Study: Hookahs Hook Teens on Tobacco

Teens who smoke tobacco through water in hookahs or use a trendy Swedish form of snuff called "snus" (rhymes with loose) are at higher risk of taking up cigarette smoking, according to a new study in JAMA Pediatrics.

Hookahs have already been shown to deliver toxic substances like benzene, posing a direct threat to the health of users. But the new study by researchers at the Geisel School of Medicine at Dartmouth College, Lebanon, NH shows using the devices is associated with a greater likelihood the user will switch to cigarettes.

In a study that included 2,541 individuals, 1,596 completed surveys at both the start of the study and at a 2-year follow-up.

Of those 1,048 (65.7%) surveyed at the start of the study said they had never smoked cigarettes though 71 respondents said they had smoked water pipe tobacco and 20 had used snus.

But two years later 39% of the non-smokers who used the water pipes had started smoking cigarettes compared to 19.9 % of the respondents who had not used hookahs.

In addition, 25 percent of the baseline non-cigarette smokers who also used snus at baseline were current cigarette smokers at follow-up compared with 5 percent of those who had not used snus..

The odds of initiating cigarette smoking, being a current smoker at follow-up or smoking more cigarettes a day were higher for those who had smoked a hooked or used the Swedish snuff, said lead researcher Samir Soneji PhD.

The researchers said their findings point to the need for the US Food and Drug Administration (FDA) to take a greater role in regulating the use of alternative tobacco products.

The FDA does not regulate the manufacturing, distribution and marketing of water pipe tobacco , and that permits manufactures to pitch their products are to teenagers and young adults. The marketing campaigns stress flavors designed to appeal to younger people, the authors wrote.