Drugs

Vape Panic Is Accidentally Killing Hookah Too

If states continue to ban flavored tobacco and vaping products, hookah could be collateral damage in the U.S.
January 14, 2020, 6:42pm
Tobacco-Flavor-Bans-Could-Make-Hookah-Extinct-in-the-U
Illustration by Hunter French

Hookah has never been the main enemy in the war on tobacco. Once feared for its potential to drive college students to nicotine, it has largely faded from the news. In the U.S., hookah lounges are mainly found in immigrant communities in major urban centers like Los Angeles and New York, a centuries-old tradition brought over from the Arab world. Many who own these establishments and frequent them cite them as communal gathering places, much like bars.

At the moment, though, hookah is on the verge of extinction.

This has been an inadvertent side effect of the vape panic. As the so-called youth vaping epidemic continues to be an issue demanding a response, more and more states, cities, and towns are trying to ban all flavored tobacco products, which they consider to be most attractive to teenagers. Often lumped into that category is what's commonly called "hookah" or "shisha": the molasses-laden and syrupy tobacco substance—usually flavored with "apple," "mint," and "papaya"—found in a hookah pipe, the large device that burns the mixture with small coals and filters the smoke through water before it enters your lungs through a long hose. You usually don't do this alone; there are even sometimes multiple hoses on the same hookah.

Now, as local lawmakers and politicians place hookah alongside what they consider kid-friendly e-liquid flavors, hookah lounge owners and the hookah industry at large are arguing that they should be exempt from such legislation. For them, their point is simple: to make hookah illegal would be a cultural affront.

"There are so many minorities represented in California alone—to criminalize a cultural tradition because of vaping seems disproportionate," said Rima Khoury, a lawyer who represents Fumari, a sizable hookah company based in San Diego.

It would interfere with their entire way of life, she said. Nowhere is this currently more prominent than in Khoury's California, where last year State Senator Jerry Hill pulled a bill intended to ban flavored tobacco products because of "hostile" amendments to it. One included an exemption for hookah because of constant pressure from the hookah industry.

"The biggest challenge has been educating lawmakers on hookah," Khoury said. "We've literally brought hookahs to city hearings. They don't fit in children's backpacks. They're not being confiscated in schools. We don't want hookah to become collateral damage in what feels like this war against vaping."

"I find it hard to believe that use of gummy bear- and bubble gum–flavored tobacco in any form is a cultural tradition," Hill said in May 2019, according to the Los Angeles Times.

He still appears to think that. In early January 2020, just a week or so ago, Hill introduced a similar bill without a hookah exemption. If it passes, California would become the second state to ban flavored tobacco products, after Massachusetts did so in a sloppy back-and-forth battle this past year. (That state does have a hookah or "smoking bar" exemption, and the law is set to go fully into effect in June.) Hill has reinvigorated a battle that the hookah industry had thought it nearly avoided on the state level, even as cities across California—including Ventura and Hermosa Beach—have moved to ban flavored tobacco and hookah along with it. Some, such as Long Beach and Burbank, have already altered their bills and exempted hookah after pushback from people like Khoury.

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Although it's something of a secondary argument, Khoury and others in the industry are worried, too, that any kind of prohibition would shut down small businesses, much like vape shops. This despite the fact that hookah clearly didn't cause the youth vape crisis. A proposed ban of flavored tobacco products throughout Los Angeles County would completely cripple Mary Danaciyan, who has operated 5 Star Hookah in Granada Hills for the past 12 years. She said that she has a three-year lease with her landlord that she can't get out of, and also supports her parents and grandmother. She emphasized that she is more than willing to work with regulators. (The Trump administration recently raised the federal age in which to purchase nicotine products from 18 to 21 and instituted a partial ban on flavored vaping products nationwide.)

"Lawmakers just don't seem to do their research," Danaciyan said. "There are a lot of elderly, Middle Eastern people in my neighborhood. They can't all go to hookah lounges. They smoke hookah at home. Including myself. For me, relaxing is reading a book and smoking hookah in my living room."

There is no denying that hookah is dangerous. It does not have the support of harm-reduction proponents and major scientists, who claim vaping to be a safer alternative to smoking combustible cigarettes and a potential off-ramp to ditching the habit. But compared to the 27.5 percent of high school respondents who said their "most commonly used" nicotine product was an e-cigarette, and 5.8 percent a regular cigarette, only 3.4 percent stated that theirs was hookah, according to the 2019 National Youth Tobacco Survey, a document released annually by the Centers for Disease Control and Prevention. And although "the vast majority of American teens have never tried hookah," misconceptions abound, particularly that it is not as dangerous as cigarettes.

"Hookah has never really been singled out and examined," said John F. Banzhaf III, a professor of law at George Washington University and longtime leader of the nonsmokers' rights movement. "It wasn't that e-cigarettes came along and changed the conversation. It's that there hasn't been the sort of hyper-focus that you've seen elsewhere."

Hookah has come under fire before. Tobacco laws, including those having to do with hookah, can drastically vary from state to state and even city to city. In 2017, according to New York City's health department, there were 400 hookah "establishments" throughout the five boroughs, four times as many as there were in 2012. Local politicians took notice: That same year, the NYC Council bolstered an already-stringent indoor smoking policy by further cracking down on hookah lounges, barring any new ones from opening up and requiring existing ones to obtain a permit and prove that at least 50 percent of their sales came from smoking. All NYC locations must also only serve non-tobacco shisha, meaning it's all flavor and no substance—smoking hookah in New York will not provide you with a nicotine rush. In Maryland's Baltimore County, hookah lounges have to close at midnight.

The debate around hookah exemptions has also brought up a question that often gets buried amid the stigma of smoking, the leading cause of preventable death in the world: Can tobacco—and nicotine—be a form of leisure? Can it be part of an activity you simply do with your friends, like drinking?

"It's important to recognize that social patterns of tobacco use have always shifted over time, and that arguments about culture need to be balanced against the interest of public health," said Micah Berman, an associate professor of public health and law at Ohio State and an expert in tobacco control. "If you are selling a product known to be highly toxic," he continued, "you are essentially on notice that more regulation might be coming at any time."

Still, none of this patchwork legislation among disparate cities and states throughout the country will matter much come May 2020. That's the date, etched in vapers' minds, when vape sellers have to submit their premarket tobacco applications to the Food and Drug Administration (FDA)—an expensive and arduous process they've claimed would shutter the entire industry and leave it in the hands of Big Tobacco–supported companies, like JUUL Labs.

Hookah companies must also submit that application, and are therefore at the whims of the same FDA approval. Their products could be stripped from the marketplace. Although there's a possibility, given some bureaucratic loopholes, that hookah manufacturers that produce flavored tobacco might be grandfathered in, essentially since they've been on the market much longer than vapes and e-cigarettes. It is, however, far from a guarantee.

"Hookah has been around for hundreds and hundreds of years," said Azim Chowdhury, a public policy attorney who specializes in tobacco regulation. "It's not a cigarette. It's not a replacement for cigarettes. It's its own thing."

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