A Libyan man smokes a hookah along the coast of the Sea of Benghazi.
A Libyan man smokes a hookah along the coast of the Sea of Benghazi. Photo by Reuters
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Cigarette smoking be a falling trend in the United States, but many teenagers are getting hooked on the Middle Eastern hookah pipe.

Almost one in five high school seniors have used the tobacco pipe, which draws smoke through a bowl of water, according to the Centers of Disease Control and Prevention report, which was published online in the journal Pediatrics on Monday. Hookahs are also known by the names nargila and shisha, among others.

"What we find most interesting is that students of higher socioeconomic status appear to be more likely to use hookah," Joseph J. Palamar, an assistant professor of Population Health at NYU Langone Medical Center, a lead author of the study, said.

"Surprisingly, students with more educated parents or higher personal income are at high risk for use. We also found that hookah use is more common in cities, especially big cities. So hookah use is much different from cigarette use, which is more common in non-urban areas."

The findings confirm previous research which found that students from higher socioeconomic backgrounds are more likely to use hookahs. White men, cigarette smokers, and people with experience of alcohol, marijuana and other illicit substances are also more likely to smoke them, according to the study/

Researchers used data from Monitoring the Future, a U.S.-wide study involving teenagers. The data sample included 5,540 high-school seniors between 2010 and 2012.

"Tobacco use and exposure to secondhand smoke are the leading preventable causes of morbidity and mortality in the U.S.," said a study co-author Michael Weitzman, a professor of Pediatrics and of Environmental Medicine at NYU.

"Cigarette use has decreased by 33% in the past decade in the U.S., while the use of alternative tobacco products such as hookahs has increased an alarming 123%. This is especially worrisome given the public misperception that hookahs are a safe alternative to cigarettes whereas evidence suggests that they are even more damaging to health than are cigarettes."