Do you know what your teen or twenty something year old is doing in college? They might be smoking tobacco with a waterpipe (aka bong or hooka).

Recently the University of Buffalo published an alarming paper about Students in schools and universities in the U.S. and around the world using waterpipes to smoke tobacco at “alarmingly high” rates.

Smoking in this manner absorbs more nicotine and other caustic chemicals. It achieves a quicker high as well as has greater negative effects.

Published in Biomedical Health Central Public Health, the paper is the first systematic review of the prevalence of waterpipe smoking across countries, age groups and genders. Systematic reviews are conducted through an exhaustive and systematic search for, assessment, and analysis of, all relevant, peer-reviewed research ever published on a particular subject.

“Waterpipe smoking is a real epidemic in the world and it’s picking up in the U.S. too,” says Elie Akl, MD, PhD, lead author and associate professor of medicine, family medicine and social and preventive medicine at the University at Buffalo’s School of Medicine and Biomedical Sciences and School of Public Health and Health Professions.

In addition to over poor health concerns with Waterpipe smoking, there are oral concerns as well – including periodontal disease and oral cancer.

To learn more about the study, go to