Sitting in front of you are three options. Your mission, should you choose to accept it, is to pick the healthiest option of the three. First, you have a regular cigarette. Next, you have an e-cigarette. Finally, you have a hookah. Which do you choose? If you are under the age of 25, you are more than likely to choose the e-cig or hookah as the healthier option.

A new study of 2,871 smokers and non-smokers between ages 18 and 34 found that nearly a quarter of them said hookah was a safer alternative to cigarettes. This belief was shared by both smokers and non-smokers alike. "This is concerning as it suggests that even a substantial proportion of nonsmokers may view hookah as being a relatively safer and acceptable way to use tobacco," researchers Dr. Olivia A. Wackowski and Dr. Cristine D. Delnevo wrote.

They also found that:

  • 62.1 percent of young adults ages 18 to 24 believed that e-cigarettes were less risky than cigarettes, while 54.6 percent of 25- to 34-year-olds believed e-cigarettes to be less risky. Additionally, 32.7 percent of 18 to 24-year-olds believed hookah to be less risky than cigarettes, while 18.5 percent of 25- to 34-year-olds believed hookah to be less risky.
  • 57.8 percent of respondents believed e-cigarettes to be less risky than cigarettes and 11.4 percent said they were unsure.
  • 50 percent of respondents said that methanol cigarettes, hookah, cigars, smokeless tobacco, and snus were about as risky as cigarettes.
  • 30 percent of all respondents believed that smokeless tobacco, menthol cigarettes, and cigars were more risky than cigarettes.
  • 24.5 percent of respondents reported that hookah is less risky than cigarettes, which was equally prevalent for both cigarette smokers and nonsmokers.
  • 31.2 percent of respondents reported that they had smoked at least 100 cigarettes before and smoked regularly at the time of the survey.

According to the study, advertising, different flavors, and the positive feelings given off by shiny, techy products may all be reasons why the younger generation thinks hookah and e-cigarettes are safer options than cigarettes. The belief that some tobacco products were riskier than cigarettes still did not stop people from using them, researchers found. Saying that other tobacco products were safer, the researchers ventured, may not encourage smokers to switch to that product. Instead, it seemed to encourage smoker and nonsmokers alike to take up the new product.

While many young people believe that hookahs or e-cigarettes are a healthier alternative to cigarettes, the fact of the matter is that they aren’t. Smoking hookah for an hour is the equivalent of 100 cigarettes, while some e-cigarettes may use the same addictive nicotine found in cigarettes. So, really the best option, if you’re a young person looking for a “healthy” smoking option, is to not smoke at all.

Source: Olivia A. Wackowski. Cristine D. Delnevo. Young Adults’ Risk Perceptions of Various Tobacco Products Relative to Cigarettes. Health Education & Behavior. 2015.