hookah smoking is a historically middle Eastern and Indian form of tobacco use that fueling a contemporary epidemic of tobacco abuse and
a nationwide public health crisis, particularly among young
adufts (American Lung Association, 2@7; Wodd Health Organi-zation
[VIHO],
2005). For centuries, hookah smoking was de-fined as a cultural phenomenon and a masculine habit endemic
only to men from Middle Eastern cultures. Currentl_v, hookah
smoking is a social phenomenon that is marketed throughout
the United States to both female and male young adults of all
ethnic backgror:nds as a safer, nonaddictive alternative to cig-arette smoking (Akl et al.,2OlO; American Lr:ng Association,
20O7). Despite numerorls public health efforts to promote a
tobaccofree environment, hookah smoking is the only form
of tobacco use that is not regulated in the United States and
is currently exempt from clean indoor air legislation, such asthe Califomia Clean Air Act, which contributes to its rapidly
growing popularity among the adolescent and young adult pop
ulations