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Dec 11, 2014 12:26 PM EST

Many college students consider hookah smoking safer than smoking cigarettes despite emerging evidence suggesting otherwise, according to a recent study.

Hookahs are water pipes used to smoke specially made tobacco that comes in flavors ranging from mint and berries to chocolate. Charcoal used to heat the tobacco in the hookah, which cools and filters the smoke through water, can raise health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals, according to the Centers for disease Control and Prevention (CDC).

Researchers from the University of South Florida suggest that because hookah smoking has not been targeted with comprehensive health campaigns similar to those warning about harmful effects of cigarette smoking, students are unaware of its health risks.

"The biggest surprise was the misperception about the dangers of hookah smoking," Jaime Corvin, principal investigator for the study, said in a statement. "They did not know the risks."

For the study, researchers interviewed 478 undergraduate and graduate students at the University of South Florida to evaluate their lifetime and current hookah use.

They found that more than half of the students surveyed (54.4 percent) reported using hookah at some point in their lives. The current prevalence of hookah use among the students within the last 30 days was 16.3 percent -- a finding consistent with other studies surveying college-aged students.

They also found that while most respondents acknowledged that hookah smoking has harmful effects, more than half of the sample perceived hookah to be a safer alternative than cigarette smoking, and 13 percent thought hookah wasn't harmful at all.

The reasons why students significantly underestimate the potential hazards smoking hookah were unclear. Corvin suggests the lighter, softer smoke emitted from the water pipe and its fruity, pleasant smell may contribute to the perception that hookah is less risky than smoking cigarettes.

The research suggests that future public health campaigns address misunderstandings about the risks associated with hookah use as well as the regulation of such alternative nicotine-delivery devices.

The findings are detailed in the CDC journal Preventing Chronic Disease.

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