Hookah pens: Gateway to smoking tobacco?

By DONALD BUCKLINMay 4, 2013 

The electronic cigarette has had a rocky start. It is frequently portrayed in the media as something only a fool would use. You might say the e-cigarette has an image problem.

Even cigarette companies managed the media better than this.

Cigarette companies joined forces with Hollywood to make cool smoking characters. Who can forget James Bond (Sean Connery) with a cigarette dangling casually out the corner of his mouth, undisturbed by all manner of physical violence, as was his hair.

Enter the hookah pen, a re-imagined e-cigarette. This is very brightly painted, an almost psychedelic contraption that is reminiscent of 1970s rock album art. It's not hard to figure out who this is marketed to. It kind of time warps you back 40 years to black-lighted Spencer's Gifts Stores. The hookah pen is an e-cigarette for the avant-garde -- and possibly our children.

In case the e-cigarette has not caught your attention, it is long, thin and vaguely cigarettelike. It uses a battery operated heating element to vaporize a liquid that you inhale. This is more flavored steam than smoke. Still, it manages to be a very smokinglike experience.

In a traditional hookah, the liquid that is burned is a mixture of tobacco and molasses. This provides nicotine and hundreds of other chemicals from burned tobacco. Note that it's not safer than any other type of tobacco smoking.

But the hookah pens advertise that the liquid burned in the device has no tobacco, no nicotine and no tar resins. So, you might ask, what's the point? Isn't smoking a hookah pen kind of like kissing your sister?

Discussions of Coke or Pepsi notwithstanding (sorry, Sharon Stone), it does give a young person practice with the ritual of smoking. They put the darn thing in their mouth and intentionally inhale warm vapors. It is part pacifier, part forbidden fun.

Once they have practiced that, it's an easy step to exchange the perfumed liquid cartridge for the real one that has nicotine.

Cigarette smoking exists today because most people got into smoking before they were old enough to make an informed decision. Nicotine, aside from being poisonous, is a pretty amazing drug. It makes you more calm and alert simultaneously. It's the only drug that does both.

So you become that James Bond person -- cool under fire and thinking faster than everyone around you. But cigarette smoking is addictive and gives you cancer and heart disease. And you have to be way smarter than JB to beat either of these.

People trying to quit smoking complain about missing the ritual as much as the physical withdrawal. The morning cigarette with the first cup of coffee is described with loving detail by any ex-smoker. They speak about not knowing what to do with their hands and the physically comforting sensation of handling the cigarettes and lighter.

The use of a hookah pen is not dangerous in and of itself. But it encourages a smokinglike habit, and that is the last thing a young person needs to experience.

Perhaps 20 years from now we will be able to tell you positively whether hookah pens lead to smoking. In the meantime, my kids don't play with guns or e-cigarettes. What about your kids?

Dr. Bucklin is a regional medical director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years.

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