Smoking from a hookah pipe is in favor with younger people as an alternative to smoking cigarettes, which is on the decline in younger generations.

A new study conducted at the New York University Langone Medical Center and published online in Pediatrics, the official journal of the American Academy of Pediatrics, attempts to determine the reasons for the increasing popularity of hookah use among adolescents.

The report, entitled "Hookah Use Among High School Seniors," analyzes data culled from questionnaires given to 5,540 high school seniors in the years 2010-2012.

In the past year, it was found that 18 percent of students reported hookah use. The numbers revealed that white and Hispanic students were more likely than black students to take up the practice, according to the report.

Contrary to the researchers' initial assumptions, students coming from a higher socioeconomic status or with a greater personal weekly income were more likely to use hookahs. High parental education levels also increased the odds that their children would use hookahs.

High-risk groups for hookah use included male and urban students, users of alcohol, marijuana and other illicit substances, former cigarette smokers and current smokers. The latter group carried the highest risk levels.

A hookah -- also called a water pipe, narghile, shisha, hubble-bubble and goza -- is considered an alternative delivery system for using tobacco products that dates back to the 16th century and was invented, depending on who you ask, in either India or Persia. A hookah is an instrument with single or multiple pipes that vaporizes a flavored tobacco called shisha under charcoal. The smoke generated by the burning tobacco then passes though a water basin. The smoke is filtered through the water and inhaled through the attached waterpipes.

Hookahs are popular for several reasons. Using one is a social hobby, as users often congregate at hookah lounges and share a hookah through the multiple inhalation pipes attached to the base. This also gives the practice an exotic or cool aura.

It is also thought to be safer than smoking cigarettes, and at present there are few legal challenges to using hookahs. It is no coincidence that as cigarette smoking in public places has largely been banned, hookah use has picked up the slack.

The problem with hookahs, though, is that their use presents in many ways a greater health risk than cigarettes. Research has indicated that hookahs emit tar, nicotine and carbon monoxide in higher doses than do cigarettes. Hookah use has now been connected to lung cancer, respiratory illness, periodontal diseases, low birth weight and a plethora of other serious medical issues.

Hookah use also tends to last longer per session than the average cigarette-smoking pattern. An average hookah session can represent the equivalent health risk of smoking 20 cigarettes or more.

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