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.
In 2018, 0.8% of middle school students and 5.6% of high school students smoked hookah. While youth who smoke cigarettes are most likely to smoke hookah, the rate of hookah use among youth who never smoked cigarettes has increased in the past ten years. 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. No type of shisha — with or without tobacco — is a healthy alternative to cigarettes.
People smoking hookah 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:
Unlike smoking cigarettes, smoking hookah can also cause carbon monoxide poisoning.
Strict 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. Flavored hookah containing tobacco may not be sold within NYC except by tobacco bars registered with the health department.
People younger than 21 are not permitted to enter hookah-serving establishments.
It is now required for all hookah-serving establishments to have permits from the Health Department and the Fire Department. They may not serve shisha which contains tobacco and must display warning signs about the health risks of hookah smoke. No new permit applications are being accepted. Existing permit holders may now renew their Non-Tobacco Hookah Establishment Permit online. Only establishments with a current permit from the Health Department may allow hookah smoking inside their premises.
The Health Department provides warning signs to licensed non-tobacco hookah establishments. The signs must be clearly visible and posted at each entrance and in each room or area, indoor and outdoor, where smoking hookah is allowed.
The Smoke-Free Air Act requires licensed establishments to:
The Fire Department requires non-tobacco hookah establishments to: