COLLEGE PARK, Md. (McClatchy-Tribune News Service) -- University of Maryland student Louie Dane was 18 when he first smoked tobacco with a hookah at a friend's house.

"There's nothing that's not great about it. You get to be with some friends having a good time," he said. "I personally think cigarettes are disgusting ... Hookah doesn't seem as bad ... (because) it's more of a social thing."

What Dane and most other fans of this increasingly popular method of smoking tobacco do not know is that one 25-minute hookah session is equivalent to smoking a pack of cigarettes, health officials said.

"People tend to inhale very deeply when they are using a hookah. They actually, in effect, get 20 times the amount of nicotine then when you smoke a single cigarette," said Donald Shell, who works on tobacco prevention efforts at the state Department of Health and Mental Hygiene.

Hookah -- also referred to as a narghile, shisha or waterpipe -- allows users to smoke flavored tobacco that is filtered through a liquid, typically water. The tobacco is placed in the bowl of the hookah and heated with a coal. The smoke is then pulled through decorative hoses after first passing through the liquid.

The practice originated in India and the Middle East in the middle of the last millennium and has since found its way into a growing number of college towns in the states.

As more hookah lounges open, health officials said they are worried users do not fully understand the risks associated with the pastime.

Cafe Hookah, which is set to open in College Park, Md., this month, will be the second hookah bar in the city. The cafe's owner, 29-year-old Abid Khan, said he chose to open the establishment because the "niche was available."

"I think that it will be unique in the sense that -- aside from making money -- it's run by young people that actually care about the students," he said.

Hookah tobacco contains many of the same harmful chemicals found in cigarettes and can cause similar long-term health effects, such as mouth cancer, lung cancer and cancer of the trachea, Shell said.

"Hookahs are flavored and put in a nice setting when you are sitting and relaxing ... But that kind of socially attractive setting is really the vehicle for delivering a really potent dose of tobacco and carbon monoxide and other chemicals, too," Shell said.

"There is no safe level of tobacco to consume," Shell said. "If you find that once you start smoking hookah and you feel like you have to go back, that's kind of a red flag."

Matthieu Drotar, 20, said he first smoked hookah when he was 17. He now smokes hookah once every two or three weeks near the University of Maryland.

"People like to try new exotic things, and the hookah bars try to recreate the feeling of being in Lebanon, or somewhere else," Drotar said. "I don't know anywhere outside of a (hookah bar) that you can get that experience."

Despite knowing some of the health risks associated with smoking hookah, Drotar said he was not worried.

"If I were smoking every day I would be concerned about it," he said.

Isabel Slettebak, a 21-year-old student at the University of Maryland School of Nursing in Baltimore City, said she smoked hookah for the first -- and last -- time when she was 20.

"I guess I decided to do it 'cause I was over 18 and I could. It seemed like a cool, older thing to try out," she said.

"The place, it was way too smoky for me. After sitting for a while, it felt like I wasn't getting enough air. Then I tried smoking the hookah and it just felt like I had drank a cup of ashes," she said.

Distributed by MCT Information Services

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