Teen users of hookah & snus likely to smoke cigarettes

Health News

Hookahs and snus are gateways to cigarettes for teenagers, a new study says. Researchers from the Geisel School of Medicine at Dartmouth in Lebanon, New Hampshire asked over 2,500 youths aged 15-23 whether they had ever smoked cigarettes or used hookah or snus during the 2010-2011 school year – and if so, how often and how much–, and once again two years later. Over 1,500 respondents completed both surveys, of which 1,048 had never smoked cigarettes at the time of the first survey. 72 of those non-smokers had used water pipes and 20 had used snus, and they were 2-3 times more likely to have started smoking, be current smokers, and smoke more often by the second survey than those who didn’t use tobacco alternatives.

Despite similarities in pronunciation or its use in an episode of Futurama, the words hookah and snu have nothing to do with sex. The former is a water pipe fitted with a number of tubes and mouthpieces (what the Caterpillar smoked in Disney’s Alice in Wonderland), while the latter is a smokeless product that resembles dipping tobacco. In the span of an hour, a hookah smoker may inhale a quantity of smoke equivalent to 100 cigarettes – thankfully it doesn’t get as bad as 200 Cigarettes. On the other hand, “in the U.S., snus is marketed by tobacco companies as less harmful than cigarettes,” study author Samir Soneji said. “Snus is not smoked, although long-term use of snus increases the risk of oral cancer, preterm birth, and colorectal cancer.”

The results of the research were published in JAMA Pediatrics on Monday. “Hookah and snus could directly lead to cigarette smoking either by introducing teens to the practice of inhaling smoke, in the case of hookah, or creating an addiction to nicotine that can be better satisfied by cigarette smoking in the case of snus,” Soneji said. “It’s also possible that some teens are vulnerable to tobacco use, in general, and would have started smoking cigarettes even if they hadn’t tried hookah and snus earlier.” Professor of medicine at UCSF School of Medicine in San Francisco Dr. Pamela Ling, who was not involved in the study, agreed. “The finding that use of both of these products at baseline predicted smoking at follow up is important, as it suggests that they may be a gateway to smoking,” she said.

Soneji believes that current regulation is too lax. The FDA has no jurisdiction over hookahs, or the flavored “shisha” used in the water pipes. “A ban on flavored shisha may make hookah less appealing to youth,” he said. Moreover, though the FDA regulates smokeless products, “tobacco companies can distribute free samples of snus because the quantity of smokeless tobacco falls is less than 0.53 ounces of smokeless tobacco,” Soneji said. “Closing the loophole would prevent tobacco companies from providing free samples of snus to young adults.” There is also a lack of awareness of the risks of alternative tobacco products. Hookah bars and lounges may not be subject to clean indoor air laws, may not serve alcoholic drinks, and may be open to 18-19 year olds. “Teen use of hookah may be growing, in part, because of a widespread misconception that hookah smoking is less harmful and less addicting than cigarette smoking,” Soneji said.

Related Read:

Teen hookah and snus users more likely to move on to cigarettes.

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