Hookah is just one name for a type of tobacco smoking called waterpipe smoking. Other common names include Shisha and Narjila. All types of waterpipes have their roots in India, Africa, and the Middle East. Hookah smoke use an indirect heat source (such as lit charcoal) to slowly burn tobacco leaves while users draw smoke through a water chamber and into their mouth using hoses. The introduction of ma’assel, a molasses-soaked smoking tobacco, in the early 1990s has led to growth of hookah smoking across the Middle East and other regions.

While many users think that smoking hookah is safer than other forms of tobacco, hookah smoking allow users to inhale even greater quantities of smoke compared to cigarettes and hookah smoking increases the risk of lung, lip, mouth, and esophageal cancer. Due to these safety misperceptions, as well as smoking-ban exemptions in the USA and Europe for hookah smoking in cafes, the prevalence of hookah smoking continues to increase around the globe.