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, www.gsahec.org/hookah.
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.

Material by bradenton.com.

When Michigan’s workplace smoking ban took effect in May, dozens of hookah bar owners in Dearborn were forced to choose between serving food or allowing smoking. Sinbad Grand Cafe owner Akram Allos chose hookah, and he says his profits have gone up in smoke. “Without food, the hookah by itself can not exist,” he told Fox 2 this week, noting that few customers have opted to bring in their own food as allowed under the law. “Nobody will enjoy a hookah without a cup of coffee or even a glass of water.”

Allos was one ever several local owners in the region to gather signatures in protest as enforcement approached, arguing the ban could hurt his business more than traditional restaurants.

Two months in, Allos tells the television station business has bottomed out at around 10 hookah sales per day, down from an average of 150. He’s laid off his kitchen staff and is bracing for further cuts.

While the ban has impacted business across the state — some say for the better — Dearborn’s large Arab-American population and resulting cultural customs left it in a tough spot.

As the Associated Press put it in the days leading up to the ban, “in perhaps no other city does the aroma of fragrant smoke, the bubbling of water pipes and the tang of Arab dishes blend so intrinsically with the local lifestyle and economy.”

From mlive.com.

Although most still are in operation, some local hookah bars have watched their profits go up in smoke as a result of Michigan’s workplace smoking ban. The law prohibits smoking in public areas, but because more than 75 percent of sales are derived from tobacco products, hookah lounges such as Blue Midnight Hookah Lounge, 330 Albert Ave., are not required to cut smoke from the premises, owner Patrick Kent said.

Because smoking is allowed, most foods are not, Kent said.

“Now, the way that the law reads, we can serve food, but it has to be ‘shelf stable,’” he said. “We can’t serve anything hot, we can’t serve anything cold (and) we can’t serve anything prepared.”

Kent said many customers have expressed dismay over the change in the law.

“We had really good hummus and some really good wraps,” Kent said. “A lot of our regulars, they were sad to see it go. But all of my customers have been very understanding of the smoking ban and supportive of the Blue Midnight.”

At Saylis Hookah Lounge & Café, 300 N. Clippert St., in Lansing, restrictions on food being served have decreased sales nearly 40 percent from their pre-smoking ban levels, owner Mahad Bussuri said.

“We had cheesecakes, smoothies, ice creams, light food like a meat pie type of thing, Middle Eastern (and) African cuisine type of stuff,” Bussuri said. “It was different, and people were looking forward to those types of things. Now we are not able to serve those.”

Having opened less than a year ago, Bussuri said he wishes he had opened somewhere outside of Michigan.

“We did not think about this law that was going to come and hit us so soon,” Bussuri said. “If I would have known about it, I wouldn’t even have taken the chance. Basically, I have dug myself in a hole and we can’t get out of it. All the money that went in, we can’t get back.”

Although it won’t affect her trip to a hookah bar, being unable to eat while smoking is unfortunate, advertising sophomore Maggie Ortlieb said.

“(Eating while smoking is) just like a social thing,” Ortlieb said. “We would probably still go, but when we are there, it just makes it nicer.”

Despite customers’ disappointment, Blue Midnight still sees nearly as many sales as before the smoking ban, Kent said. On an average weeknight, he said he gets 45-50 customers, and double that on the weekends.

“It has affected us a little bit, but the bottom line is we still have hookah,” Kent said.

Material from: statenews.com, July 28, 2010

Women have been banned from smoking water pipes in cafes in Gaza because it “leads to divorce”.
Hamas leaders said it was “inappropriate” for females to sit cross-legged and puff on the traditional pipes.
A spokesman said: “Many women who smoke in public were divorced when their husbands saw them.”
The ban is the Islamist group’s latest attempt to impose Muslim rules in Gaza.

But for many of the 1.5million people penned into the tiny strip by an Israeli and Egyptian blockade, smoking is one of the few pleasures.

Accountant Haya Ahmed, 29, who has smoked for 10 years, said it would make water pipes more desirable for rebellious women.
Hamas also banned women from riding motorbikes, calling it “culturally inappropriate”.
But a law saying men could not work in female hair salons wasn’t enforced.
Cafe owners plan to challenge the pipe ruling.

From mirror.co.uk

Nasir Hakeem, the owner of Tandoor Indian Restaurant is making a place that adult smokers (over 21) in Clarksville can appreciate; a place Downtown they can go to relax, and socially smoke. “I want to bring more people into downtown Clarksville, and at the same time expand the cultural diversity that our community has to offer people looking to relocate into the area.” said Hakeem.
The business is strategically located at 138 University Blvd, the former location of Retro’s Arcade; just a short walk from the Austin Peay State University main campus, and in close proximity to University Landing Apartments. The hookah bar will open on Friday June 25th 2010, with a grand opening/ribbon cutting planned for July 1st.

The hookah bar will offer a wide variety of flavored tobacco’s that smokers can enjoy via soothing water pipes, along with a variety of Mediterranean style foods, beer, & sodas and other drinks including traditional Turkish style coffee. The store is open from 11:00am till 11:00pm however they will be closed on Mondays. They will be serving food all day. Please note all seating is in the traditional Majlis style where everyone sits in a booth on the floor up against soft and colorful cushions.
Some of the special amenities that the Hookah bar will be offering include Arabic Television and Sports Channels on located TVs scattered throughout the bar; Free Wifi; on Friday and Saturday evenings, they plan to have live belly dancing; and there will also be pool tables available.
This will be his second offering of the Hookah in Clarksville, Hakeem’s first was closed after an electrical fault in a sign triggered a fire that destroyed his original Indian Restaurant & Hookah Bar in November of 2007.
Hakeem wants everyone to, “Come out and experience a different culture, our unique food, and the relaxing atmosphere that you will find no where else in Clarksville! There no longer any need for Clarksville Residents to drive all the way to Nashville to enjoy the Hookah!”

From clarksvilleonline.com, June 29, 2010, By Bill Larson

Hookah parlors are fast catching up the vogue in Bangalore. The once popular pastime of Mughal rulers and rustic folk alike, “hookah” is slowly catching attention of the curious college-goers and the youth around. As more and more gather around the traditional water pipe, people see a renewed interest in ’smoking’ and it doesn’t stop here as customers continue to pile up in a beeline to enjoy a “long and relaxing” puff at cafes.

This slowly is making a way into moving in to households and parties as well, state some parlour owners.

Ashwin, who runs a hookah parlour stated: “Unlike a lit butt of cigarette that throws up a strong pungent odour, smoke emanating from a flavoured tobacco that has been ignited and cleansed in water settled in crystal bottoms (of the water pipe), is extremely relaxing and pleasant.”

He further added that close to 50-100 persons visit the parlour on weekends.

From cw.topnews.in, by Kavita Sharma, June 23, 2010

Nathan Porter sucks in a mixture of tobacco, molasses and strawberries through a water pipe and into his lungs. The owner of the Huka Bar & Grill exhales and the smoke smells faintly of fruit, then disappears.
“We can get all these lit up,” he gestures to the dozens of hookah pipes sitting at each table in the large room, “but you’re not going to see this cloud of smoke.”
It’s his 5-year-old business that is now up in the air. More than a year after the state banned smoking in bars, public health officials now say hookah clubs violate the law’s intent.

Leaders of the state’s 12 local health departments want legislators to clarify whether they intended to include tobacco smoked through water pipes, along with cigarettes and cigars, when they amended the state’s indoor air act to protect people from second-hand smoke.
“Health officers believe that hookah smoking likely poses a second-hand smoke risk, as does regular tobacco smoking,” says Gary Edwards, executive director of the Salt Lake Valley Health Department. “And if that’s the case, then we believe that it should fall under the same requirements that regular tobacco smoking does.”
Effective in January 2009, the state banned smoking in bars and clubs. The law defines smoking as “any lighted tobacco product in any form.”
Porter maintains his business doesn’t violate the law. The flavor of tobacco and flavorings, called shisha, is not taxed by the state as tobacco is, he said. Nor is it lit.
Instead, it sits on a screen below pieces of heated charcoal. A hose is attached to the lower body of the pipe, filled with water. As a smoker inhales through the hose, heated air is drawn down over the tobacco.
“I wasn’t looking for a loophole,” Porter explains of his reason for opening the bar. “I was looking for a niche.”
He and his family opened the bar in 2005, before the smoking ban was passed. Porter said he met with the Salt Lake Valley Health Department last year, and the department decided the club didn’t flout the law.
Health officials are raising concerns now due to questions from the public and because of the growing interest in hookah bars. They appear to appeal to young adults, especially near colleges and universities.
An applicant recently asked to open a hookah bar in Provo, prompting the Utah County Board of Health this week to draft a resolution declaring them illegal. Health officials raised fears that hookahs and their flavored tobaccos, which range from apple-cinnamon to chocolate, will appeal to teens and young adults, and get them hooked on nicotine.
“We think this should be [regulated] under the Indoor Clean Air Act,” said Joseph Miner, Utah County’s health department director.
The unanimous decision to draft the resolution ignores advice from the Utah County Attorney’s Office, which said Utah County shouldn’t regulate the bars if Salt Lake County has chosen not to.
But Utah County Commissioner Gary J. Anderson, also a member of health board, said he doesn’t see any difference between cigarettes and hookahs.
“If someone came in and said they wanted to open a cigarette bar, would we let them proceed?” he asked rhetorically.
Rep. Paul Ray, R-Clearfield, who advocates for anti-smoking legislation, said he wants to know more about hookah bars, based on a dozen calls he has received in the past two weeks from people wondering about them.
As chairman of the interim Health and Human Services committee, he said the topic will likely be on the agenda next month. Also, attorneys for the state health department are exploring whether it can make a rule to include water pipes in the definition of smoking.
“My question is, how is the atmosphere?” Ray said. “What’s the air like in the building?”
Porter welcomes the chance to explain his business, since adding hookahs to the law would put him out of business. If changes are made, he hopes they would apply to new applicants only.
He said his was the first hookah bar to open in the state — and it is believed to be the only one now open. It has never allowed indoor cigarette smoking.
“I don’t smoke. I don’t like to be around it,” said Porter, adding that most of his relatives who run the bar with him are members of the LDS Church, which advises its members to not smoke.
The American Lung Association and the World Health Organization have raised concerns about the health effects of water pipe smoking on the smoker, saying it carries similar risks of addiction, cancers and heart disease as cigarette smoking.
There is little evidence about the second-hand smoke risks from hookahs. Unlike cigarettes, which emit unfiltered smoke from the tip, the only smoke produced by hookahs is exhaled by the smoker, Porter notes, adding that the hookah smoke is filtered by the smoker’s lungs and the water in the pipe.
“Not all the smoke is the same,” he added, pointing out that cigarettes include hundreds of ingredients, compared to four in shisha.
But other recent studies on hookahs and second-hand smoke say a one-hour water pipe session generates ambient carcinogens and toxicants equal to two to 10 cigarette smokers.
“There is therefore good reason to include water pipe tobacco smoking in public smoking bans,” according to the authors of an article published in the international journal Atmospheric Environment this year.
Porter’s customers disagree, motioning to the smoke-free air.
“If you don’t want to smoke, don’t come here,” said Dianne Allen, who was visiting from Washington state. “It’s like, if you don’t want to exercise, don’t go to a gym.”

From sltrib.com, June 18, 2010

Ahmedabad: The Gujarat high court has asked the city police to conduct a re-inspection of hookah bars in the city and furnish details of any possible illegal hookah bars.The high court order came after a hookah bar owner informed the court that though the city police have conducted their inspection, they have not visited their (this particular owner’s) hookah bar yet. It is important to note here that a couple of months ago, the Gujarat high court had asked the city police to conduct an inspection of hookah bars.

The city police then submitted a report saying that most hookah bars are complying with norms, as per the notification of the city police commissioner.

The high court had made specific queries about the number of hookah bars carrying on business in the city, whether they are categorised as hotels or restaurants, the total number of rooms in case of hotels, seating capacity in case of restaurants, and whether they have a separate smoking area.

Brijesh Jha, deputy commissioner of zone-1, submitted a survey report last month. According to the survey report, there are 34 hookah bars in the city, out of which two could not be surveyed as they were closed down, and another three were being renovated.

The report said that all hookah bars come under the category of restaurants, and all of them have separated their smoking zones from the eateries.

According to the report, the police have collected samples of substances from all the hookah bars and have sent them to the Forensic Science Laboratory (FSL) to check for presence of nicotine. The FSL report is now awaited.

From dnaindia.com, June 18, 2010

Parents and students alike were stationed outside the future home of a Mansfield Hookah bar Saturday, protesting its planned Friday opening. ”Just say no! Marley’z got to go,” chanted a Mansfield parent. “No head shop! Go save our kids!” Feet away, another parent held a sign that read “crack pipes too close to schools.” Marley’z Lounge will sell and serve flavored tobacco as well as pipes and other products. The parents are concerned about the store selling K2, a legal mix of herbs sprayed with a synthetic form of the psychoactive ingredient found in marijuana. ”I’m here to protest it being sold in my neighborhood near my school,” said resident Alma Tsunami. About 60 miles away in Allen, the City Council asked the city attorney to draft an ordinance banning the substance. Though, the only store there that sold the product was shut down by the city earlier this week because of repeated code violations.

“The head shops are just a legal way of getting around what’s already illegal,” said resident Patrick Cook. “K2 is a product not to be smoked yet is sold at these types of shops.”

Students also attended Saturday’s protest.

“I’m just trying to protect my generation from doing any of this stuff,” said student Chris Blackwell.

However, the man who owns the shopping center that will soon house Marley’z defended the business, saying that all its products will be legal.

“My tenant is not going to sell K2 here,” said Zahid Rao.

Soon, counter protesters arrived, calling the protest “ridiculous” while citing the business’ right to sell the products under the law. Meanwhile, Rao questioned why the group didn’t hassle a tobacco store located about a block away.

But the protesters still plan to take their fight to Monday’s council meeting. They said until regulation is passed for the selling of K2, they want the store out of their neighborhood.

Members of the city council said they are awaiting a briefing from the city attorney and want to research their options in regulating the substance.

cbs11tv.com, June 16, 2010

Michigan’s statewide smoking ban takes effect this Saturday.

The law exempts some casinos and cigar bars. But establishments like hookah lounges are left out. Now at the eleventh hour, businesses are hoping they can carve themselves out of the ban.

Emad Shatara says hookah is a staple in Middle Eastern culture. It’s also a traditional pastime offered to customers at his lounge, Eastown Hooka.

“Water is in the base. We put the charcoal on top and it burns the tobacco, it sucks it in and it comes out of the pipe,” Shatara said.

Shatara and his partner have been in business for five years. They assumed hookah would be exempt from the state smoking ban like cigar bars, but it is not. The ban takes effect May 1. Matt Marsden, spokesperson for Senate Majority Leader Mike Bishop of Rochester says no one person or group lobbied for the hookah industry.

“They didn’t come together on time and our main distributor there got everyone in too late for the ban,” Shatar said.

Mike Berry, Vice President of the National Heritage Association in Dearborn, representing Arab Americans, is hoping for a last minute exemption.

“What we’re trying to do right now is get a quick fix until the law is brought back up sometime next month in front of legislators again,” said Berry.

Berry says veterans around the state are also asking for an exemption, and the National Heritage Association plans to include their grievance as well.

Marsden, says the situation is unfortunate. He says Senator Bishop opposed the ban for this exact reason. Bishop argued the ban interrupts the free market process.

“I’m not sure however that there will be any desire by anyone to reopen the discussion on the smoking ban,” Marsden said.

The cigar industry successfully lobbied for an exemption, as did casinos.

Meantime, Shatara has filed for a Tobacco Specialty Store license. It means he can still sell hookah, but no more coffee, soft drinks or food.

“With an average hookah, people want tea, they want a Turkish coffee,” Shatara said.

Shatara estimates he will lose 30 percent of his sales. He’s already let go of most of his staff.

“We had to let go four of our employees as far as a host, our kitchen cook and our wait staff. Pretty much it’s a two man operation,” he says.

Other hookah lounges in the state operating as restaurants must stop selling the tobacco. Herbal, non tobacco hookah is also prohibited under the ban.

It’s a big hit to small businesses and Arab Americans who want to enjoy a time honored custom.

Berry says if the hookah is not added to the exemption list, business owners are prepared to file suit on the grounds the smoking ban is discriminatory towards Arab Americans.

By Christa Graban, Wzzm13

A 23 to 26 percent increase in tax on tobacco products will cut consumption and significantly increase excise revenue, a researcher said on Sunday.

“A disproportionately higher tax on tobacco than income growth will reduce tobacco consumption” said Dr. Mahfuz Kabir an economist of Unnayan Shamannay, an NGO.

Presenting the findings of a research, Kabir said a 15 percent rise in tobacco product price will effectively reduce consumption.

To get the expected result, tax has to be increased by 23 percent on cigarettes and 26 percent on ‘bidi’, he added.

“A 23 percent increase in tax on cigarettes of all brands will cut consumption by 4 to 6 percent.” At the same time, the tax increase would raise cigarette price by 15 percent.

More importantly, Kabir said, tax hike by that percentage will also result in an increase of revenue earning by at least Tk. 903 crore in 2010-11 financial year.

Research has found that the consumers of ‘bidi’ are among the worst affected by tobacco consumption.

Kabir calculated that 26 percent tax increase on ‘bidi’ will cut consumption by 1680 million sticks, while increasing price by 15 percent and will yield additional Tk. 68 crore as revenue in the next financial year.

According to Global Adult Tobacco Survey (GATS), 43.3 percent population of Bangladesh consumed tobacco products in 2009; of them, 23 percent smoked cigarette or bidi.

Every year 57,000 people die from tobacco consumption and nearly 382,000 become disabled.

At present, the average tax on cigarette and ‘bidi’ are 64 and 56 percent respectively. Total consumption of tobacco product during 2008-09 was between Tk. 9,000 and Tk. 10,000 crore, according to the research.

Bangladesh earned a total of Tk.5,393 crore from tax on tobacco product in the last financial year.

Khondker Ibrahim Khaled, chairman of Bangladesh Krishi Bank, said that they are trying to formulate a policy that would bar any agriculture loan for tobacco farming.

He, however, hastened to add that the loan could be provided to the export-oriented tobacco farming.

Khaled also said that it is unrealistic to expect that everyone will quit smoking. To minimise the pernicious effect of tobacco consumption, he suggested that they can smoke local ‘hukka’.

RALEIGH — Most bars and restaurants are obeying North Carolina’s new indoor smoking ban, but some hookah bars are ignoring the law, saying they are exempt.

The Winston-Salem Journal reported that state officials say the state’s no-smoking law, which took effect Jan. 2, applies to all bars, even the state’s approximately 20 hookah bars.

But hookah bar owners and their proponents point to a section of the law that defines “smoking” as “the use or possession of a lighted cigarette, lighted cigar, lighted pipe, or any other lighted tobacco product.”

They say that while the tobacco used in hookah smoking is heated by charcoal, it’s never lit because a small metal screen or piece of foil provides a physical barrier between the coals and the tobacco.

Hookahs are long pipes used with flavored tobacco. Smokers heat tobacco and flavoring and use a tube to draw the smoke through a bowl of water to cool it.

An attorney for the Division of Public Health says hookahs fall under the “lighted pipe” definition.

“Your typical modern hookah tobacco is tobacco mixed with molasses or honey — depending on the brand — glycerin, flavoring and sometimes a little dye. So it’s very wet. If you tried to take a lighter to it, it just wouldn’t work because it’s too wet,” said Adam Bliss, the owner of Hookah Bliss, a hookah bar in Chapel Hill.

Hookah Bliss is doing business as usual, as are hookah bars in Wilmington and Asheville. In Burlington, Racco Hashem, owner of the county’s lone hookah bar, said he has added outdoor seating to accommodate customers who want to use the pipes at his restaurant, Racco’s Italian Restaurant and Café.

Hashem said that so far, the smoking ban has not affected business at the hookah bar, which he opened as part of the restaurant in September 2007.

State Rep. Hugh Holliman, the chief sponsor of the smoking ban, said the Legislature never intended to cripple hookah bars.

“It’s not our intent to penalize hookah bars. We just don’t want to start making exceptions that are adverse to healthy consequences,” said Holliman, D-Davidson and the majority leader in the N.C. House.

It’s possible the Legislature would revisit the issue later this year, he said. “I would be willing to take a look at that and see if we could work a compromise,” he said.

Under the law, bars and restaurants that allow customers to smoke inside get written warnings for the first two offenses. After that, they can be fined $200 for each offense.

Local health directors are responsible for enforcing the law, based mostly on public complaints.