The 2005 study found that more than 80 percent of youths, aged between 13 and 15, who are current smokers use the nargileh water pipe, towards which parents tend to tolerate more than cigarette smoking.

According to the American Lung Association, more than 90% of beginning hookah smokers think cigarette smoking is more addictive.

"The increasing trend of nargileh use among young people is alarming, and rapid action is needed," said Dr. Rima Afifi-Soweid, who conducted the study in collaboration with researchers at the WHO.

According to Dr. Afifi-Soweid, kids who promise their parents that they will not smoke are much more likely to fulfill their commitment than those who do not.

"That's an easy and cheap intervention we could encourage," she said at a recent symposium on smoking held at Issam Fares Hall.

Waterpipe use may increase exposure to carcinogens because smokers use a waterpipe over a much longer period of time, often 40 to 45 minutes, rather than the 5 to 10 minutes it takes to smoke a cigarette. Due to the longer, more sustained period of inhalation and exposure, a waterpipe smoker may inhale as much smoke as consuming 100 or more cigarettes during a single session. A study of hookah smokers found that nicotine and cotinine increased up to 250% and 120% respectively after a typical 40 to 45 minute smoking session.

Panelists at the symposium concurred that the best way to fight the "smoking epidemic" is by improving anti-smoking policies, incorporating smoking cessation courses into medical and nursing schools and ensuring the implementation of the Framework Convention on Tobacco Control, an international WHO-drafted treaty that was signed and ratified by almost 150 countries.

Lebanon, which has ratified the treaty in 2005, has yet to implement it.

Studies provide compelling initial data which suggest that waterpipe smoke is at least as toxic as cigarette smoke. Existing research into the direct and singular effects of waterpipe smoking is complicated by the fact that many waterpipe users also smoke cigarettes.

Another potential problem is that commonly used heat sources that are applied to burn the tobacco, such as wood cinders or charcoal, are likely to increase the health risks from waterpipe use because when burned on their own these heat sources release high levels of potentially dangerous chemicals, including carbon monoxide and metals.

Dr. Nadim Kanj, a pulmonary specialist, noted that more than two million people are killed every year in the developing world because of tobacco-related illness. He said that number is expected to increase to seven million by 2030 while the total number of tobacco-related deaths is expected to shoot to 10 million by 2030.

A study of mostly Arab-American teens in Michigan found the odds of a teen experimenting with cigarettes were more than 8 times greater if they had “ever smoked” a waterpipe. Also, although
limited research has been done in this area, the secondhand smoke from a waterpipe is potentially dangerous because it contains smoke from the tobacco itself as well as the smoke from the heat source used to burn the tobacco.

Source: American Lung Association, Naharnet