Hookah use on the rise among affluent teens

A growing number of adolescents are smoking hookahs instead of cigarettes, and users are more likely to be of higher socioeconomic status, a new study reports.

When researchers from New York University Langone Medical Center analyzed 2010 to 2012 data from a nationally representative sample of 5540 high school seniors in the annual Monitoring the Future survey, they found that 18% of the students reported using a hookah in the past year (mean prevalence of the 2010-2012 data).

The most recent data from the Centers for Disease Control and Prevention show a rise in hookah smoking among high school students from 4.1% in 2011 to 5.4% in 2012; even more recent figures from Monitoring the Future reveal a jump in 12-month use among high school seniors from 18.3% in 2012 to 21.4% in 2013.

High parental education level increased the likelihood of hookah smoking, as did weekly student income of more than $50 from a job or $11 to $50 from other sources. Male and urban students were more likely to use a hookah; black students were less likely than white students to do so.

Hookah use was higher among users of alcohol, marijuana, and other illicit substances as well as former cigarette smokers. Current cigarette smokers had the highest risk of all. The researchers had expected that finding but not the data on higher socioeconomic status among hookah smokers. They had anticipated greater use among poorer adolescents.

The researchers point out that although young people generally believe that hookah smoking is less damaging and addictive than cigarette smoking, existing data, albeit limited, suggest that this is not an accurate assumption. Hookahs have been shown to deliver higher doses of tar, nicotine, and carbon dioxide than cigarettes, and they have been linked to a variety of adverse effects, including lung cancer, respiratory and periodontal disease, and low birth weight. 

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