Research suggests cigarette smoking has hit an all-time low. However, another form of tobacco use is rising in popularity.
Hookah smoking is most popular for people ages 18 to 24, according to the U.S. Centers for Disease Control and Prevention.
"They can't go out and drink, so they go out and smoke hookah," said Jacob Hudlund, a hookah lounge worker.
Hudlund, 21, started smoking hookah a few years ago.
"I was actually a cigarette smoker beforehand and I just started smoking hookah with friends," he said.
He said there are few places here in Omaha, Nebraksa, to do hookah. And most people around town have never heard of it. But for those who have, he notices it is mostly younger people.
"Eighteen to 25 is gonna be our most popular age range, a lot of times we get a decent amount of new smokers but we also have a lot of regulars," Hudlund said.
He says he thinks younger people are attracted to hookah because it is a very social pastime.
"A lot of times if you are smoking hookah, you're smoking with two or three other people and you guys are passing around a hose and maybe playing board games at the time," said Hudlund.
Daisy Dai, an associate professor at the College of Public Health at the University of Nebraska Medical Center, agrees. She adds that the popularity could be linked to the myth that hookah is healthier than traditional smoking.
"The reality is of every hookah session that lasts one hour, the hookah smoker during that session actually takes 200 puffs on average, and to smoke a cigarette it only takes 20 puffs," she said.
Just like regular cigarettes, hookah contains nicotine that can be linked to cancers and addiction. However Hudlund said it can be hard to tell just how much nicotine is actually in a round of hookah. The percentages are based off the type of leaf used in the hookah.
"The blonde leaf, that's a lot lower in nicotine might be closer to .03 (percent) or a little lower, but like the dark leaf could be higher maybe roughly around like .06," he said.
Dai says another issue that can be related to hookah smoking is the diseases that can be passed through sharing the mouth piece on the pipe.