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Pipe Dreams: Hookah smoking is cool, but is it safe?

Meridian Hookah Lounge
Florida has dozens of hookah bars in the state’s bigger cities and college towns — including this Meridian Hookah Lounge in Oviedo, near the University of Central Florida. A recent Florida Youth Tobacco Survey found “alarmingly high” rates of hookah use among Florida adolescents. [Photo: Brook Pifer]

On a recent night out in Tampa, 26-year-old Tara Wasserman and a handful of her friends nestle into a dark, plush booth at her favorite hookah hangout, the Meridian Hookah Lounge. For $12 apiece, Wasserman and her friends can sample a variety of sweet tobaccos, smoked through the water pipe at the center of the booth, and stay until the lounge closes at 3 a.m.

The specially cured “shisha” tobaccos come in flavors like guava, strawberry and coconut. Wasserman and friends choose a blend, and servers place a sticky lump of shredded tobacco into a small bowl that’s connected by a stem to the pipe’s water-filled glass base. A piece of foil is placed atop the tobacco, and atop the foil goes a hot coal that heats, but does not ignite, the tobacco. Hoses, each attached to the stem of the hookah, snake across the table.

Smoking a hookah — also known as a “narghile” or “hubble-bubble” — involves drawing tobacco smoke through water in a glass-filled base. A loophole in Florida’s 2003 ban on indoor smoking enables hookah bars to offer food along with hookahs. [Photo: Michael Heape]
Along with the tobacco, each smoker gets a plastic tip that she attaches to a hose; sucking on the hose pulls air past the coal and creates a sweet-tasting smoke that’s inhaled after it bubbles through the water. The silky smoke gives off a pleasant aroma similar to sweetened incense or potpourri.

Wasserman and her friends chit-chat about life and listen to music as they puff away, sometimes competing to see who can blow the best smoke rings. Like many hookah devotees, Wasserman, a teacher, is middle-class, mainstream — and wouldn’t touch a cigarette. She likes the “chill atmosphere” of the hookah lounge. The shisha tobacco, she says, “will give you just as much yummy nicotine as cigarettes, without the nasty taste and rat poison.”

A centuries-old Indian apparatus that spread to the Middle East, the hookah is a cousin of the water pipes and bongs often used to smoke marijuana. The beginning of the hookah bar trend in Florida appears to date to 1999: When Jason Bajalia opened the Casbah Cafe in Jacksonville’s upscale Avondale neighborhood, he incorporated hookahs and flavored tobaccos into his theme.

“We started off as just a little Middle Eastern cafe. We’d serve Turkish coffee and pastries and fresh fruit juice and hookahs,” says Bajalia. “It got pretty popular pretty quick and we evolved into a full-service restaurant with entertainment, belly dancing and Middle Eastern musicians, and it just kept growing from there.”

“Relative to a single cigarette (about 500 milliliters of smoke), a single water pipe use episode (about 90,000 milliliters) is associated with 1.7 times the nicotine, 6.5 times the CO, and 46.4 times the tar.”

— “Waterpipe Tobacco Smoking: An Emerging Health Crisis in the United States,”
American Journal of Health Behavior, 2010

Today, Florida has dozens of hookah lounges where anyone over 18 can join in the hookah smoking. Most are in larger cities like Tampa, Orlando, Miami and Jacksonville or near college campuses. There are at least eight hookah bars or restaurants in Gainesville near the University of Florida, and at least two in Tallahassee near Florida State.

While the typical college student-oriented lounge features plush couches, dim lighting and free wi-fi, a more authentic Middle Eastern hookah experience is available at places like Al-Aqsa in Tampa. Attached to a Middle Eastern grocery, the sparsely decorated cafe attracts a mostly Muslim crowd that gathers under fluorescent lights to play cards or watch TV and smoke.

Bajalia says hookah smoking has grown decidedly more mainstream. When he opened the Casbah Cafe 11 years ago, most of his customers were Middle Easterners or “military guys” from the nearby naval air station who had developed a taste for shisha while serving in Iraq and Afghanistan. Today, he says, Casbah attracts people from all walks of life and all age groups. “We have symphony-goers sitting next to Middle Easterners sitting next to a local Jacksonville family.”

How trendy have hookahs become? The Ritz-Carlton on South Beach hosts a “Hookah Lounge Happy Hour” each Thursday and Friday night at its swanky DiLido Beach Club. In Fort Lauderdale, the Hookah Express will deliver a hookah directly to your home, condo, pool or beach. The company’s “rent-a-hookah” service includes two bowls of tobacco and costs $20.

Hookah Smokers
Anyone 18 or older is allowed into most hookah bars. Smokers typically pay $10 to $30, which includes tobacco, a plastic tip for the hose and use of the pipe. It costs hookah bar owners “less than $1 to make a bowl” of tobacco, says Brennan Appel, director of the online hookah store SouthSmoke.com. [Photo: Michael Heape]

Aiding the hookah trend is a loophole in the state’s 2003 law than bans indoor smoking. The law defines smoking as “inhaling, exhaling, burning, carrying or possessing any lighted tobacco product.” With hookahs, however, the tobacco is merely heated by the coal — it’s never technically on fire. And so hookah bar operators can serve hookah and chicken kebab side by side, an act that would be illegal if their patrons were smoking cigarettes or cigars instead.

Perhaps the biggest factor working in favor of hookahs is their cachet — the perception by fans like Wasserman that smoking flavored tobacco lacks the stigma that cigarettes carry and that the practice of smoking it is a milder experience, and therefore safer, than cigarette smoking.

Twenty-year-old Amber Gordon from Tampa describes hookah smoking as “really smooth. It’s not harsh. It’s not anything comparable to a cigarette. There’s no bad aftertaste. There’s no bad smell on your breath. Honestly, it’s like smoking candy.”

Smoke rings

The most recent Florida Youth Tobacco Survey, which tracks smoking among public middle and high school students in Florida, found “alarmingly high” rates of hookah use among Florida adolescents, with rates among high school students approaching figures reported by samples of university students. In 2007, only 9.3% of female high school students and 12.3% of male high school students had ever tried hookah smoking. By 2009, 14.2% of high school girls and 17.3% of high school boys had smoked tobacco through a water pipe at least once.

Meanwhile, research indicates hookah smoking is likely every bit as dangerous as cigarettes. Studies, including a 2005 report published in the journal Food and Chemical Toxicology, have found that a single hookah smoking session delivers up to four times the nicotine, 11 times the amount of carbon monoxide and 72 times the tar of a single cigarette.

Wasim Maziak, an associate professor at the University of Memphis’ School of Public Health who received a grant from the National Institutes of Health to study what he calls the hookah “epidemic,” says hookahs are a far more insidious threat than cigarettes. “Unlike cigarette smoke, which is hot, the hookah smoke is usually a lower temperature because it is cooled as it passes through the water. It’s not hot, so it’s less irritating. It’s smooth and it’s also, with the flavor of the fruit, it gives that misperception of being lighter smoke.”

The idea that the water is filtering out any toxins is a myth, says Tracey Barnett, an assistant professor at the University of Florida’s Department of Behavioral Science and Community Health who has studied the hookah-smoking trend. “Again, that’s pretty naive,” says Barnett. “Cigarettes have filters too, but we know you can’t filter out all the toxins associated with it.”

Barnett says the fact that it’s the charcoal that is burning — not the tobacco — only adds to the danger. In fact, she says, the burning charcoal is actually “more harmful” and emits “a lot more carbon monoxide” than the tobacco. “You aren’t allowed to barbecue inside with charcoal because the carbon monoxide rate inside your apartment would just go through the roof. Well, the thing that’s sitting atop all those hookahs is a little piece of charcoal, and the carbon monoxide they’re giving off, including secondary, are really high levels,” says Barnett.

Meridian Hookah Lounge
Owner Marc Karimi of the Meridian Hookah Lounge in Oviedo (above) calls hookah cafes “the new coffee shop.” Owners say federal legislation that would raise the tax on hookah tobacco by 775% would put them out of business. [Photo: Brook Pifer]

Hookah business owners like Marc Karimi, of Meridian Hookah Lounge in Tampa and Oviedo, respond that the hazards of hookah smoking are overblown and that much of the research to assess the health risks of hookah smoking is flawed. For instance, in some of the studies, the coal is placed directly onto the shisha, causing it to combust, rather than just smolder. “If it got to the point where it’s burning, not smoldering, nobody here would smoke that.”

Bajalia, however, says he’s in no position to say whether hookah smoking is any safer or riskier than smoking cigarettes. He says he made a decision five years ago to provide customers at Casbah Cafe with a warning card that explains the dangers of hookah smoking. “So many people don’t know what it is. They ask me, they’re looking at the little charcoals on top and ask me, ‘Is that what we’re smoking?’ A lot of people don’t have a clue. So we actually say, ‘Hey this is a tobacco product. You are smoking. We believe this contains the same risks as smoking.’ ”

Hookah opposition

While hookah bars have gained wide acceptance in many areas of Florida, some communities and landlords aren’t so welcoming. Bajalia says that when he looked into opening a hookah cafe in St. Augustine several years ago, the city council told him not to bother. “They said, ‘Absolutely not. We’ll shut you down.’ ” In Tampa, some strip malls near the University of South Florida have posted signs stating that smoke shops or smoke lounges need not apply to lease space.

Hookah Smoking Among Florida High Schoolers
Smokers 2007 2008 2009
Non-Hispanic whites 13.0% 17.4% 20.3%
Non-Hispanic blacks 3.4 3.4 4.9
Hispanic 11.8 14.5 16.1
Other 18.0 15.6 18.4
Females 9.3 12.5 14.2
Males 12.3 14.4 17.3
Source: Florida Youth Tobacco Survey, Florida Department of Health

Earlier this year, Soloman Wassef encountered significant opposition from the city council when he tried to obtain a beer and wine license for the hookah lounge he planned to open in downtown Lakeland. Even the former mayor showed up at a commission meeting to protest the establishment. While the commission ultimately approved Wassef’s plan to open the Hookah Palace, it was with one caveat: Only those who are 21 years and older can enter.

Lakeland City Commissioner Justin Troller, an American government teacher and wrestling coach at Lakeland Senior High School, is no fan of underage smoking but says city officials can’t deny licenses to people who want to operate legal businesses. Morever, he says he’s hoping that the Hookah Palace might help to “bring a diverse crowd” to the downtown that the city has spent millions renovating. “Here’s an opportunity to bring something new and different.”

But Howard Wiggs, one of the city commissioners who opposed the Hookah Palace, says he believes his colleagues made a mistake. While the city didn’t have any sort of mechanism to veto the hookah bar on the basis of the smoking issue, Wiggs says they could have chosen not to permit an additional bar to come into the downtown. “Approval of this bar sent an inappropriate message. The American Cancer Society has thoroughly evaluated this form of tobacco and it is harmful.”

“It’s really smooth. It’s not harsh. It’s not anything comparable to a cigarette. There’s no bad aftertaste. There’s no bad smell on your breath. Honestly, it’s like smoking candy.”

— Amber Gordon, 20, Tampa

In addition to a backlash from health experts and landlords, hookah bars also face tax issues. Eight years ago, soon after the advent of the hookah craze, the tax rate on tobacco in Florida was 25% of the wholesale price. Today it’s at 85%. The hookah industry, meanwhile, is keeping a close eye on federal legislation, H.R. 4439, which would raise the tax on hookah tobacco by 775%. The “Tobacco Tax Parity Act of 2010” is intended to bring tax rates on pipe tobacco, which includes hookahs, in line with the higher rates imposed on rolled tobacco. But hookah proprietors say that a 250-gram (8.75 ounce) box of hookah tobacco that currently retails for $5.99 would cost more than $20 if this bill passes, which could put them out of business.

Manny Franco, general manager of the Blue Lizard Hookah Lounge near USF in Tampa, says such a tax increase would make it impossible to eke a profit out of the hubble-bubble. If that happens, he says he plans to offer only herbal hookah, a nicotine-free product made from tea leaves.

With that, Franco packs a bowl with strawberry/lemonade-flavored, herbal hookah and ignites a coal. “The hookah, I think is kind of secondary,” he says. “People come here to socialize.”

More Than Pipe Dreams

Jason Bajalia, who included hookah smoking when he opened the Casbah Cafe in Jacksonville 11 years ago, says he knew he was on to something when patrons began offering him $400 to $500 to buy hookah pipes he’d purchased from Egypt for just $10. Today, he says, business is still going strong, with between 120 and 130 hookah sessions each day. While 50% of his sales come from food, hookahs and alcohol each make up another 25%.

Brennan Appel, director of the online hookah store SouthSmoke.com, sells hookahs and hookah supplies to Bajalia and dozens of cafes around the country. He says the typical hookah cafe can make a killing. “It’s costing them less than $1 to make a bowl, and they’re charging $15 to $30. The rest of cost is labor to clean the hookah up. If you have a place that services 100 hookahs a day and they charge $20, that’s $2,000 a day.”

Pipe Dreams
[Photo: Michael Heape]