What to Expect at a Hookah Bar

What to Expect at a Hookah Bar Addiction Nicotine Use Print Hookah Bars, Air Quality, and Your Health By Terry Martin facebook twitter Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. Learn about our editorial policy Terry Martin Medically reviewed by Medically reviewed by Sanja Jelic, MD on February 28, 2016 Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine.   Learn about our Medical Review Board Sanja Jelic, MD Updated on August 14, 2019 Barry Lewis/Getty Images More in Addiction Nicotine Use After You Quit How to Quit Smoking Nicotine Withdrawal Smoking-Related Diseases The Inside of Cigarettes Alcohol Use Addictive Behaviors Drug Use Coping and Recovery Hookah bars  are commercial establishments where people gather to smoke flavored tobacco from a hookah pipe. Other names for a hookah bar  includes hookah lounge, hookah cafe, hookah den, and shisha bar. Originating in India and spreading to several Middle Eastern countries, traditional hookah lounges are coffee houses that also serve hookah. Out of deference to Muslim traditions, they do not serve alcoholic beverages. As they have gained popularity in Western cultures over the years, however, many hookah bars in the United States  do serve alcohol along with food and a variety of tobacco flavors. What Theyre Like Hookah bars in the U.S. are often decorated in trendy, modern themes to appeal to young patrons.  You may or may not find alcohol in these places, but many of them are set up to serve it, along with live music. Hookah is often smoked in small groups, so youll probably find the lounge is able to accommodate that with bean bag chairs or comfortable couches grouped around the hookah table. That said, lone patrons can easily order hookah for one, as well. If another person wants to join in later, an additional line is simply added to the hookah pipe. You might also be able to  buy oxygen, which is another unusual offering gaining recreational popularity. The oxygen that is purer than what is ambient air is typically bubbled up through flavored waters to be breathed in for a period of time. Flavorings give the oxygen a pleasing aroma, and fans of oxygen sniffing claim it helps with everything from energy boosts to hangovers. There is no science to back it up though, and those selling it are careful not to make medical claims about recreational oxygen use. Hookah Bars  in the United States Hookah bars have sprung up primarily around college towns in the United States. While smoking bans have become more strict with increased public awareness, hookah bars seem to be an exception with their ability to obtain indoor smoking permits. Other commercial locations that are allowed smoking permits are cigar bars and tobacco purveyors. The first hookah lounges in the U.S. were coffee/tea houses that served immigrant communities. Hookah was an additional offering at these establishments, not the main focus. That all changed when The Hookah Lounge opened its doors in Las Vegas, Nevada.  As the name suggests, hookah was the primary offering, but alcohol and Middle Eastern food were also served. The Hookah Lounge attracted mostly men of Middle Eastern descent initially but drew a more diverse crowd  over time. Today, The Hookah Lounge has two locations in Las Vegas. Others emulated the winning formula, calling their establishments hookah lounges as well.  There were lawsuits filed to protect the name,  but it was a futile effort. The term hookah lounge became synonymous with the hookah experience, rather than describing a specific place. The owners of that first hookah lounge in Las Vegas took to calling themselves Americas Original Hookah Lounge in ads to differentiate themselves from others. Other countries have also seen an uptick in hookah bars. Germany, Spain, The Netherlands, and the United Kingdom all have hookah lounges and theyve even gained popularity in Russia. Air Quality Young adults have taken to this form of smoking, in part because its considered to be a  unique and acceptable way to socialize with friends, but also because there is a misconception that hookah is a safe way to smoke  tobacco.  It isnt, and some of the facts about hookah smoking might surprise you. Researchers from Johns Hopkins studied the air in several hookah bars over a 9 month period.  In particular, they measured  nicotine  and  carbon monoxide  levels, along with  particulate matter  in hookah smoke smaller than 2.5 microns.?? Their findings showed that the air in enclosed spaces where hookah is smoked is laden with carbon monoxide and breathable particulate matter from the tobacco smoke in concentrations that are higher than in public spaces where cigarette smoking is allowed. Nicotine content was not as high, but it was measurable.   In another study, researchers focused on 55 healthy people with some level of hookah smoking experience in the past.??  Participants were asked to abstain from all tobacco use for a week. They then spent an evening smoking at a hookah bar.  Urine samples were collected and tested. Researchers  found that nicotine levels after were as much as 70 times higher than they were before the hookah bar exposure.  Additionally, NNAL, which is a nasty carcinogen that is specific to tobacco smoke, was present in participants in twice the amount as before, and VOCs, also hazardous to breathe in, were detected in elevated amounts between 14% and 91%. While this study looked at hookah smoking specifically, it adds to the picture of the chemicals that are floating around  in the ambient air of a hookah bar.  Inhaling the air in the enclosed space of a hookah bar is not healthy for anyone. Avoid Hookah Smoking and Hookah Bars It is a mistake to think that hookah is a safe way to smoke tobacco, and that just because hookah lounges exist, that they too are safe. Tobacco is inherently dangerous for your health, whether you are smoking it or using a smokeless variety.??  Additionally, all tobacco products contain nicotine, so it is also addictive.  The best way to steer clear of the risks is to avoid using it in any form. If you are thinking about quitting, you can read about how to get started.