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Hookah Concerns Rise With Its Popularity

Photo by KRISTEN MARTINEZ

Mike Higgins and Jon White, both 21, are among a growing number of young people who use hookah, an ancient form of smoking from India and the Middle East.

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By ANNA PETERS, KRISTAL ROBERTS and KRISTEN MARTINEZ

Special to The Tampa Tribune

Published: February 28, 2009

TAMPA - Mike Higgins brings the hose to his mouth and inhales one deep puff. He blows out, and a cloud of watermelon-flavored smoke floats, then dissipates above him. He leans back against the plush red couch, putting his feet on the edge of the coffee table where his hookah is gurgling.

Rather than hit a bar or a club in Ybor, Higgins, 21, spent a recent Friday night smoking hookah at the Blue Lizard Hookah Lounge in Tampa.

Hookah, an ancient form of smoking from India and the Middle East, is growing in popularity in the United States, especially among 18- to 24-year-olds. But there are health concerns.

Hookah usually consists of a bowl, where tobacco is heated with embers or charcoal; a water-filled base; a pipe; and a hose.

When a smoker inhales, the flavored tobacco smoke is sucked from the bowl into the water-filled base. Then the smoke bubbles up through the water and through the hose to the smoker.

Jolene Bivens, Tampa Bay regional director of the American Lung Association, said smoking hookah is popular because it's viewed as a safe way to smoke.

"It's not safer. Just like people think filtered cigarettes are safer or that light cigarettes are safer, there are a lot of myths out there," Bivens said. "It's the same product, just a different delivery device."

The lung association views hookah smoking as a potential gateway to cigarette smoking.

"People who haven't turned to cigarettes turn to hookah because of the misconception that it's safer and this starts their addiction to tobacco and nicotine," she said.

The appeal isn't lost on cigarette makers, who are marketing cigarettes in some of the same flavors hookah tobacco comes in.

"With the smoothness and the ease of smoking hookah, it's an easy transition from one product to another," Bivens said.

There are six hookah lounges within a three-mile radius of the University of South Florida's Tampa campus.

Higgins said he started smoking hookah more than a year ago. Before trying hookah, he said he didn't smoke anything.

"Prior to this, I was pretty anti-smoking," Higgins said. "I don't smoke cigarettes for that reason. Cigarettes are gross, and if you continue smoking them, you would get addicted. Right now, if everyone in here was smoking cigarettes, I know I wouldn't be able to sit in here."

Health Concerns

The World Health Organization and tobacco-free groups are working to combat misconceptions about hookah.

Hookah allows a person to inhale more smoke for longer than cigarettes, making it more dangerous, according to a WHO study of water-pipe smoking in 2005.

"Research has shown that its effect on the lungs is very similar to cigarette smoking," Bivens said. "And hookah smokers tend to smoke longer than someone smoking a cigarette, so all the chemicals you would normally smoke in one cigarette you're now multiplying."

Other studies by Tobacco Free U, an anti-smoking organization that works with college students, found that hookah exposes smokers not only to toxins and carcinogens but also other health risks such as hepatitis, herpes and mononucleosis, which can be contracted when people share a hose.

"Any time you burn anything, carbon monoxide is a byproduct of it, and when carbon monoxide enters your bloodstream, it's fighting for the oxygen molecules in there," Bivens said.

This can lead to an increase in heart rate and blood pressure. Tobacco smoke paralyzes the filtering system of the lungs, which can result in colds and respiratory infections, Bivens said.

But patrons at the Blue Lizard said they like the environment and do not see hookah smoking as dangerous, but rather a way to spend time with friends.

That's what Deepum Patel, 22, came to do as he sat in a corner chatting over a hookah.

"When people think of hookah, they think of smoke related to cigarettes," Patel said. "Cigarettes are harsh - harsh on your lungs and harsh on the back of your throat. Hookah is very different, and the smoke density is very light. It's a lot easier to inhale."

The Business Perspective

Manuel Franco and his son Manny Franco, owners of the Blue Lizard, said their business is growing.

Franco decided to open the Blue Lizard after visiting his son while he was working in another hookah lounge.

"When I went to visit this place he was working in, it wasn't what I was expecting," Franco said. "I walk in and the environment was kind of neat. It was legitimate and there was nothing shady about it-a bunch of students just kicking back with their laptops, just having a good time hanging out with their friends."

Franco encourages patrons to take a deep breath and rub their fingers across the walls because he said he is dedicated to keeping the lounge clean.

"There is an impact of secondhand smoke, but one of the things we did immediately when we opened was we installed an air purification system that completely cycles all the air in the room about once every five minutes so that it completely cleans it."

But not everyone is sold on the effectiveness. The American Nonsmokers' Rights Foundation says even expensive particulate air cleaners cannot remove enough tar particles to eliminate the cancer risk associated with the smoke.

Even though medical studies show hookah smoking is not a safe alternative to cigarettes, the Francos said they believe smoking hookah occasionally is not dangerous.

"So much of it is not even about hookah to begin with, it's about relaxation and getting away from the everyday grind of classes," Manny Franco said. "If you smoke hookah every single day for multiple hours a day, it's probably not going to be good for you, so it's all about moderation."

The Francos also offer 44 tobacco-free, herbal alternatives for those who are concerned about tobacco's effects.

"They actually print off the label of ingredients, which you won't see on cigarettes." Manny Franco said. "You have your flavoring, honey, I mean it's all there, and you can read everything."

Tobacco-free hookah smoking is just another way to justify an unsafe behavior, Bivens said.

"It's like saying there is less poison, so you're going to have to decide what your level of toxicity is as far as tobacco-free hookah," she said. "It all goes back to the whole idea that the only thing that's ever supposed to be in your lungs is clean air."

A 2008 Indo-Pakistan study of hookah smoking and cancer found that pipe smoking causes lung cancer, though the risk may not be as high as with cigarette smoking.

The tobacco in hookah burns at a lower temperature than cigarettes - 392 degrees Fahrenheit, compared with 1,700 degrees - lessening the carcinogenic effects, the study found.

Despite numerous health advisories regarding hookah, the Francos contend there is a key difference between smoking hookah and cigarettes.

"When you light up a cigarette, when it's done, it's gone, there is nothing there," Franco said. "Here, you're not burning the tobacco, you're vaporizing the flavor. There have been studies both ways, but you don't hear people waking up in the morning not being able to get going because they haven't had hookah."

The reporters are students in the University of South Florida's multimedia journalism class. Keyword: Hookah, for a video story, a photo gallery and a map of area hookah lounges.

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