Hookah use has become increasingly popular in America, especially among college students. But what many students may not realize when they go to a hookah lounge are all the health risks associated with the smoke they inhale.

In a fact sheet by the Centers for Disease Control and Prevention, hookah smoke is not only as toxic as cigarette smoke in equivalent amounts, but the smoker also gets 100 to 200 times the amount of smoke compared to that of smoking a cigarette.

One out of three college students have smoked hookah, according to a recent study lead by Dr. Brian Primack in the June publication of the journal “Nicotine and Tobacco Research.” Out of those students who smoked, 50 percent of them did not smoke cigarettes.

The study took a sample of more than 100,000 participants of various backgrounds from 152 different universities. Out of these participants, most respondents were female (65 percent) and white (71 percent).

“Although current waterpipe use was reported across all individual and institutional characteristics,” the authors wrote. “Fully adjusted multivariable models showed that it was most strongly associated with younger age, male gender, White race, fraternity/sorority membership and nonreligious institutions in large cities in the western United States.”

Primack states in the study that hookahs “should be included with other forms of tobacco in efforts related to tobacco surveillance and intervention.” The study said hookah is just as addicting as cigarettes because of the nicotine inhaled into the lungs. Smoking hookah can also lead to diseases such as stomach, mouth, lung and throat cancer and a decrease in fertility.

Al Narah Hookah Lounge is one of two hookah lounges in Eugene, Ore. CEO Lara Yasin said she markets the lounge mainly to college students — advertising on campus and at movie theaters but mostly on Facebook.

Many hookah lounges are marketed on their social aspect, which is why U. Oregon junior Nathan Paulsen enjoys smoking hookah every now and then with a group of people.

“It brings people together,” Paulsen said. “You smoke it with friends and it sparks a conversation.”