This is an update on information I discussed in this column some time ago. The name hookah refers to what many call a water-pipe and is most often used in social settings where one or more people may share one device. Hookah goes by several other names including shisha, bori and narglile and others.

Hookah smokers seem to perceive that hookah smoking is less harmful than smoking cigarettes, but hookah smoke contains the same toxic elements as cigarette smoke including nicotine, tar and heavy metals.

Hookah smoking sessions typically last about one hour with the smoker taking in anywhere for 100 to 200 puffs per session. The hookah smoker would consume about the equivalent of 100 cigarettes during the smoking session. Sadly, the most common age group to engage in hookah smoking is the 18-24 year olds.

There are some nontobacco products that are used but they contain carbon monoxide and other toxic agents associated with smoking related cancers and disease. There really is no safe way to smoke tobacco. The Indian physician, Ifran Shaik, invented the hookah for his leader, King Akbar but this invention did not leave the world with a safer way of smoking tobacco. It just left us with another way to shorten our lives while pretending to ignore the outcomes.

My best advice is to remember that as an organism we are designed to breath air, anything else you breath in is potentially not just harmful but deadly.