The patios at local hookah bars are crowded on summer evenings when the trendy practice provides a nice way to relax after busy days, said Arab Cowboy co-owner Dawn Scheel.

But according to a Tuesday New York Times article, young people underestimate the health risks, not realizing they may be as severe as those associated with smoking cigarettes or other tobacco products. Many people believe the water pipes filter out harmful carcinogens, but that’s simply not true, said Philip Huang, the medical director for Austin Travis County Health and Human Services.

“If you compare hookah smoke to cigarettes, it can have 15 times more carbon monoxide, far more tar and byproducts like nickel and lead,” Huang said.

“The way that a hookah is smoked, you’re taking longer and harder drags on the pipe, so you get increased levels of the carcinogens and nicotine.”

Scheel said Arab Cowboy uses high quality shisha to keep tar and other harmful chemicals out of the shop. She added that hookah smoking has a cultural and social value other types of smoking lack and said most people smoke hookah occasionally or in a large group, so they aren’t likely to inhale as much tobacco as a
pack-a-day smoker.

“Austin is still growing with its hookah culture,” Scheel said. “My husband [owner Anouar Bhiri] is from Tunisia, and we love the culture of hookah there. We wanted to bring a new idea of it to Austin, that it’s not a dark and dingy thing to do. It’s a cafe sort of thing to do, and it’s a very social thing to do.”

Austin resident Carolynne Eerit frequents Kasbah, a hookah bar on the drag, and said she has read mixed reports about whether hookah is more or less harmful than cigarette smoking. Regardless of the health risks, Eerit said smoking hookah feels good compared to other types of smoking because it is cooled through water.

“You don’t get the nasty throat, so even nonsmokers are willing to try it,” she said.

Austin’s smoking regulations can make it hard for hookah establishments to conduct their business, Scheel said. Any establishment that allows indoor smoking such as a hookah bar or smoke shop can only make 5 percent of revenue from non-smoking items, such as food and drinks. In May, Arab Cowboy transitioned its operation to have a full restaurant and bar inside. The smoking area is now outside under a covered, fanned patio in order to meet city regulations.

City code does not allow for exceptions for businesses that may want to offer both smoking and food sales indoors, said Robert Wright, the supervisor for the environmental and consumer health department of Austin Travis County Health and Human Services.

“The city code reads how it reads. We can’t make an exception for an establishment even if their clientele has different expectations about the presence of smoking,” Wright said.