Helping Parents Prevent Youth Substance Abuse


What is Hookah?

Hookahs are water pipes that are used to smoke specially made tobacco.  The tobacco comes in different flavors such as apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon, making it more appealing to young people.  Hookah smoking is typically done in groups, with the same mouth piece passed from person to person.

Hookahs vary in size, shape, and style. A typical modern hookah has a head (with holes in the bottom), a metal body, a water bowl, and a flexible hose with a mouthpiece.

Hot charcoal which is separated by a foil sheet is used to heat up the tobacco, creating smoke. When users draw on the mouthpiece the hose draws more heat on the tobacco, helping accelerate the heat transfer. The smoke is then pulled through the water bowl or water chamber and cools before it reaches the lungs. 

Although many users think it is less harmful, hookah smoking has many of the same health risks as cigarette smoking.  Smoking hookah delivers the addictive drug nicotine and it is at least as toxic as cigarette smoking.

Hookah Smoke:

  • Contains many of the same harmful toxins as cigarette smoke
  • Has been associated with lung cancer, respiratory illness, low birth weight, and periodontal disease.
  • A typical 1-hour-long hookah smoking session involves 200 puffs, while an average cigarette is 20 puffs.
  • Increases the health risks by producing smoke that contains high levels of carbon monoxide, metals, and cancer-causing chemicals.
  • Poses a serious potential health hazard to smokers and others exposed to the emitted smoke.

Other Health Effects of Hookah Smoke:

  • Infections may be passed to other smokers by sharing a hookah mouthpiece.


In recent years, there has been an increase in hookah use around the world, most notably among youth and college students. The Monitoring the Future survey found that in 2014, about 23% of 12th grade students in the United States had used hookahs in the past year, up from 17% in 2010. In 2014, this rate was slightly higher among boys (25%) than girls (21%). CDC's National Youth Tobacco Survey found that from 2013 to 2014, hookah smoking roughly doubled for middle and high school students in the United States. Current hookah use among high school students rose from 5.2% (770,000) to 9.4% (1.3 million) and for middle school students from 1.1% (120,000) to 2.5% (280,000) over this period.

Hookah is also called:

  • narghile
  • argileh
  • shisha
  • hubble-bubble
  • goza
  • water pipe
  • borry

Learn More:

Hookah Smoking a Growing Threat to Public Health
It’s a Trap
More Teens Smoking E-Cigarettes, Hookah


Use the TalkSooner app for tips on how to talk to your kids about not using alcohol or other drugs.