My friends and I don’t smoke cigarettes, but we smoke hookah sometimes to chill out. We heard that since the smoke is filtered through water, it’s way safer than cigarettes. Is that true?

Great question! You’re not alone–many teens who would never touch cigarettes are tempted by the social vibe and fun flavors of hookah. Teens have been inundated with anti-cigarette messaging for decades, and it’s working—cigarette smoking has fallen out of favor among young people over the past 40 years. However, new ways to consume tobacco are cropping up along with confusing misconceptions about their safety. Bars and restaurants that do not allow cigarette smoking often have hookah lounges that people under the legal drinking age can access. Hookah tobacco, or shisha, comes in flavors like peach, cappuccino, and mint that seem harmless compared to cigarettes.

But this yummy-sounding smoke contains the same gross carcinogens as cigarette smoke–including nicotine, a highly addictive and harmful substance. In fact, a 45 to 60 minute hookah session exposes you to the same amount of tar and nicotine as an entire pack of cigarettes! In addition to nasty carcinogens, smoking hookah exposes you to some gnarly germs if the cafe doesn’t clean their hookah well.

However, people don’t smoke hookah in the same way they smoke cigarettes–usually, it’s an occasional social activity, not a daily practice. You and your friends can try experimenting with other chill-out activities and spaces that don’t involve breathing tar right into your lungs–like going for a walk together or chilling out at a coffee shop. If you do continue to smoke hookah, try to reduce the frequency of your shisha sessions and make sure that the cafe you go to actually cleans their hookahs!

Be honest with your medical provider if you smoke (anything)! Although they may encourage you to adopt healthier habits, they won’t judge you–and smoking can seriously impact their recommendations for your health, including which types of medication are safe to prescribe.