Hookah: The legal high

As *Joseph inhaled, the explosive and sporadic life cycle of the bubble could be seen through the murky glass bowl. For 10 seconds, the living room was quiet except for the rumbling and clicking noise coming from the water pipe from which Joseph was inhaling, as he filled his lungs with smoke. When his lungs couldn't take any more, he put down the skinny black tube to which his mouth had been glued and exhaled. A puffy white cloud left his mouth, ending with some impressive, apple-scented smoke rings.

Joseph looked like the caterpillar from Alice in Wonderland as he sunk into his couch like a king. The night had only just begun.

Unlike some UB students, Joseph is smoking a legal plant - tobacco.

Joseph has been smoking hookah for four years. For him, it's not only a relaxing way to end the week - it's a part of his Lebanese culture. Shisha, as it's referred to in many Middle Eastern cultures, is a popular way to relax with friends and family. Recently, the trend of smoking hookah has crept into the American culture and many smokers don't know how dangerous it is.

Hookah is tobacco smoked out of a water pipe. Usually, the tobacco is flavored to give it a more appealing taste, according to Joseph. Flavors range from lemon mint - Joseph's favorite - to any combination of fruit.

In order to "make the perfect hookah," one needs a vase, centerpiece, a hose, a bowl, hookah tobacco, aluminum foil, a thumbtack, tongs, coal and an ashtray, according to Joseph.

Joseph starts the systematic ritual by filling the colored glass base with cold water from the sink. He attaches the centerpiece and makes sure it's sealed tightly. This enables the smoke to be filtered, which causes the clacking bubble noise.

Next, he starts to pack the hookah tobacco into the bowl. He starts out by dusting the tobacco around the edges and then the center - similar to the way a kid would decorate his ice cream with sprinkles. The bowl is packed to perfection when Joseph can smoothly run his finger across the top and not brush off any tobacco.

He then wraps the whole bowl in aluminum foil - shiny side up - the way his mom might wrap up a container of leftovers after a family dinner. Except, unlike his mom's leftovers, he uses the thumbtack to poke holes in the shiny metal. This will enable the tobacco to come out of the bowl smoothly.

Joseph stacks it all up: base, hose, bowl and ashtray. The tower is crowned with a piece of burning florescent orange charcoal.

After inhaling the tobacco from the water pipe, Joseph is overcome with a smooth laziness and a smile forms on his face.

He considers himself unique among his friends, as he prefers the mellow feel he gets from smoking hookah to the energized feel he gets from drinking alcohol.

"[Hookah] is so relaxing; everyone is just chilling out and talking and having fun," he said. "When you drink [alcohol], it's still fun, but it could lead to craziness. That never happens with hookah. You know how you watch a movie and there are people doing it, it's actually the same thing. And it's not illegal."

Just like alcohol, water pipe smoking has legal restrictions. Because it contains high amounts of tobacco, similar to cigarettes, it is illegal for anyone under the age of 18 to use. Eighteen percent of students at UB have smoked tobacco from a water pipe, or smoked hookah, according to the National Collegiate Health Survey conducted in 2010.

Sonia Eid, the manager of Mezza, a restaurant and hookah lounge on Elmwood Avenue, checks patrons' photo identification before selling hookah to them for $20. They take the age restrictions seriously, Eid said. She believes the age restriction is the only way hookah is similar to smoking cigarettes.

She said hookah is an art form while cigarettes are just an addiction.

"You have to take your time," Eid said. "[Hookah] is something you do once in a while."

Eid and Joseph share the belief that hookah is not harmful. They couldn't be more wrong.

"The smoke that emerges from a water pipe contains numerous toxins known to cause lung cancer, heart disease and other diseases," according to a study done by the World Health Organization (WHO) regarding tobacco product regulation.

Tobacco passes through a water bowl before it's inhaled out of the hose, so hookah smokers generally believe the nicotine disappears or is absorbed.

In reality, a water pipe smoking session may release more smoke over a longer period of time than when smoking a cigarette, according to the WHO study.

Elie Akl, lead author and associate professor of medicine, family medicine and social and preventive medicine in the schools of Medicine and Biomedical Sciences and Public Health and Health Professions, thinks people need to be aware that water pipe smoking is increasing, especially among youth, and it may be a gateway to cigarette use in adulthood.

"The problem is that some people are advocating the hookah, or water pipe, as safer than cigarettes," Akl said. "It's perceived as less addictive."

Alk started doing research five years ago because he agreed there was not enough research out there concerning the dangers of hookah smoke.

He said there are several misconceptions about the safety of hookah. People claim the column of water effectively purifies the smoke from harmful elements, and heating ,as opposed to burning, the tobacco is not as harmful. Alk said that's just a myth.

Because he grew up around hookah, Joseph doesn't think addiction or health risks are a big deal. He has been smoking for four years and said he is definitely not addicted.

"I honestly never smoke unless I'm with other people," Joseph said. "My family does it on any occasion. Like on Thanksgiving, we all go smoke hookah in the living room. On Christmas, everyone smoked at my aunt's house. Pretty much after dinners and stuff, if we have nothing else to do, and we are just talking, we'll pull out the hookah. It's definitely only for a family and friend gathering."

There are some times when he smokes three times a week and others when he goes two months without touching the water pipe. He believes addiction isn't something that would be common for Middle Eastern smokers, such as himself and his family, because he has was taught hookah moderation while growing up. He said people in the United States who don't grow up under Middle Eastern influence tend to overuse the hookah and don't know how to limit themselves.

"If an American college student owns a hookah, they tend to smoke it more just because it's sitting on their living room table," Joseph said. "They will use it and think, 'Eh, why not?'"

Akl is fearful of the increasingly rapid spread of the drug amongst high school and college students.

"It appears to be increasing worldwide, with a particularly concerning trend among pregnant women and children," Akl said. "Hookah smoking is likely to increase a number of cancers and negatively affect fetal development; it possibly increases lung and heart disease."

Because Joseph only smokes occasionally and limits himself, he doesn't believe he is in danger of smoking affecting his health. He said he would be worried if he smoked every day, but because he only smokes, on average, three times a month, he's not concerned. He thinks the only people who should be worried are those who don't moderate their smoking.

"People should treat hookah more like a cigar than a daily habit - something you do once in a while," he said.

When Joseph gets married and starts a family of his own, he plans on continuing the Lebanese custom of smoking hookah with his wife and with his children - when he feels his children are old enough. He isn't worried about any health concerns or addiction concerns presently or in the future, despite the research conducted.

While it's still a cultural tradition for Joseph, he acknowledges the recent spread of popularity regarding hookah. He has introduced it to many of his friends, many of whom are from various cultures and never smoked the flavored tobacco.

He tells them it's the "smoothest thing you will ever smoke ever. You will get a little lightheaded the first time, so make sure to pass the peace pipe when that happens, let it wear off and get it back."

This smooth feeling is often the reason many people don't view hookah smoking as dangerous as other tobacco products.

"Unfortunately, the water produces a false sense of security," according to shishaware.org, a website promoting the dangers of hookah smoking. "It cools the smoke so it feels less irritating. But just because it feels less irritant, it doesn't mean it is. In fact, shish is also linked to many health effects that cigarettes are linked to ... People weren't worried about cigarettes 50 years ago."

Despite research, Joseph happily believes hookah smoking is becoming more of a social custom than solely a cultural custom. He thinks everyone should experience the water pipe once because "one time won't hurt."

"Good news is you won't get addicted [if you] just do it once in a while," Joseph said. "Just don't make it the only social activity that you do with your friends."

Eid agrees.

She sees the various people who come to Mezza to either try hookah for the first time or to relax with a group of experienced friends and family. She enjoys how hookah is becoming widespread.

When people smoke for the first time, they often don't know what flavor to pick, Eid said. She always recommends the "Mezza Mix" - a blend of tropical fruit flavors. It's the most popular out of all the flavors on the menu.

Mezza gets its tobacco from a company that grows its own product. She tells the company what flavor she would like to try, and if she likes it, that flavor will end up on the menu at Mezza.

While many UB students are heading to lounges, Joseph prefers to smoke at home, though his parents and sister don't smoke. He is allowed to take his hookah in the garage. He said the smoke differs from cigars or cigarettes because the smell doesn't linger on furniture, in the carpets or on clothing.

When Joseph isn't smoking at a family member's house or in his garage, his favorite place to go is Mezza, where he relaxes and smokes outside with friends. He thinks the opening of hookah lounges around Buffalo is great for the Middle Eastern culture as a whole.

"Someone opening a hookah lounge is like an Italian person opening up a pizza place. It's the same thing," Joseph said. "It's opened up by people of the culture, and it kind of spreads out to those who may not be familiar with it. That's amazing."

*The subject's name has been changed at his request

Email: features@ubspectrum.com