getting waaaay less bad stuff than even light smokers who smoke a few cigarettes a day, or even just one a day.

      June 7, 2012 at 17:51 | Report abuse |
  10. jeff

    People in america use hookas to smoke pot, not tobacco

    June 7, 2012 at 17:35 | Report abuse | Reply
    • Burbanked

      You're wrong there Jeff I reside in the good 'ol USA and I have neighbors who use a hookah on their backyard patio and all that's smoked in it is tobacco. You need to get out more.

      June 7, 2012 at 18:39 | Report abuse |
    • Ian

      lol wrong. so wrong.

      June 7, 2012 at 19:51 | Report abuse |
    • DarqueSide

      Not true! I know a number of people who smoke pot and a number of people who smoke hookah. The pot smokers don't use a hookah and the hookah smokers don't smoke pot!

      June 7, 2012 at 22:51 | Report abuse |
  11. carlos

    I would rather be next to a hookah smoker than to an grossly obese person.....phew, the smoke smells fruity.....the other one.....you decide

    June 7, 2012 at 17:35 | Report abuse | Reply
    • vulpecula

      Have you ever heard of second hand smoke? I've never heard of second hand obese.

      June 7, 2012 at 19:28 | Report abuse |
  12. Toni

    Everyone talks like they do this once a week or so but how many have one of these at home and do it daily cus they feel its easier than smoking a cigarette? I know of a lot of young adaults who have it at home and act like its no big deal. Wait till they get older and feel the real impact of their actions. Gonna drive up all of our health insurance costs.

    June 7, 2012 at 17:37 | Report abuse | Reply
    • Meghon

      I have one at home and smoke it maybe once a month. it's not more convenient than cigarettes, there's a lot more set up involved and it's no fun to smoke alone.

      June 7, 2012 at 19:15 | Report abuse |
  13. urmomlol

    The fact that people even need to be told this is terrifying.

    Well, at they say, nobody ever went broke underestimating the intelligence of the American public.

    June 7, 2012 at 17:38 | Report abuse | Reply
  14. mouse

    "The researchers don’t know yet if hookah is addictive." *facepalm* Yes, cnn, tobacco is addictive.

    June 7, 2012 at 17:38 | Report abuse | Reply
    • droidphd

      Wrong. Nicotine is addictive. Tobacco has no addictive traits whatsoever.

      June 7, 2012 at 20:45 | Report abuse |
  15. Ken Margo

    Folks, be real. If inhaling smoke was good for you, firefighters wouldn't wear masks. If you are an adult, as far as I'm concerned, do as you please.

    June 7, 2012 at 17:40 | Report abuse | Reply
  16. Liz

    Report: Alarmist Americans warn of the dangerous of young adults smoking a natural plant a few times a year, while simultaneously downing chemical pills in the form of antidepressants, blood pressure medications, sleeping pills, daily...

    June 7, 2012 at 17:43 | Report abuse | Reply
    • Quixoticelixer

      Just because something is natural doesn't mean it is harmless. Synthetic drugs prescribed in this country undergo a battery of testing by the FDA in order to become qualified at treating a specific disease.

      June 7, 2012 at 19:09 | Report abuse |
  17. Supra

    Smoke is smoke.

    June 7, 2012 at 17:44 | Report abuse | Reply
  18. Ken Margo

    You're right Liz. WE TRAIN people to be drug addicts by prescribing drugs like they're cotton candy. Instead of getting them help, we throw 'em in jail and give 'em criminal records that dog them for the rest of their lives.

    June 7, 2012 at 17:47 | Report abuse | Reply
  19. Gurgi

    The faster the hooka smokers die, the quicker the gene pool gets cleaned out.

    June 7, 2012 at 17:48 | Report abuse | Reply
  20. Anomic Office Drone

    If someone has to explain to you that tobacco smoke is the same as tobacco smoke, please continue to smoke heavily.

    June 7, 2012 at 17:48 | Report abuse | Reply
    • Ken Margo


      June 7, 2012 at 17:50 | Report abuse |
    • Jason

      I love this comment.

      June 7, 2012 at 18:06 | Report abuse |
  21. jony

    Guessing college students are smoking something other than tobacco in those hookahs

    June 7, 2012 at 17:59 | Report abuse | Reply
    • Meghon

      Of course you would. And it's not really true. Anyone who cares for the piece they just paid over a hundred dollars for would never smoke weed out of them, it ruins the flavor. So no. Just because we're in college doesn't mean that we're all potheads.

      June 7, 2012 at 19:18 | Report abuse |
  22. iBod

    Speaking as a college student, I fall into this one third. Not unfortunately, however. I am one who absolutely HATES cigarettes; but I viewed Hookah very favorably. I thought it was a great experience I would do again. The place near my college has a very relaxing atmosphere. The last time I went was the first time I went. I'd say mostly because of the expense, which I, truthfully, do not know how some college kids can do it every so many weeks. Quite a burden that can add up quite quickly for frequent goers. Even those who say they go once a month - don't know why they would waste their money on such frequency. Oh, and me? It has already been a little over a year since my first, and last, visit. Just thought I would throw that out there.

    June 7, 2012 at 18:04 | Report abuse | Reply
    • Ken Margo

      You obviously control the hookah more than the hookah controls you. Unfortunately individuals lose self control and spiral out of control. Cost be damned they gotta get a fix. I wish more were like you.

      June 7, 2012 at 18:09 | Report abuse |
    • Jason

      I used to go to hookah bars quite frequently between the ages of 18 and 20 (note that what I'm saying lines up with what the owner of the hookah bar said in the article). Now that I'm 21, I really don't go anymore, because I can now go to bars. Hookah wasn't all that expensive. If my memory serves me correctly, you could smoke one bong for over an hour, and it was only $10. That's really not that expensive if you share it with someone else.

      June 7, 2012 at 18:11 | Report abuse |
    • Jason

      Also note that I've had a job ever since I was 16, even throughout my first few years of college. I work about 30 hours a week, so $5 or $10 is nothing to me compared to most college kids.

      June 7, 2012 at 18:13 | Report abuse |
    • minhajarifin

      I'm glad you are staying away from all this and in a few years you will be very grateful. Some of my very athletic friends have lost their stamina due to smoking, they used to be fast runners and now they start breathing heavily in a small friendly soccer match. Remember what Russel Crowe said in Gladiator, 'What we do in life echoes in eternity.'

      June 7, 2012 at 18:14 | Report abuse |
    • JD

      minhajarifin –
      So this quote from a barbarian in a hollywood movie is your little gem.
      Here's another one You will return to the dust from which you were formed just like everyone else if not sooner

      June 7, 2012 at 18:49 | Report abuse |
  23. Gil Nodges

    This is why I only smoke grass in my hookah............

    June 7, 2012 at 18:04 | Report abuse | Reply
  24. minhajarifin

    I think when friends get together they want to feel like they are being slightly bad, so they'll smoke something or drink too much. I wish we could sit in a circle and pass something nice to each other...start with a large bunch of broccoli that gets smaller as it is passed around the circle and if someone gets over excited and eats two of them everyone in the circle shouts, 'go go go go wohooo!'

    Minhaj Arifin
    Author of
    How Desis Became The Greatest Nation On Earth

    June 7, 2012 at 18:06 | Report abuse | Reply
    • Jeff

      LOL! That's an intriguing thought. You'd think that we would have some kind of "survival genes" that would prompt us to want to behave just as you suggested, just as so many animals in the wild instinctively avoid poisonous foodstuffs. I wonder what went wrong?

      June 7, 2012 at 21:58 | Report abuse |
  25. 0rangeW3dge

    "The researchers don’t know yet if hookah is addictive." – – as if it was "hookah" and not the tabacco that was addictive?, because, obviously, the researchers weren't smoking tobacco at the time that they made this statement.

    Can you smoke your bath salts in a water pipe?

    June 7, 2012 at 18:14 | Report abuse | Reply
  26. hemo

    This is bad, if white people start using the hookah, which was an invention by the CIA to keep all non-whites below the poverty line, its defeating the purpose of the hooka! and yes we find that hookahs in paintings and scripts from long ago, but those were just planted into the history books to trick the non-whites!

    June 7, 2012 at 18:23 | Report abuse | Reply
  27. Leucadia Bob


    June 7, 2012 at 18:23 | Report abuse | Reply
  28. JMGangi2

    While some Shisha (which is what is smoked from a hookah) has tobacco, not all do. There are tobacco-free versions of Shisha. I wonder if those are as damaging as well.

    June 7, 2012 at 18:24 | Report abuse | Reply
  29. VA29

    I had a friend who used to smoke hookah everyday for about 3 hours with his friends...I kept telling him there was no way that was healthy and he told me "it's not bad for you because the water filters out the bad stuff" All I could do it look at him like an idiot. The problem with hookah is people have a huge misconception that it's "healthy" either way you are still inhaling smoke into your lungs. Sure if you do it every now and then it's not going to hurt (much) but for people who do it multiple times a week...you might as well smoke the cigs, it's no better.

    June 7, 2012 at 18:32 | Report abuse | Reply
  30. blughst20

    Back when I was using a hooka the only thing I smoked was weed.... and maybe a little hash

    June 7, 2012 at 18:41 | Report abuse | Reply
  31. billybob

    I've smoked teh hookah a few times but never felt addicted, it tasted good but my throat still got tore up from the crap. I haven't done it in over a year.

    June 7, 2012 at 18:42 | Report abuse | Reply
  32. stopthemadness

    NO one and I mean NO ONE uses a hookah for tobacco. If they do they are Arabic. No one smokes a hookah for tobacco AT least not anyone I know and I know some pretty out there teachers who went to school with me.

    June 7, 2012 at 18:43 | Report abuse | Reply
    • Johdar

      Funny, that. I have smoked tobacco from a hookah. As does anyone who uses one of these at a hookah bar. Stop automatically assuming that just because it is a water pipe that it is used to inhale THC.

      June 7, 2012 at 19:43 | Report abuse |
  33. Brett

    I had a 4 hose hookah when I was stationed in turkey, and I guarentee we weren't smoking tobacco & molasses!!

    June 7, 2012 at 18:46 | Report abuse | Reply
  34. Lerp

    Never smoke anymore because the day after I wind up with like an acute nicotine withdrawal in the form of a crushing headache.

    its that wacky tabaccy

    June 7, 2012 at 18:59 | Report abuse | Reply
  35. sirrahad

    I have smoked weed, hash, tobacco, and a few 'legal' things I bought from the back pages of Rolling Stone many years ago, in a hookah. I smoked cigarettes for a long time, quit them a little over a year ago. I smoke cigars now (one a day, that's all). As I write this, I am enjoying a CAO Criollo, first generation Cuban seed grown in Nicaragua, very nice, very relaxing.

    June 7, 2012 at 19:00 | Report abuse | Reply
    • sirrahad

      Oh, and opium, too.

      June 7, 2012 at 19:48 | Report abuse |
  36. Tr1Xen

    If Obama had a son, he would be smoking the hookah!

    June 7, 2012 at 19:01 | Report abuse | Reply
  37. iplaymasta

    There is also herbal shisha, no tobacco just molasses. that's what i smoke and it's not that bad. its just vapour.

    June 7, 2012 at 19:37 | Report abuse | Reply
  38. rob2tall

    tastes far better with pot :>)

    June 7, 2012 at 19:40 | Report abuse | Reply
  39. Seth Bullock

    Free people can self destruct as they please.

    June 7, 2012 at 19:41 | Report abuse | Reply
  40. Chaz

    Hooka is good stuff, better with a gram of weed in it, that was what we did in college when we smoked the hooka.

    June 7, 2012 at 19:42 | Report abuse | Reply
  41. Sammy

    Many of the statements made here (comments by readers) are highly inaccurate.

    Smoking tobacco (NOT MJ) via hookah is very common now among adolescents and young adults. Literally hundrends of hookah/waterpipe bars are popping up all over the US and the large majority are on/near college campuses. Many of them are smoking in groups, but many are not. There is now a large population of smokers who order supplies for thier use at home and smoke alone or with only one other person. A notable proportion of these folks are "hammering it out for an hour" (as one poster mentioned above). And importantly, yes they are smoking TOBACCO.

    YES, tobacco-free Shisha can also be harmful. ANYTIME you burn something and smoke it, you introduce a variety of harmful chemicals into your lungs.

    The comment re: "yes, cnn, tobacco is addictive"...The method through which one consumes a drug has a great impact on whether or not it is addicting. Thus, this comment is clarifying that hookah is a different method of consumption than cigarettes, and thus the addictive properties may be different.

    June 7, 2012 at 19:45 | Report abuse | Reply
  42. MabMonster

    Hookah isn't nearly as bad as a cigarette. Yes the person smoking hookah is smoking a lot longer than 8 minutes it takes for a single cigarette, but the tobacco in cigarettes are doctored to contain more nicotine and have more chemicals, like the stuff in rat poison and such. Hookah tobacco (Also known as shisha) is all natural with less tar and less nicotine per inhale than a puff of a cigarette.

    June 7, 2012 at 19:46 | Report abuse | Reply
  43. Tweek

    I love smoking cannabis out of these

    June 7, 2012 at 19:48 | Report abuse | Reply
  44. Sammy

    "A bong is a bong is a bong. A "hooka" only has one purpose, and always has." WRONG - So not true in many Middle Eastern and Asian countries. Smoking tobacco via hookah is a long standing, cultural phenomenon for these folks.

    "There is also herbal shisha, no tobacco just molasses. that's what i smoke and it's not that bad. its just vapour." WRONG - how do you "light" the molasses? I'm guessing with charcoal? The burning charcoal is inhaled into your lungs. I'm guessing that inhaling charcoal smoke is NOT good for you.

    June 7, 2012 at 19:52 | Report abuse | Reply
  45. Sammy

    "Hookah tobacco (Also known as shisha) is all natural with less tar and less nicotine per inhale than a puff of a cigarette" - WRONG. The pack says "no tar". This is accurate because the product in the pack isn't burning. But once you burn that product, tar is produced. Another way to deceive the customer.

    June 7, 2012 at 19:54 | Report abuse | Reply
  46. Sammy

    And FYI...nicotine does not cause cancer. It's the other stuff that does - tar, carbon monoxide, etc.

    June 7, 2012 at 19:55 | Report abuse | Reply
  47. Alsy

    A teen at my high school stabbed another teen five times after they smoked hookah. While the guy who did was bullied harshly by the guy he stabbed for a long time beforehand and had a motive, he did just smoke that stuff and most people with a clear mind don't murder each other. Staying away from that stuff seems like a good idea.

    June 7, 2012 at 20:05 | Report abuse | Reply
  48. bob

    Why all the hooka scares now ? is it cutting info profits of cigarette companies ?

    June 7, 2012 at 20:06 | Report abuse | Reply
  49. Dan

    I think there is certain majority in Congress in D.C. that must be taking in this stuff.

    June 7, 2012 at 20:19 | Report abuse | Reply
  50. Jim

    Bull. A hookah is for smoking dope.

    June 7, 2012 at 20:19 | Report abuse | Reply
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