Hubble Bubble Trouble: The Need for Education about and Regulation of Hookah Smoking

Abstract

A Middle Eastern tradition, hookah smoking involves burning flavored tobacco heated by charcoal, creating smoke that is filtered through water and ingested through the mouth using a hose. Hookah lounges are increasingly locating around college campuses in the United States, and websites offering hookah paraphernalia target U.S. high school and college students. In two studies involving interviews with college-age hookah smokers and analysis of website marketing practices, the authors investigate consumer beliefs and attitudes toward hookah smoking and the way it is portrayed online. The findings indicate that it is a social phenomenon, with young people introducing peers to the practice and websites promoting shared consumption experiences. Contrary to medical evidence, young people believe smoking sweetened tobacco through a hookah is nonaddictive and safer than cigarettes. Hookah lounges often are exempt from age restriction laws because many double as cafés and other eating establishments. Traditional tobacco warnings are not present in lounges or on websites. The findings highlight potential health dangers of hookah smoking and the need for education regarding this practice and demonstrate that regulatory oversight is needed.