"Smoking hookah," otherwise known as inhaling flavored tobacco product through a hose affixed to an elaborate water pipe, is growing in popularity, particularly among Florida high school students. Moreover, it's increasing in popularity among Hispanic Florida high school students. The habit is replacing the trend of traditional cigarette usage, and has become a favorite among teenage boys and teenage girls. The Florida Youth Tobacco Survey has indicated that the rate at which teenage girls smoke hookah has caught up to boys. Hispanic teens are leading that trend, as they are most likely to try and then continue the habit.

Many teens are under the assumption that a hookah is a safe alternative to cigarettes, when in fact it isn't. The Center for Disease Control (CDC) has indicated that users of a hookah expose themselves to more toxins than those who use the occasional cigarette. Hookah is, on average, smoked for 45 minutes at a time, thus delivers 36 percent more tar, 70 percent more nicotine and 15 times more carbon monoxide into the body. The associated health problems "include but are not limited to cardiovascular disease, oral disease, cancer and decreased (lung) function," according to a postdoctoral research fellow at the Stanford University School of Medicine in California.

Since 2007, the number of Florida boys who tried hookah rose from 12 to 17 percent, and the number of girls who used a hookah rose from 9 to almost 17 percent, with Hispanics being at the forefront of those statistics, being more likely (22 percent) to try hookah than non-Hispanic whites (19 percent) and non-Hispanic blacks (five percent). Eleven percent of Hispanic teenagers in Florida smoke hookah regularly.

The Florida Youth Tobacco Survey was given to a random sample of public high school students (between 4,000 and 40,000 students fill out the tobacco survey annually) leading to the report that indicated that one-in-six teenagers used tobacco in 2012, compared to one-in-nine in 2007.

"Since its use can pose significant health risks, hookah smoking is a trend that is of concern not only in Florida, but also in communities across the United States," said Kymberle Sterling, from the Georgia State University School of Public Health in Atlanta.

Sold in hookah cafes and smoke shops, and offered with flavored tobacco fermented in fruit extract and molasses, it is far more palatable and attractive than other tobacco products. Many believe hookah to be a 'gateway' to other uses of tobacco among individuals who would normally remain naïve to the legal drug.

Most states require that customers in hookah lounges be 18 or older to enter, but teenagers can easily gain access to a hookah without going into a lounge.