In a dimly lit room, decorated in vibrant colors, with the sounds of relaxing music, the scene is set for the practice of one of the most deeply rooted Middle Eastern and Indian traditions: smoking hookah. This tradition involves smoking flavored tobacco, called shisha, from a tall, often elegantly decorated water pipe, filling the room with a sweet and fruity aroma.

But the exoticism of this tradition has recently traveled West, particularly to college towns. Throughout the United States, hookah bars have been opening in the hopes of attracting young smokers, according to an article published in the journal Public Health Nursing.

While there are only 16 hookah bars in Pennsylvania, according to hookah-bars.com, Omar’s Hookah Café recently brought the tradition to Lancaster Avenue. The new, student-friendly locale alerts passersby “We accept Wildcard” with a sign sitting prominently in the storefront window.

Hookah bars supply their customers with water pipes packed with shisha, ranging in flavors from mango to vanilla, and individual hoses with disposable mouthpieces allowing customers to sit back, relax and puff away.

“It’s really the alternative to the bar scene,” said Mark Farley, the property owner of Omar’s Hookah Café in Bryn Mawr, which opened about five months ago. “The hookah experience is actually people sitting down and having a conversation. It’s not like a bar where you sit there pounding beers.”

Customers travel from New Jersey and Delaware to visit the newly opened hookah bar and restaurant, according to Farley.

An estimated 100 million people worldwide smoke tobacco from water pipes on a daily basis, according to the Harvard Mental Health Letter.

The recent rise in popularity of hookah smoking has also become the center of interest for many health care professionals.

In a survey conducted through the Office of Health Promotion, Villanova students were asked to report on topics including their hookah use, the perception of its harm and its social acceptability. The study showed that 51 percent of the students have tried hookah. Furthermore, 84 percent of the students surveyed believe smoking hookah was socially acceptable among their peers.

Ineffective cleaning of shared water pipes can be the source of infectious diseases, according to the American Lung Association, though local owners argue that they mitigate this potential problem by providing customers with disposable caps to cover the mouthpieces of the shared hookahs.

The American Lung Association also reports that hookah bars can be a source of second-hand smoke for non-smoking bystanders.

Indoor smoking regulations are an area of the law that should be evaluated, according to Ruth McDermott-Levy, a professor in the College of Nursing.

In the same survey of Villanova students, 51 percent of the students believed that smoking hookah had fewer health risks than smoking cigarettes.

Starbuzz, the brand of shisha used at Omar’s, contains zero percent tar, and with .05 percent nicotine, there is no physical addiction factor.

However, the charcoal used in the process of smoking hookah increases the carbon monoxide, heavy metals and particulate matter in the inhaled smoke, which is not found in cigarettes.

Researchers at the American University of Beirut also found that the practice of smoking hookah bodes health risks of its own.

Since hookah smokers inhale more volume and do so for longer periods of time, the hookah smoke inhaled in a typical one-hour session is equivalent to the smoke of 100 cigarettes, or five packs.

However, during a typical session, more than five people usually take turns inhaling, according to Farley.

“It’s something you do maybe once a week,” he said. “And it’s not like you’re smoking the whole time you’re here.”

Regardless, smoking hookah increases risks for lung cancer, respiratory disease, heart disease, nicotine addiction and mouth cancer, according to the American Lung Association.

While these risks are listed on the cans of shisha, customers at hookah bars are normally seated at a table and provided with the shisha already out of the package and ready to be smoked. This setting takes away any opportunity to view the Surgeon General’s warning with the potential health hazards associated with smoking hookah.

There is a need for education and policy change, especially with regard to how the customer is warned of the health effects, according to McDermott-Levy.

Daina Amorosano and Kelsey Ruane contributed reporting to this article.