Teenagers are smoking fewer cigarettes today, but that doesn't mean they've given up tobacco altogether. A new study in Pediatrics has found that almost one-quarter of young adults in Montreal have used waterpipes (also called shishas or hookahs) in the past year.

The habit is particularly popular among young, English-speaking males who lived on their own and had a higher household income. In addition, the research team found that waterpipe users were more likely to use other psychoactive substances such as cigarettes, marijuana, illicit drugs and alcohol.

As part of the longitudinal cohort investigation (NDIT Study), 871 youth aged 18 to 24 completed questionnaires on their sociodemographic characteristics, water-pipe smoking habits, and use of other psychoactive substances. The research team found that 23 percent of respondents had used a waterpipe within the last 12 months and that 5 percent had used waterpipes one or more times in the past month.

"The popularity of waterpipes may be due in part to perceptions that they are safer than cigarettes. However, waterpipe smoke contains nicotine, carbon monoxide, carcinogens and may contain greater amounts of tar and heavy metals than cigarette smoke," warns senior investigator Jennifer O'Loughlin, a professor at the University of Montreal Department Of Social and Preventive Medicine.

The researchers conclude that "[e]vidence-based public health and policy interventions are required to equip the public to make informed decisions about water-pipe use."

Citation: Dugas et al., 'Water-Pipe Smoking Among North American Youths', Pediatrics, May 2010; doi:10.1542/peds.2009-2335