If you casually dabble with hookah, however, you might not bat an eye at an hour-long smoking session. New research shows lots of young people don't know that 100 cigarettes and an hour of hookah are about equal in terms of the amount of smoke inhaled -- and therefore in the damage they can cause to a person's health, including increased risk for heart disease, cancers, stroke, blood clots and death, to name a few.
A 2005 report by the World Health Organization found that hookah smokers typically take 50-200 puffs during an hour-long smoking session, while people take an average of 8-12 puffs per cigarette. Factoring in the differing amounts of smoke inhaled per method, the organization wrote, a 60-minute water pipe session may be the same as smoking 100 cigarettes or more.
Yikes. If the parallel is surprising to you, you're not alone. A study just published in the journal Health Education & Behavior found that many young adults believe smoking hookah and cigarette alternatives is a less risky behavior than smoking cigarettes. Researchers analyzed data from 2,871 smoking and non-smoking millennials, roughly 25 percent of whom said they believe hookah is safer than cigarettes. Once again, this is false.
Americans are smoking standard cigarettes at a lower rate than ever before. This is good news. Still, the message that smoking is bad has clearly not effectively carried over to all nicotine-based products. Earlier this year, the Centers for Disease Control and Prevention reported that for the first time, hookah and e-cigarette use is more popular among young people than traditional cigarettes, and the more recent study showed 62 percent of young adults believe e-cigarettes are less harmful than standard cigarettes.
"This might be associated with differences in advertising messages these groups are exposed to, the variety of flavors these different products are offered in, and in the case of e-cigarettes, possibly an inclination for younger people to attribute more positive feelings toward newer products that are seen as new and 'techy,'" said the study's authors, Olivia A. Wackowski and Cristine D. Delnevo of the Rutgers School of Public Health, in a press release.
For now, there's an ashtray's worth of contradicting information about e-cigarettes. Electronic cigarettes may be less hazardous than cigarettes because they release vapor instead of smoke, and they don't burn. Some experts argue that they are safer -- though not "safe" -- and can help smokers eventually quit their smoking habit altogether. But a recent study revealed that e-cigs can also be a catalyst for conventional smoking: they're a gateway drug.
While the safety of e-cigarettes continues to be explored, anyone considering picking up the habit should know that they won't be doing themselves any favors. The same goes for smoking hookah: Both hookah and e-cigs can be addictive, and both transfer cancer-causing chemicals into the mouth and lungs of a smoker.
CORRECTION: A previous version of this post listed only the high end of the range of puffs taken by the average hookah smoker, according to the study. It has been updated to include the full range of 50-200 puffs per hour.
Also on HuffPost: