In New York City, the number of establishments serving hookah in 2017 — nearly 400, according to Yelp — was more than four times higher than in 2012. They are often concentrated in neighborhoods popular with youth and young adults, including the Lower East Side, East Village and Inwood.
Young people (ages 18 to 20) in NYC are three times more likely to smoke a hookah than those who are 21 and older. This may be because they underestimate the health risks of smoking hookah and are unaware that they are inhaling harmful smoke when they visit a hookah-serving establishment.
Between 2008 and 2016, the percentage of middle school students in NYC who had smoked hookah increased from 2.9% to 5.6%. The percentage of high school students who have smoked hookah is now 16.4%. This is particularly troubling because some studies suggest that young people who smoke hookah may be more likely to try cigarettes.
A hookah, or water pipe, uses burning charcoal to heat shisha, a flavored blend of herbal substances. Tobacco is a popular and common ingredient in shisha, but some shisha is tobacco-free. There is no type of shisha — with or without tobacco — that is a healthy alternative to cigarettes.
Hookah smokers and those around them are exposed to toxic chemicals in hookah smoke. These toxic chemicals come from two different sources: the charcoal that is burned to heat the shisha and the shisha itself. Many of these chemicals (PDF), such as carbon monoxide, tar and formaldehyde, are also found in cigarette smoke. When shisha contains tobacco, the smoke also contains nicotine, which is addictive. Water does not effectively filter out unhealthy chemicals from hookah smoke.
The chemicals in hookah smoke can increase your risk of:
New NYC laws about hookah went into effect in 2018. Retail stores and other establishments are banned from selling or serving shisha to people younger than 21. People younger than 21 are not permitted to enter hookah-serving establishments.
It is now required for all hookah-serving establishments to have a permit, only serve non-tobacco shisha, and display warning signs about the health risks of hookah smoke. After October 22, 2018, no new permit applications will be accepted.
If you have a Non-Tobacco Hookah Establishment permit, see below for additional guidance on how to comply with the law: