For some college students, a typical weekend activity involves sitting around the coffee table and passing a waterpipe, legally. Hookah smoking among college students has increased in recent years, which has many health officials worried about the health risks and the potential for further tobacco addiction.
"It is the traditional way to use tobacco. It goes back many centuries," said Ken Ward, associate professor of health and sport sciences at The U of M. "In the 1990s it got trendy all of a sudden."
A hookah is a waterpipe used to smoke flavored tobacco, called shisha.
According to some records, the hookah originated in sixteenth century India when a physician suggested that tobacco should be filtered through water so it would be "rendered harmless."
This unfortunate misconception has kept some people thinking the hookah is a healthier way to smoke.
"Actually, because it's filtered, one might have a tendency to inhale more deeply for longer," said Joel London, a spokesperson for the Centers for Disease Control offices on smoking and health.
The typical hookah session lasts for one to three hours. Smoking is focused as much on social interaction as it is on smoking. Health officials have found the length of the sessions as one of the main health problems.
"It's a social thing," Ward said. "If you're doing it for hours at a time, it means your exposure is increased."
A World Health Organization study estimated that a waterpipe smoker inhales as much smoke during one session as a cigarette smoker would get from smoking 100 cigarettes. Many college students who smoke hookah though, said they do not think it is as dangerous as cigarettes.
"They always say it's not as bad," said Shayla Lawrence, senior Spanish and anthropology major. "I guess it's still not a good habit."
Lawrence smoked for the first time during Ramadan this year. She went to the home of a Lebanese friend who had been fasting all day in observance of the holiday. Lawrence had never smoked hookah before, but decided to try it. She said she enjoyed the relaxation and conversation around the pipe.
"I guess because it's something different," she said. "With the hookah, it's like, 'Wow, this is some exotic thing.' It's different, especially in a place like Memphis."
Brennan Appel, owner of Smokesouth.com, an online hookah retailer, said the trends picked up in 2002 in California and have spread across the country.
"The increase has been dramatic since then," he said. "One person can have a profound effect on a group of people. People are constantly being introduced to the product."
His main demographic is 18-35 year olds. He said hookah appeals to the college-aged person because it's something new.
Benyamin Yaffe, senior journalism major, started smoking hookah when he traveled to Israel his sophomore year of high school.
"It's so natural over there," he said, "to gather around, tell stories and smoke hookah, just like we were watching TV."
Yaffe smoked occasionally when he returned to the states and then more when he bought a hookah his sophomore year of college. When his first waterpipe broke, Yaffe's mom brought him a new one from Morocco. He said she knows and doesn't care that he smokes.
"It's a way of culture," he said.
And Yaffe enjoys spreading that culture.
"I've thrown many hookah parties," he said. "It's really a good way to have a social event. And it's legal."
Yaffe pointed out that the nicotine content on his cola-flavored shisha is only .2 percent, but the WHO concluded that the lower nicotine content is a misguided safety.
While a cigarette smoker inhales about 8-12 shallow breaths during a cigarette, a waterpipe smoker may take 50-200 puffs and take in several times the amount of smoke.
"It's that Russian roulette game that we play with carcinogens," London said. "Shisha is inhaled more deeply and frequently and for longer periods and is considered more dangerous than cigarettes."
Many college students who smoke hookah believe that the social fun outweighs the health factors.
"It's not as fun if you don't have someone there with you," Yaffe said. For his hookah parties, Yaffe would have 20 to 25 friends over to "smoke and relax."
They all smoked out of his hookah, which only had one hose and mouthpiece. The World Health Organization found that sharing a waterpipe mouthpiece results in an increased risk of transmission of diseases like tuberculosis and hepatitis.
"It's kind of a double edged sword, to an extent," the CDC's London said. Not only is the smoker increasing his or her chances of lung cancer and heart disease, he or she is also increasing the chances of contracting communicable diseases."
The University of Memphis' Ken Ward said many people have a double standard when it comes to cigarettes and hookah.
"People are experimenting, and they often don't see hookah as dangerous," said Ward. "Even people who think cigarettes are nasty and unhealthy - they'll smoke hookah. Nicotine is one of the most addictive drugs, and cigarette smoking is one of the most prevalent cases of drug abuse."
One concern Ward voiced was the fear that people who start with hookah will move to regularly smoking cigarettes. London of the CDC echoed this concern.
"Those who have never started and want to try should be well advised that it could lead to other forms of tobacco addiction," London said. "They are likely to find themselves down the path to becoming a full-time smoker."
