While cigarette use is declining precipitously among youth, evidence indicates that American adolescents are turning to ethnically-linked alternative tobacco products, such as hookahs, cigars, and various smokeless tobacco products, according to a report from the Centers for Disease Control and Prevention (CDC).
Researchers found that one in five high school seniors has smoked from a hookah and those of higher socioeconomic status are more likely to use it.
The study, by researchers affiliated with New York University's Center for Drug Use and HIV Research (CDUHR), used data from Monitoring the Future (MTF), an ongoing annual study of the behaviours, attitudes, and values of American secondary school students.
This study examined data from the 5,540 students who were asked about Hookah use from 2010-2012. The researchers found the annual prevalence (use in the last 12 months) of hookah use was nearly 1 in 5 high school seniors.
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"What we find most interesting is that students of higher socioeconomic status appear to be more likely to use hookah," said Joseph J Palamar, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC).
Hookah, an ancient form of smoking, in which charcoal-heated tobacco or non-tobacco based shisha smoke is passed through water before inhalation, is rapidly gaining popularity among adolescents in the US.
The researchers found those students who smoked cigarettes, and those who had ever used alcohol, marijuana or other illicit substances were more likely to use hookah.
"Cigarette use has decreased by 33 per cent in the past decade in the US, while the use of alternative tobacco products such as hookahs has increased an alarming 123 per cent.
"This is especially worrisome given the public misperception that hookahs are a safe alternative to cigarettes whereas evidence suggests that they are even more damaging to health than are cigarettes," he said.
The study is published in the journal Pediatrics.