It’s a Saturday night. A group of college students are gathered in a circle with friends smoking Khalil Mamoon The newest local hookah lounge is their favorite hang out.

A hookah is a pipe with a long, flexible tube that draws smoke from the bowl of water to which it is connected. This instrument of Near Eastern origin allows the user to smoke flavored tobacco called shisha. Think: caterpillar in Alice in Wonderland.

Though smoking hookah has been around for centuries, hookah use is on the rise amongst college-age Americans. In fact, one in three college students has smoked hookah, according to a recent study conducted by Brian Primack, an associate professor at the University of Pittsburgh School of Medicine. At the same time, the number of cigarette smokers is declining.  “No one wants to be seen smoking a cigarette, but there are a million pictures of kids blowing smoke from their mouths while smoking hookah on Facebook,” said Renee Borshchukova, a rising junior at Nova Southeastern University. “It’s just the new trend right now.”

Although, research has not yet shown if hookah is addictive.One hookah session delivers approximately 100 times the smoke as a single cigarette, and participants inhale twice the amount of nicotine as they do with a single cigarette, according to CNN Health.  A 2005 WHO report states that smoking using a waterpipe poses a serious potential health hazard and is not a safe alternative to cigarette smoking. Smoke from a waterpipe contains high levels of toxic chemicals, including high levels of carbon monoxide, metals and cancer-causing chemicals.