Hookah
A young girl smokes hookah with her brother in Islamabad May 8, 2014 Reuters

Hookah, the only form of tobacco that is not regulated, is believed to be a substitute to cigarettes for many young adults in the United States, identified studies. The study is published in Nursing Research.

Hookah is being marketed heavily and is exempt from legislations leading to clean indoor air, like California Clean Air Act. More than 2,000 shops were found in California which sold hookah and its related products. Also, 175 hookah cafes were found which seemed to be located near universities and colleges in Los Angeles.

Mark Rezk-Hanna, lead researcher for the study from UCLA, said, "The goal was to identify factors influencing perceptions, attitudes and preferences toward hookah smoking, adding that there was an urgent importance of more research and campaigns to increase public knowledge on the dangers of hookah smoking, especially among young adults."

As a part of the research, Rezk-Hanna and his team visited three hookah lounges and interacted with young adults between 18 and 30 years and asked them if they believe that hookah smoking could harm their health. About 57 per cent of them replied in the negative, saying that they thought that it wasn't harmful.

On further interaction with them why they thought that it was not harmful, 47 per cent of them said that the smoke is filtered out through the water. About 35 per cent believed that the fruit flavour used detoxifies the harmful chemicals present in tobacco. Sixteen per cent assumed that since hookah contains tobacco which is not addictive and has no nicotine, hookahs cannot be deemed harmful. On questions of attractiveness of hookah over cigarettes, 60 per cent said it was a way of socialising.

The youngsters seemed to take to hookah smoking because they felt it wasn't dangerous to their health and can be a perfect replacement for cigarettes.