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Clearing the air about hookah's dangers

SARASOTA — A sign outside a downtown Sarasota bar offered four medical school interns a clear example of the challenge they faced this summer trying to educate their peers about the dangers of hookah.

The sign advertised the smoke from hookah, also known as a water pipe or shisha, as “soothing vapor that is cleansing to the lungs.”

What the interns already knew — and have since shared in presentations to college students and community leaders in Manatee and Sarasota counties — was that hookah carries many of the same health risks as cigarettes and can be even more dangerous to those unaware of that.

“It’s just misadvertised and mislabeled. A lot of the users have a lot of misconceptions,” said Cathryne Dutka, a nursing student at the University of Tampa.

Dutka and three Lake Erie College of Osteopathic Medicine students — Brian Welch, Stefanie Johnson and Shinelle Pierre — just finished an eight-week internship at Gulfcoast South Area Health Education Center in Sarasota. Their focus: building a website, research and educational materials to inform the public about what they say is a growing trend among college-aged young people.

“Our service area has a growing number of those hookah bars, Manatee and Sarasota especially. There are really quite a few of them popping up,” said Emily Hite, the tobacco training coordinator at the education center. “I think it’s popular on residential campuses in our area because a lot of them can use in their personal space, that’s also very popular.”

According to the Centers for Disease Control, hookah is a 400-year-old Middle Eastern tradition in which a bowl of flavored tobacco is heated by charcoal. The resulting smoke passes through water before traveling up a mouthpiece that is shared from person to person.

The interns say most users are unaware the smoke is dangerous. A typical one-hour hookah session can involve the user inhaling 100 to 200 times the smoke from a cigarette, the CDC says.

“That’s an enormous amount compared to cigarettes,” said Pierre, a second-year pharmacy student at LECOM. “Some students don’t think they’re smoking, because the water being used at the base of the hookah is cooling the smoke that comes in. Because it feels lighter, they believe it’s a vapor when it’s really smoke, and the smoke still contains tars, carcinogens, nicotine.”

Other dangers include the remnants of burning charcoal added to the traditional carcinogens in secondhand smoke, and the possible spread of communicable disease through shared use of the mouthpiece, the interns said.

The interns polled recent high school graduates about hookah use and visited wellness coordinators at State College of Florida, New College of Florida, Ringling College of Art and Design and Edison State College. Freshmen at several of the campuses will receive hookah educational pamphlets in their orientation packets this fall. New College officials have agreed to place informational messages about hookah on the school’s Facebook and Twitter pages.

The interns’ research found that students who smoke hookah do so for the smell and taste of the product and as a way to socialize with friends.

“It’s a pretty intricate process to set up the hookah and get all the things together. Once they get it together, they sit down and have a social experience,” said Welch, a third-year pharmacy student and the architect of the interactive website,

Some users also like hookah because it’s chic, the interns said. An informational poster they distributed to local college campuses is titled “TOXIC Not EXOTIC.”

“One of the kids we talked to actually really liked it because of the artwork of the pipe itself,” said Johnson, a second-year medical student at LECOM. “He was going to Ringling, and he loved all the art on the pipe.”

Hite praised the interns for their work this summer and said college staff will use the educational materials for years.

“It’s nice having the age group that’s being targeted also be the age group that’s working on your campaign. That has been really effective,” she said. “Their materials are really catchy for that target population of 18- to 24-year-olds.