Hookahs, or water pipes, usually have a vase with water surrounding the pipe stem. At the top of the pipe hot coals are placed in a bowl where they heat flavored tobacco until it begins to smoke. Users then suck on a hose to draw the smoke down through the pipe stem and into the water. The smoke then rises above the water and enters the hose. Users puff on the hose to inhale the tobacco.

Many young people mistakenly believe that hookah use is safer than cigarette smoking. In fact, it has many shared risks. Hookah users are still inhaling the same 4,000 hazardous chemicals found in cigarette smoke. Filtering the smoke through the water does not remove cancer-causing polycyclic hydrocarbons, lung damaging volatile aldehydes, addiction-causing nicotine, heavy metals or carbon monoxide which can lead to cardiovascular disease.

Studies have shown that it takes about 10 puffs to smoke a cigarette, yet a one-hour hookah session involves 100 puffs. Each hookah puff contains 10 times the volume of a single cigarette puff, which means that during a hookah session a person inhales 100 times the volume of a single cigarette. One public service ad compared a one-liter soda bottle to the amount of smoke inhaled with just one cigarette. The ad then explained that hookah users inhaled 100 of those soda bottles during a single 45-minute session.

Hookah use is not benign. It is not safer than cigarette smoking. And it holds the same potential for addiction.

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