My friends and I don’t smoke cigarettes, but we smoke hookah sometimes to chill out. We heard that since the smoke is filtered through water, it’s way safer than cigarettes. Is that true?

Great question! You’re not alone—many teens who would never touch cigarettes are tempted by the social atmosphere and fun flavors of hookah. Teens have been inundated with anti-cigarette messaging for decades, and it’s working. Cigarette smoking has fallen out of favor among young people over the past 40 years.

However, new ways to consume tobacco are cropping up along with confusing misconceptions about their safety. Places that don’t allow cigarette smoking often have hookah lounges, that people under the legal drinking age can use. Hookah tobacco, or shisha, comes in flavors like peach, cappuccino, and mint that seem harmless compared to cigarettes.

But this yummy-sounding smoke contains the same gross cancer-causing substances (also called carcinogens) and toxic compounds (like tar and carbon monoxide) as cigarette smoke. This includes nicotine, which is highly addictive and can mess with the way teens’ brains develop.

Of course, people don’t smoke hookah in the same way they smoke cigarettes. Usually, it’s an occasional social activity, not a daily practice. But according to the National Institute on Drug Abuse, in a typical hookah session you’ll inhale 125 times the smoke, 25 times the tar and over two times as much nicotine as when you smoke a cigarette.

Smoking hookah can also expose you to nasty germs if the café doesn’t clean their hookah well.

The next time you and your friends are thinking of doing hookah, try suggesting a different activity. Go for a walk, listen to music, play a board game together, or go to a coffee shop or diner. If you do keep smoking hookah, try to reduce the frequency of your shisha sessions and make sure that the cafe you go to actually cleans their hookahs!

Remember that it’s important to be honest with your health care provider about whether you smoke anything—whether it’s hookah, e-cigs or traditional cigarettes. Although they may encourage you to adopt healthier habits, they won’t judge you. Plus, smoking affects which types of medication are safe to prescribe.

A version of this post was originally published in August, 2016.

Photo from just_a_cheeseburger on Flickr.