While cigarette usage has declined among young people, a latest New York University study has found a high prevalence of hookah among high school seniors at the same time.

Based on a national survey of 5,540 students between 2010 and 2012, researchers from the Center for Drug Use and HIV said that one in five youths (18 percent) smoked hookah. American adolescents from well-off families are also more likely to use the Middle Eastern-style pipe.

Researchers said that there is a sharp rise in hookah-use among teens as they are not aware of its dangerous effects on health.

"It's more of a socially accepted behavior compared to cigarette smoking. For cigarettes, the stigma has been increasing," said Joseph J. Palamar, an assistant professor of Population Health at NYU Langone Medical Center and one of the authors of the study, NY Daily News reports. ".. You're even more likely if you live in a big city like New York."

The study affiliated with Centers for Disease Control and Prevention (CDC) wanted to determine the prevalence and usage of hookah among teens. Researchers used data from Monitoring the Future (MTF) that surveys students at about 130 public and private schools in 48 states.

Researcher Palamar also found that students, whose parents are highly educated or are associated with higher personal income, are more likely to use them. Hookah use is also popular in cities, particularly big cities, unlike cigarette-use that is more prevalent in non-urban areas.

The study titled "Hookah Use Among U.S. High School Seniors," is published in Journal Paediatrics.