Hookah smokers call it smooth and relaxing. Doctors call it dangerous, even saying it’s worse than picking up a cigarette. On any Friday night, people fill J.J. Hernandez’ hookah bar in Jacksonville. “At capacity,” said Hernandez. “It’s a cultural thing.”

The practice dates back at least 500 years to India, but now hookah bars can be found a nationwide, including in the River City.

There are more than a dozen hookah bars around town. Hernandez opened one about a year ago. “It’s very popular. It’s the in. It’s the fashion trend,” said Hernandez.

But when it comes to smoking hookah, a man by the name of Dave Paul doesn’t need to socialize at a bar. “Just a nice way to relax,” said Paul.

If Paul needs a hookah fix, he just loads a pipe up with the flavored tobacco and puffs away on the hose at home. “It just helps you wind down,” said Paul.

Paul calls it meditative, a practice he started about 10 years ago. At times, it’s been every day of the week.

“It was kind of a ritualistic thing. It was just the thing where, ‘ok, I’m done with the day, sit down, what do I want? I want a hookah’,” said Paul.

After so many years smoking hookah, countless times, Paul said it’s not as addictive as cigarettes.

“I know people who smoke every five seconds, they are fiending for one. They’re like, ‘oh my God, I haven’t had a cigarette in five minutes. I need one…’”

But medical experts are now comparing the dangers of cigarette smoke to that of hookah, saying smoking hookah for an hour is the equivalent of smoking 100 cigarettes.

Dr. Lynnette Kennison said there are very valid reasons for hookah smokers like Paul to be concerned. “The reality is, you’re getting much more than just flavor,” said Kennison.

Smoking hookah consists of lit charcoal and flavored tobacco on the head of the hookah pipe. The body of the pipe holds a water bowl and a hose.

Air is drawn through the tobacco, into the body of the pipe and passes through the water before being inhaled through the hose. “These are toxic elements that people consume and don’t realize,” said Kennison.

There’s tar, nicotine and mostly carbon monoxide, she said. A new University of Florida study found that people leaving hookah bars had carbon monoxide levels more than three times higher than people leaving traditional bars.

The Mayo Clinic also links hookah with lung and oral cancers as well as heart disease.

“For one thing, you don’t get the oxygen delivered to your heart, to your organ systems. It’s like being choked and you’re getting a depletion of oxygen,” said Kennison.

Kennison, also a professor at Jacksonville University, is urging students to make a conscious decision before hitting the pipe.

“When I’ve talked to students…Pretty much the answer is, the tobacco has been purified and you don’t get any nicotine. You don’t get any tar. You don’t get any carcinogens because it’s all going through the water,” said Kennison.

But that’s not true, said Kennison.

But Paul said he’s had no health problems and even with warnings from medical experts, he’s just not sold on the dangers.

“Next thing you know, they’re going to be telling you the sticks in pop ices….something is going to seep out and give you some sort of mouth cancer…,” said Paul.

Hookah smoking will continue at the Paul household. “It won’t be an everyday thing, more of a recreational it’s a nice day, let’s have a hookah,” said Paul.

And more hookah bars are expected to continue popping up. “It’s still growing. It’s a lot of room for it to grow still,” said Hernandez.

Those in the world of medicine wouldn’t mind seeing that trend go up in smoke.

Some other concerns from medical experts:

Hookah smoking by pregnant women can result in low birth weight babies.
Doctors with Mayo also say some pipes in bars aren’t properly cleaned which increases the risk for spreading infectious diseases.
Hookah supporters say the pipes are properly cleaned and as with anything, it’s all about moderation.