It's a beautiful evening and you're puffing smoke rings with your friends, but while the fruit punch taste you inhale may be sweet and relaxing, officials say it comes with the cloudy possibility of future illness.
Hookahs are single or multiple stemmed water pipes used to smoke tobacco. They continue to be a popular fixture around the UA campus. But health officials say many students remain ignorant of the ill health effects of shisha, the flavored tobacco smoked in hookahs.
A May report issued by the Journal of Adolescent Health said hookah use is growing among college students, despite growing consensus that it may be as dangerous as cigarettes.
Hirbod Jalili, a Pima Community College computer sciences student from Iran, said he grew up smoking hookah, starting at age 14. In Iran, ""there's no age for it, anyone can do it. It's a tradition,"" he said.
Usually families and friends smoke together as a relaxing hobby, Jalili said. Tea and dates are often served along with the hookah as complementary items.
Hacène Chaouch, an optical engineering graduate student from Algeria, said, ""We know it's harmful and it's not the reason we get together, but it's something to do when we are together. It's social.""
Local café Espresso Art, 944 E. University Blvd., offers hookah smoking starting from noon outside and 6 p.m. inside until closing at midnight each evening. Owner Danny Mannheim said he enjoys offering an international feel to his café. Mannheim said his café is usually filled with students, professors, Middle Easterners, among others, who choose between 20 shisha flavors, including peach, mint and grape.
A hookah session generally lasts 45 to 80 minutes, depending on how many people are sharing the pipe, how often they inhale and how good the smokers are at tending the coals.
Because the sessions last longer than a typical cigarette break, users are exposed to more smoke. During a one-hour hookah session, smokers may inhale a volume of smoke comparable to consuming the volume of 100 to 200 cigarettes, according to the Centers for Disease Control and Prevention's Web site.
The CDC states that hookah smokers face the same risk of harmful health effects as cigarette smokers. Oral cancer, lung cancer, reduced pulmonary function, heart disease and decreased fertility are some of the hazards due to shisha smoking. Other dangers include infectious diseases transmitted from pipe sharing such as herpes, hepatitis and tuberculosis.
A common misconception is that the toxins in the tobacco are minimized due to the smoke passing through water, said Michael Cameron, clinical manager for Arizona Smoker's Helpline. He said that even after it has passed through water, the smoke produced by a hookah contains high levels of toxic compounds, including carbon monoxide, heavy metals and cancer-causing chemicals. Hookah smoking delivers the addictive drug nicotine in at least as much toxicity as cigarette smoke.
""The biggest problem is that additives, such as orange peel and rose petal fragrances, obscure the harshness of the smoke, so people don't realize as easily that they are inhaling toxins and nicotine,"" Cameron said.
The National Institute on Drug Abuse said in its May Director's Report the addictive profile of hookah compared to cigarettes is largely un-researched. However, the institute has called for further research in this area as the number of hookah smokers is surpassing the information available about its risks.
""There is no safe form of tobacco,"" said professor Scott Leischow, the associate director for behavioral and social sciences research at the Arizona Cancer Center. ""As long as you are digesting tobacco, you are digesting something addictive that has carcinogens that can cause cancer.""
When asked why he smoked hookah, Bobbie Womack, a marketing sophomore, laughed and said, ""They don't let you smoke weed in public."" He smokes when he and his friends come together in the evening. ""You don't see it deteriorating your body, you just see people coming together.""