Lately, it seems as if teenagers only talk about “packing a bowl of cane mint.” Although hookah originated a long time ago in the 16th century in the Persian Empire, it has gained much popularity since. Some music artists are even writing songs which promote the use of hookah. A hookah, also known as a shisha, consists of a base, a stem, a hose and a bowl. The base is filled with water while the bowl is packed with flavored tobacco. Charcoal is then used to heat the tobacco and produce smoke.

A new study published by the American Academy of Pediatrics shows that about 18% of high school students have smoked hookah. The Centers for Disease Control (CDC) recently reported that alternate tobacco products — products such as hookah and electronic cigarettes —  are on the rise. According to the CDC, between 2011 and 2012, hookah use rose from 4.1% to 5.4% among high school students. Hookah is even beginning to make its presence among middle school students.

Multiple reasons exist for why young people begin or continue to smoke hookah. Aside from smoking hookah for fun, some teens believe hookah serves as some type of stress reliever.

“After a hard day at school, I love coming home and smoking hookah,” said John (not his real name), a senior at Clark. “It helps me release tension and just relax for a while.” Smokers often find comfort in hookah as it helps ease their stress levels caused by school and other personal problems in their lives.

Other students smoke hookah because they feel that it helps them fit in with their friends and also helps give them a “cooler” image. “Sometimes I feel like I have to smoke hookah because all my friends do,” said Sarah (not her real name), a junior at Clark. “I guess you could call it peer-pressure.” Another reason for teens smoking hookah is the feeling of rebellion associated with it. They enjoy the thrill they get from smoking hookah as a form of rebellion, as it helps express their feelings when they are fed up with their parents or other figures of authority.

A major contributing factor to why hookah has become so common among adolescents is the availability of various flavors. The various flavors range from fruity sensations to other distinct flavors such as cane mint, vanilla, chocolate and gummy bear. Smokers find pleasure in inhaling flavored smoke. They also become attached to trying the assorted flavors they are offered. “I love the way hookah tastes,” said Dave (not his real name), a junior at Clark. “Not only does it taste good, but it also smells amazing.”

One reason why teenagers smoke hookah is because they think hookah is simply a “boost.” They find the enormous clouds of smoke leaving their mouths when they exhale very appealing and entertaining. As hookah has become more popular among teens, they have also began performing tricks with the smoke, one of the more popular being blowing an “O” with the smoke.

Hookah is a time passer, many users say. A hookah session, sometimes popularly referred to as “sesh,” with friends is a great way to socialize, according to Dave. Many teens find that during nighttime, when they do not have any special activities planned, sitting in a circle with a group of close friends and a hookah is an ideal and fun way to spend their time.

“Smoking hookah with my group of friends has become a tradition. Every Friday, we sesh in my garage,” Dave said. “We sit in a circle and socialize while taking turns puffing the hookah and passing it around.” The presence of the hookah has a certain special charm of making this activity worthwhile whereas many teens may find the same activity without the hookah to be boring.

Although the legal age to purchase or smoke any tobacco products is 18, it is very easy for teenagers to get a hold of tobacco. Many teens have friends over the legal age to purchase tobacco that they can go to and ask them to buy them the products they need. Another way students can gain access to tobacco is by waiting outside smoke shops and paying older strangers the money including a tip to buy them the products they desire. Another option for teenagers under the age of 18 seeking tobacco products is obtaining a fake ID, which can be done as low as $50.

To educate students in middle schools and high schools, Clark Magnet High School’s Kids Against Tobacco Smoking (KATS) organizes trips to various campuses. In their presentations, KATS members use props and slideshows to show the consequences of smoking tobacco. KATS is divided into different groups. There are groups mainly focused on different tobacco products such as chewing tobacco, cigarettes, cigars, hookah and e-cigarettes.

Due to the increase in hookah smokers, KATS members have incorporated more information about hookah in their presentations. “Through KATS, I learned more about how harmful hookah is,” said John, a former KATS member. “After listening to some presentations about hookah, I’ve cut down on smoking.”

“Teenagers have been raised to socially accept hookah, therefore causing hookah bars to become prevalent,” says KATS advisor Judy Sanzo. “The flavors of hookah mask the harmful substances in tobacco, such as nicotine. Nicotine is poison and can cause death at a young age. Sharing the same hose with many individuals while smoking hookah can also cause other diseases such as a cold and oral herpes.”

Despite KATS members’ efforts to educate students about the dangers of hookah, some students still continue to harm themselves by smoking. “I understand that hookah can kill me,” said Dave. “But I still like smoking.”