2011-06-01 P-D: “Smoking ban has hookah bars in haze”

Who would have thought that hookahs would move in to fill the void left by smoke-free bars? I can’t imagine this device, which appears to deliver tobacco smoke to the user’s lungs, will be materially safer than a cigarette. The article notes:

According to the U.S. Centers for Disease Control and Prevention, hookah smoke delivers the addictive drug nicotine and is at least as toxic as cigarette smoke. Hookah smokers are at risk for the same kinds of diseases caused by cigarette smoking, including cancers and decreased fertility. The charcoal used to heat tobacco produces high levels of carbon monoxide, metals and cancer-causing chemicals.

The St. Louis Post-Dispatch article included a detailed illustration explaining the workings of a hookah which I also found on-line at http://www.hookahshisha.com/hookah_setup_diagram.htm.

Hookah - Click to enlarge

The following is a brief explanation of how the hookah works:

Inhaling via the mouthpiece draws air in through tobacco and charcoal in the bowl on top of the pipe, where the tobacco is burned, producing tobacco smoke. The smoke passes down into the water-filled jar in the base, before exiting to the tube at the top of the jar connected to a hose and mouthpiece.

At the bottom of the Post-Dispatch illustration of the hookah these additional health risks were noted:

* More smoke – Person inhales more smoke over a longer time compared to cigarette smoking
* Exposure – Increased carbon dioxide and nicotine exposure may contribute to heart disease and cancer.

Smoking ban has hookah bars in haze

BY MICHELE MUNZ • mmunz@post-dispatch.com > 314-340-8263 | Posted: Wednesday, June 1, 2011 8:46 am | Comments (64 as of June 2, 2011, 6:16 am)

May 24, 2011---Ali Abdulrazzak blows out a puff of smoke at Ranoush Nights, a new venue in the Delmar Loop. Ranoush Nights offers hookah but has no alcohol or food in order to comply with a smoking ban. Abdulrazzak works at the hookah lounge.
Photo: Emily Rasinski erasinski@post-dispatch.com

Since a smoking ban went into effect in St. Louis and St. Louis County at the beginning of this year, numerous hookah lounges and cafés have found various ways to continue lighting up, resulting in a confusing mix of services that some — even hookah lounge owners — say is unfair.
         The Middle Eastern restaurant Ranoush, located in the Delmar Loop, spun off into a separate business a few blocks east and into St. Louis, selling only hookah, soft drinks and coffee.
         At Al Waha on South Grand, the owner moved hookah smoking to the patio.
         Nara Café downtown closed its doors to those younger than 21 to allow hookah smoking inside.
         Other restaurants limited their hours or food sales so they could sell hookah inside to customers, including those under 21.
         “Are you a restaurant? Are you a bar? Or are you a hookah lounge? What are you? That’s what’s hurting me,” said Ranoush owner Aboud Alhamid, who said confusion has resulted in an uneven playing field. He took a strict interpretation of the ban and opened Ranoush Nights three months ago with no food or alcohol service so as not to lose the 18- to 21-year-old hookah smoker and those who want to smoke inside.
         Some hookah café owners argue for exceptions or even the creation of a special hookah license, saying that hookah smoking is a unique service — a deep-rooted Middle Eastern tradition tied to socializing, relaxing and meditating that dates to the 16th century.
         “It’s ethnic. It’s different,” says Riyad Alwadi, owner of Al Waha. “It’s not like smoking cigarettes.”
         Hookah is a water pipe used to hold tobacco soaked in flavorings such as apple, coconut, cherry and mint. Charcoal is used to burn the tobacco, and users inhale the water-cooled smoke through a hose.
         According to the U.S. Centers for Disease Control and Prevention, hookah smoke delivers the addictive drug nicotine and is at least as toxic as cigarette smoke. Hookah smokers are at risk for the same kinds of diseases caused by cigarette smoking, including cancers and decreased fertility. The charcoal used to heat tobacco produces high levels of carbon monoxide, metals and cancer-causing chemicals.
         Hookah smoking is also communal; each person uses his or her own replaceable and disposable hose tip. One hookah session costs about $12 for the group and lasts 45 minutes to an hour.
         Arguments over whether hookah lounges (as well as a downtown cigar bar) are considered a restaurant, bar or retail tobacco store have led Pam Walker, the director of the St. Louis Department of Health, to refer the issue to the city’s legal counsel for interpretation.
         “These hookah bars and cigar bars are a new phenomenon, and there’s a question over where they fall,” Walker said. “As you can see it’s kind of complex, and I need a lawyer to figure it out.”
         An exemption in the law was meant to be applied narrowly — to bars serving patrons 21 and older with food sales less than 25 percent of total food and alcohol sales. The city also requires that serving areas be less than 2,000 square feet.
         “It was meant for these tiny little places with just a microwave in the back … the corner bar that’s been there forever,” Walker said. “But people are trying to drive a train through it.”
         Retail tobacco stores earning more than half their revenue from tobacco and tobacco products are also exempt under the ordinance.
         The St. Louis County Department of Health has taken a stance that businesses “where they only hookah” are not regulated in any way as a restaurant or a retail store, said Gerrin Butler, the food and environmental program manager. These business do not sell food or alcohol. “The ones that decided just to open up a hookah bar, we don’t regulate them,” Butler said. “We recognize that that’s an establishment that doesn’t meet any of those clear definitions.”
         Because many states and cities have enacted smoking bans, hookah lounges have been growing in popularity in the U.S., especially around college campuses.
         Double Apple Café and Hookah Lounge opened in February near St. Louis University, and Café Nura opened six months ago near Webster University.
         The Ninth Street Hookah Lounge opened more than a year ago in the college town of Columbia, Mo., and Jinn Lounge opened about two months ago in Kirksville, Mo., home of Truman State University. Hookah lounges in the Central West End and Delmar Loop are popular spots for Washington University students.
         Double Apple co-owner Keren Arismendi said her partner Tareq Khoury used to own a hookah lounge near Lindenwood University in St. Charles. “It was a very busy area, and this area is the same,” Arismendi said. “They are all college kids, and they all love hookah.”
         Arismendi and Khoury got their business permit before the start of the ban. They had planned to open at 11 a.m. with a full menu but learned that would force their hookah services outside. Instead, they limited their menu and don’t open until 4 p.m. They also serve alcohol and allow minors, she said.


         Health officials fear that ways around smoking bans — as well as outright exemptions for hookah lounges — reinforce the belief that hookah is less harmful than cigarettes. The misconception combined with hookah’s increasing popularity represents a growing public health issue, they say.
         “The popularity of hookah smoking among young adults is quite alarming given the potential for negative health effects,” said Wake Forest University assistant professor Erin Sutfin, the lead researcher on a study published in April about hookah use among college students. “Unfortunately, many young adults are misinformed about the safety of hookah smoking, and some mistakenly believe it is safer than cigarette smoking.”
         Little research has been done on hookah use by young adults. But Sutfin surveyed nearly 3,800 students from eight North Carolina colleges and universities about their drug habits and knowledge.          The research found that 40.3 percent reported having smoked tobacco from a hookah, and 17.3 percent said they actively used hookahs. The hookah smokers were most likely to live within 10 miles of a hookah venue and believe that smoking from a hookah is less harmful than smoking a cigarette.
         A 2008 Internet-based survey of nearly 750 college freshmen found that 20 percent had smoked hookah in the past 30 days. Small studies in Florida and California show that significant numbers of high schoolers have smoked hookah. The findings have researchers pointing to the need to address the legality of hookah lounges.
         “State smoke-free bans need to include hookahs in their policies,” Sutfin said. “Several states with strong smoke-free policies have exemptions for hookahs. Hookah cafés create the perception that this is a safe activity. It is not.”
         Users interviewed at various hookah lounges, however, say they smoke hookah in moderation and don’t feel like it’s addictive. “It’s not a gateway to anything. I don’t want to smoke cigarettes,” said Carlos Restrepo, 21, a junior at Webster University. He says he enjoys the relaxed atmosphere and the social aspect of hookah smoking, especially with his younger friends.
         Hookah café owners said they were unsure how the law was going to be effective when it was being debated, and they continue to struggle to get straight answers on how to be in compliance.
         Rimla Javed, owner of the Café Nura in Webster Groves, sells a few pastries and sandwiches, but mainly coffee along with her hookah. She said she has been told by health department officials that she has to have a liquor license in order to sell hookah inside “because only bars can be exempt from the smoking ordinance.”
         But she’s willing to do that, “even though she does not want to sell alcohol” and because hookah is her niche, she said. “My biggest competition is Starbucks, and I can’t compete with Starbucks.”
         Unless the law is changed, hookah smoking will disappear from St. Louis in five years.
         The city ordinance ends all exemptions in 2016, but the county does not have such a sunset clause.

5 responses to “2011-06-01 P-D: “Smoking ban has hookah bars in haze”

  1. Mogasp, the article is biased, as can be seen in its two bullet points:

    “More smoke – Person inhales more smoke over a longer time compared to cigarette smoking” This simply compares a single hookah “session” of a half hour or so with smoking a single cigarette for five minutes or so. Of course they’ll inhale more smoke and of course it’s for a longer period of time. So what? They’re doing it a few times a week — not twenty times a day.

    “Exposure – Increased carbon dioxide and nicotine exposure may contribute to heart disease and cancer.” Huh? Increased CO2? That’s a problem? Even if they meant CO, neither the amount of CO nor nicotine in such occasional doses have ever been shown to have anything to do with CHD or cancer. Heck, you could argue that such sessions several times a week might be GOOD for the heart: the nicotine stimulant would produce heart activity similar to exercising several times a week.

    Also: See Kamal C presentation @ Conf.#2 at antiprohibition.org
    – MJM

    mogasp: Your comments appear valid. They don’t address the risk to employees of course, which is why MoGASP wouldn’t support an exemption for such places.

  2. Fair enough Mogasp. Although some antismoking advocates like to argue for the right of employers to hire only nonsmokers. In cases like that of course they’d have to recognize the right of employers to hire only smokers.

    If a hookah bar hired only smokers then the argument about “risk to employees” would be pretty invalid. Heh… it’d be sort of like arguing that swimsuit models who spent all day tanning on the beach could sue indoor employers who expossed them to the UV radiation given off by fluorescent lightbulbs!


  3. The problem with MoGASP’s position is that you assume that all the employees want protection. I have repeatedly stated that in a free society one is free to take risks and businesses are free to cater to those risks. The anti-smoking movement is doing more to promote smoking then the tobacco companies ever could. Just look at Candada and Scotland where smoking is demonized and have complete bans. During and after the smoking bans in the early part of the 20th century cigarette and alcohol consumption went up as a result of prohibition and bans. Children rebel and they will hed right for what you deamonize. The bad boy image of James Dean is a classic example. The modern day facination with Charlie Sheen is a modern day example. Cigarete smoking has been on the decline for decades on its own, all you will manage to do is revrse this trend.

    Marshall P Keith

  4. Marshall’s point about employees having the right to be free to take some risks and for employees to offer positions with such risks is valid. Think for a moment about drive-in diner that decides to revive the 1950s atmosphere by having its wait staff take and deliver orders to cars while on roller skates. Obviously skating represents a risk of injury, and when doing it in the context of a car-filled environment it represents a clear increase in the risk of death. And, “in the current economy some employees might clearly feel forced to choose between their lives and a paycheck” in taking such a job.

    So should such a diner be illegal? After all, roller skating is clearly neither inherent nor necessary to the dining experience, and requiring skaters also discriminates against many with minor disabilities. A lawsuit under the ADA might have as much traction as the one being pushed by Antis regarding Nevada casinos and their lack of smoking bans.

    – MJM

  5. Another classic problem with mogasp wanting to protect hooka bar employees, is that if hooka bars are banned, there will be no employees.

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