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Hookah Use among California’s Educated Rises despite State Anti-Smoking Efforts

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California has some of the toughest anti-smoking laws in the country and has led the nation on banning public and workplace smoking, tobacco education and cessation programs. This two-decade effort has paid off, state officials say.

California has seen a decline in cigarette smoking across all demographic groups, down 38 percent from 1990 and women consistently continue to smoke less than men, according to a 2010 Public Health report.

The report says Californians buy roughly half the number of cigarettes as residents of other states. From 2005 to 2008, 9 percent fewer packs of cigarettes were sold in the state.

But according to new research from University of California San Diego (UCSD) Californians may be trading one habit for another.

UCSD School of Medicine researchers say between 2005-08, hookah use among California adults rose 40 percent. Use among the college crowd, those aged 18-24, was even higher.

Researchers say the increased popularity of the hookah -- a water pipe used for smoking tobacco -- “may be caused by the social nature of the behavior coupled with the misguided belief that it is less harmful than cigarettes,” according to the study published early online in American Journal of Public Health.

Wael Al-Delaimy, MD, PhD is associate professor and chief of the Division of Global Health in the UCSD Department of Family and Preventive Medicine. He says the rise in hookah use is particularly alarming, precisely because of the state’s anti-tobacco leadership role.

Hookah lounges have sprung up across the California in the past decade. “Though public indoor cigarette smoking is banned throughout California, hookah use is permitted in designated lounges. This may create the impression that hookah is a safer alternative to cigarettes, which is simply not true,” Al-Delaimy, who led the research, said in a written statement.

The Centers for Disease Control and Prevention (CDC) says hookah smokers are at risk for the same kinds of diseases as are caused by cigarette smoking, including oral cancers, lung cancer, stomach cancer, esophageal cancer, reduced lung function, and decreased fertility.

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