Hookah use among California youths ages 18 to 24 is rising rapidly, according to a study published in the American Journal of Public Health. The study’s authors say the increased popularity of the hookah—a water pipe used for smoking tobacco—may be caused by the social nature of the behavior coupled with the misguided belief that it is less harmful than cigarettes.

“This rise is particularly alarming because it’s happening in California, a state that leads the nation in tobacco control,” said Wael Al-Delaimy, MD, PhD, associate professor and chief of the global health division at the University of California, San Diego School of Medicine. “While cigarette smoking has decreased nationwide and in California, reports of ever using hookah have increased, especially among adolescent and young adults.”

Most users report smoking hookah with many friends, according to Al-Delaimy. “Though public indoor cigarette smoking is banned throughout California, hookah use is permitted in designated lounges. This may create the impression that hookah is a safer alternative to cigarettes, which is simply not true.”

Using data from the state-wide California Tobacco Surveys, the researchers found that from 2005 to 2008 hookah use among all adults increased by more than 40%. In addition, by 2008, hookah use in California was much higher among young adults—24.5% among men, 10% among women—than it was among all adults—11.2% among men, 2.8% among women.

The research team also found that hookah smoking among men and women was more common among non-Hispanic Whites, with at least some college education. Unlike cigarette smoking—where those with higher education smoke less—hookah use is higher among those who are more educated.

Source: University of California, San Diego Health Sciences