As the prevalence of cigarette smoking declines in North America, smoking water pipes– also known as hookahs – is becoming more popular.

A new study, “Water Pipe Smoking Among North American Youths,” published in the June print issue of Pediatrics (published online May 10), describes the demographic characteristics of water-pipe users. Using data collected from questionnaires sent to 1,208 people ages 18 to 24 in Montreal, Canada, researchers found that 23 percent had used a water pipe during the previous year. Water pipes were more popular among people who were younger, male, speaking English, not living with their parents and who had a higher household income. Water-pipe users were also more likely to have used other psychoactive substances, such as marijuana.

The study authors suggest that the growing popularity of water pipes may be due in part to perceptions that they are safer than cigarettes. However, water-pipe smoke contains nicotine, carbon monoxide and carcinogens, and may contain greater amounts of tar and heavy metals than cigarette smoke. The authors suggest that more research is needed to understand the health effects of water pipes.

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.