By Allegra Tepper

Giselle* ’11 sits with her sister and mother at the dinner table.  Outside the window to her sister’s apartment are the crowded streets of a Middle Eastern city, where, according to Giselle, hookahs are an inescapable fixture.  Her mother passes her the hose and she takes another puff; it’s customary to gather round the three foot tall ornate contraption before moving on to dessert.

When Giselle returns home, there’s no longer a hookah, or a single or multi-stemmed water pipe used for smoking shisha tobacco, standing between her and apple pie after dinner.  In fact, Giselle reserves the pipe solely for her days abroad, but can’t say the same goes for her peers.

“Right now, the cool thing is having a hookah,” Giselle said. “It used to feel like I had chain-smokers all around me, but people are cutting down on cigarettes because it’s no longer trendy.”

Today, the party surrounds the pipe.

What teenagers don’t know is that if that party goes on for too long, serious health risks may arise.  Giselle believes, along with most of her peers, that smoking from a hookah is the answer to the nicotine addiction.  The hookah apparatus consists of a base that is filled with water, a bowl, a heating device that contains the tobacco and other products, a pipe that connects the bowl to the base and a hose that is attached to the base to allow the smoke to be inhaled.  That smoke, according to the World Health Organization, exposes the individual to high levels of toxic compounds including carbon monoxide, heavy metals and cancer-causing chemicals as well as significant levels of nicotine. 

According to Jameel Hourani, a pulmonologist at Cedars-Sinai Medical Center in Los Angeles, the smoke inhaled in a single 60-minute hookah session amounts to 100-200 times the smoke from a cigarette; that single session is believed to be as harmful as a pack of cigarettes a day. One in five deaths in the United States is due to tobacco use according to the American Cancer Society, which includes cigarettes, cigars and water pipes. A study by the ACS showed that 50 percent of high school students had smoked tobacco in any of various apparatuses, and in 2008, more than a quarter of adolescents age 12 and older were regular tobacco smokers. That comes out to roughly 71 million American teens.

“How you’re smoking the tobacco doesn’t make a difference,” Cedars-Sinai pulmonologist Warren Roston said.  “The addiction is stemming from the nicotine, and that’s still entering your body.  While there are carcinogens in the paper that are being eliminated, they still exist in the tobacco.”

The tar intake from a 45-minute hookah session is 36 times that from smoking a cigarette for five minutes, Hourani said. 

“A leisurely hour of puffing on a hookah produces the same carbon monoxide as smoking a pack of cigarettes a day,” Hourani said.

For Giselle and her friends, it might be time to think twice before passing the hose. According to a study in the Journal of Periodontology, water pipes smokers were five times more likely than non-smokers to show signs of gum disease. The American University in Cairo discovered in 2005 that 17 percent of cases of Tuberculosis in the eastern Mediterranean were due to smoking hookah.

Phoebe ’11 owns a hookah, and smokes with pals “as much as she can,” usually on a weekly basis.  She’s quick to acknowledge the health effects, but despite her awareness, has no plans of breaking the habit.

“I do it regardless of whether or not it’s ‘hip,’” Phoebe said.  “I do it because it provides a fun, social setting, and because of the health risks, I can’t understand why anyone would do it to be hip.  But I still see 8th and 9th graders doing it all the time, because that’s exactly what they think.” 

Giselle agrees that smoking hookah has enhanced the social smoking that once revolved around a pack of Marlboros.

“Cigarettes used to be the social thing, but with hookah, it’s about relating to people, having a conversation while you share it,” Giselle said.  “It’s not obnoxious to ask for a hit from a hookah like it is when you ask for a cigarette.  It creates that social atmosphere.”

You’ll likely find Phoebe at Habibi Cafe and Lounge located in Westwood, which Giselle says is the hookah mecca of Los Angeles, smoking a pipe of her favorite flavor of shisha, vanilla mint.  Westwood has abundant hookah bars and tobacco shops that Phoebe says provide an unparalleled atmosphere for the practice of Indian origin. 

“We have a large Persian population in this area, and I think that played a part in hookah’s growing popularity,” Hourani said. Giselle agreed that adolescents are curious about the cultural aspects of the practice, and that the mystery of Middle Eastern traditions exceed the appeal of the American cigarette icons.

Congeniality or not, the greatest appeal may be that IDs are a non-issue at local hookah bars, making the age limit of 18 an easy obstacle to conquer for adolescents as young as the eighth grade.

Smoking a hookah typically costs $10 to $15 at a cafe, and Phoebe says that she uses a fake ID to purchase the tobacco for her own hookah at CVS pharmacies, where three ounces of tobacco cost less than $6.

“You can’t be addicted to hookah like you can be addicted to cigarettes,” Giselle said. “You don’t see kids running down Halkirk smoking a hookah and trying to catch the bus.”  Despite the lack of mobility of a two-foot tall water pipe, hookahs are just as addictive if not more addictive that cigarettes.

“Cigarettes are addictive because of the nicotine, and that doesn’t change with a hookah,” Roston said. 

However, Hourani believes that until the press gives hookah dangers even a portion of the attention that it has given cigarette health implications, adolescents won’t understand the consequences of their smoke sessions.  And while students have observed the aftermath of cigarette addiction in for their parents and grandparents, the mystery of the hookah keeps both teens and their parents oblivious to the health risks.

“If my mom found me with cigarettes, I’d be living in a box off the 405 freeway,” Giselle said. “But if she found me with a hookah, she wouldn’t mind at all.”

*names have been changed