A national cohort study found waterpipe tobacco (hookah) smokers were more than twice as likely to try cigarettes than nonsmokers. Yet only 16% of non-waterpipe users showed any susceptibility to cigarette smoking. A majority of the hookah users were men between the ages of 18-21, with only high school diplomas. This study did not determine a cause-and-effect relationship, but one is plausible.
PositiveTip: While often believed to be safer, young and old should be encouraged to stay away from waterpipe smoking.