Olivia A Wackowski and Cristine D Delnevo from School of Public Health of Rutgers University in US studied data from 2,871 smoking and non-smoking young adults, ages 18-34.
They found that a quarter of young adults believed hookah to be less risky than cigarettes - a belief shared by current cigarette smokers and those who had never smoked cigarettes before.
"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," the researchers said.
Additionally, 32.7 per cent of 18 to 24-year-olds believed hookah to be less risky than cigarettes, while 18.5 per cent of 25 to 34-year-olds believed hookah to be less risky.
The study also found that 57.8 per cent respondents believed e-cigarettes to be less risky than cigarettes and 11.4 per cent said they were unsure.
Half of the respondents said that methanol cigarettes, hookah, cigars, smokeless tobacco, and snus were about as risky as cigarettes.
About 24.5 per cent of respondents reported that hookah is less risky than cigarettes, which was equally prevalent for both cigarette smokers and nonsmokers.
Nearly 31.2 per cent of respondents reported that they had smoked at least 100 cigarettes before and smoked regularly at the time of the survey.
"This might be associated with differences in advertising messages these groups are exposed to, the variety of flavours these different products are offered in, and in the case of e-cigarettes, possibly an inclination for younger people to attribute more positive feelings toward newer products that are seen as new and 'techy'," researchers said.
They speculated that promoting other tobacco products, such as snus, as safer may not encourage smokers to switch products but instead encourage new product uptake for both smokers and nonsmokers.
The study was published in the journal Health Education and Behaviour.
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