Hookah is just as dangerous as cigarettes, so why do so many people smoke it?

The number of people smoking hookah has nearly doubled, a finding concerning to health professionals since the habit has dangerous repercussions similar to smoking cigarettes, according to a new study.

Published in the journal Nicotine & Tobacco Research, the study was led by Michael Weitzman, MD, from New York University’s College of Global Public Health and the departments of pediatrics and population health at NYU’s School of Medicine. The research was based on the National Adult Tobacco Survey, which looked at hookah use among people in each state.

Weitzman and his team calculated how many U.S. adults smoked hookah over participants’ lifetime as well as their current use and found that 12 percent of American have smoked hookah. The number of young adults aged 18-24 currently smoking hookah is nearly 20 percent, identical the number of people currently smoking cigarettes.

"We believe that our research adds to the understanding of the geographic and socio-demographic factors underlying hookah use," Weitzman said in a statement.

Hookah, though not as addictive as cigarettes, is still addictive. There are common misconceptions that it is safer than smoking cigarettes, which is what fosters its social desirability. But it has similar health effects as cigarettes and users often inhale more smoke using hookah than cigarettes. There are common misconceptions that it is safer than smoking cigarettes, which is what fosters its social desirability.

Single, adult males with high levels of education and more income are characteristics associated with those who are smoking hookah the most, a big contrast to cigarette smoking, which is more common among poorer and less educated people.

"Given the existing state level autonomy in developing hookah sensitive regulations, continuous monitoring of state level hookah related policies and prevalence of use could help explicate 'what works' within the US context at the state level, " Weitzman said. "Such monitoring can help guide the development, implementation and evaluation of evidence-based targeted interventions for the prevention of hookah use that are responsive to the state level policy and regulatory context."

In future studies, the researchers hope to determine the associations between usage rates and state policies that regulate the age a person has to be to buy hookah tobacco.