Middle East Arab world In many places in the
Arab world, the smoking of shisha is a part of traditional culture, and is considered a social custom. Social smoking is typically done with the use of a hookah with a single hose which is passed around the group or double
hose, but some hookahs can employ up to four hoses. When the smoker is finished, the hose is either placed back on the table, signifying that it is available, or is handed directly to the next user. Social convention dictates that the mouthpiece and hose should be folded back on itself in such a way that the
mouthpiece is not pointing at the recipient. Disposable mouth tips are sometimes used in cafes. Many
cafés in the Middle East offer hookah. Cafés are widespread and are common social gathering places (akin to
public houses in Britain). Some
expatriate residents arriving in the Middle East frequent hookah cafés in lieu of
pubs in the region, especially where
prohibition is in place and alcohol is not served. In the
Levant (Syria, Palestine, Lebanon, Jordan), hookah (sometimes referred to as "", or "") is widely used, and its availability is nearly universal. Hookah has become part of the culture. Smokers are often seen on the side of the streets, parks, bus stops, and other public venues. Cafes are sometimes observed to be fully occupied by hookah smokers, even during late hours of the night. It is not uncommon to see women smoking hookah. In the Levant, it is very social, and the activity is often accompanied by a game of Tawla (Backgammon), cards, or tea.
Iran in
Qajari dress smoking tobacco In Iran, the hookah is known as a
ḡalyān (, also spelled
ghalyan,
ghalyaan or
ghelyoon). It is similar in many ways to the Arabic hookah but also differs in several ways. One difference is the uppermost part of the hookah, the "ghalyoun," locally called 'sar' (, i.e. head), where the tobacco is placed. Compared to Turkish hookahs, the Iranian version tends to be somewhat larger. Additionally, the majority of the hose is flexible and covered with soft silk or cloth, while Turkish hookahs often have mouthpieces and partially rigid hoses which are as long as or longer than the flexible part of the hose. Each smoker will typically carry their own personal mouthpiece (called an , ). The is a detachable hookah mouthpiece, and is usually made of wood or metal and may be decorated with gemstones. are considered to be decorative and are a highly personal item. Public smoking venues will often carry disposable or cleanable for the use of smokers who do not carry their own. The exact date of the first use of ḡalyān in Persia is not known. According to Cyril Elgood, it was
Abu’l-Fatḥ Gīlānī, a Persian physician at the court of the Mughal emperor Akbar I, who "first passed the smoke of tobacco through a small bowl of water to purify and cool the smoke and thus invented the hubble-bubble or hookah." However, Ahlī Šīrāzī refers to the use of the ḡalyān in one of his poems, thus dating its use to at least as early as the time of
Ṭahmāsp I in the late 14th century. Iranians had a special tobacco called
Khansar (, presumably name of the origin city). With Khansar, coals would be put on the Khansar without foil. Khansar has less smoke than the normal tobacco.
Caucasus Azerbaijan It is one of the popular entertainment and hangout activities, mostly among young men in Azerbaijan, especially in
Baku.
South Asia Pakistan Hookah (called chillum or huqqa in Pakistan) is the most common way to consume tobacco among elderly in lower socio-economic and rural people in Pakistan. However, in recent years, use has increased among youth and urban residents, who often consume hookah in cafes.
India Hookah was popular in India especially during
Mughal rule. The hookah then become less popular; however, it is once again garnering the attention of the masses, and cafés and restaurants that offer it as a consumable are popular. The use of hookahs from ancient times in India was not only a custom, but a matter of prestige. Rich and landed classes would smoke hookahs. Tobacco is smoked in hookahs in many villages as per traditional customs. Smoking a tobacco-molasses shisha is now becoming popular amongst the youth in India. There are several chain clubs, bars and coffee shops in India offering a wider variety of muʽassels, including non-tobacco versions. Hookah was recently banned in Bangalore. However it can be bought or rented for personal usage or organised parties only.
Koyilandy, a small fishing town on the west coast of India, once made and exported hookahs extensively. These are known as
Malabar Hookhas or Koyilandy Hookahs. Today these intricate hookahs are difficult to find outside of Koyilandy and not much easier to find in Koyilandy itself. Due to their harm to health, hookah has recently been banned in many states in India. There have been numerous raids and bans recently on hookah smoking, especially in
Gujarat Nepal Hookahs (हुक़्क़ा), especially wooden ones, are popular in Nepal. Historically, hookah usage was considered to symbolize elite family status. Today, however, hookahs have become popular among tourists and young people.
Bangladesh Hookah, as the traditional smoking device, has been commonly used in Bangladesh since the Mughal ages. But mu'assel wasn't introduced in Bangladesh until the early 2000s. Hookah became very popular among the young crowds, and hookah bars and lounges opened up in large numbers to cater to those crowds. However, due to health concerns and unregulated consumption, the government banned hookah in late 2010 and hookah lounges were ordered to shut down. A few hookah lounges were given permission to continue business as they mostly served to foreigners.
Southeast Asia Philippines In the Philippines, hookah use was more or less traditionally confined to the
minority Arab Filipino and
Indian Filipino communities. The custom has also been present in the indigenous
Muslim Filipino community (a considerable
religious minority), where a historical following of Middle Eastern socio-cultural trends led to the hookah being a rare—albeit prestigious—social habit of the nobility in the vital trade hubs of
Mindanao such as
Cotabato and
Jolo. Hookah was meanwhile virtually unknown to the predominant
Christian Filipinos in
Luzon and the
Visayas before the late 20th century. Presently, hookah use is gaining popularity among younger, more cosmopolitan Christians, particularly with college students and
young adults who may be underage and thus unable to purchase
cigarettes. In the
National Capital Region and other
conurbations such as
Metro Cebu and
Metro Davao, hookahs and flavoured shisha are available in various high-end bars, clubs and "shisha lounges" as well as in traditional Middle Eastern restaurants.
Vietnam In
Vietnam, shisha has been around for a long time, with the response of young people, so the hobby of smoking shisha is becoming more and more popular. Most people think that smoking shisha is better than smoking due to less nicotine. People can smoke shisha at cafes, karaoke bars and bars in Vietnam.
South Africa In South Africa, hookah, colloquially known as a
hubbly bubbly or an
okka pipe, is popular.
United States and Canada store window in
Cambridge, Massachusetts, United States. Hookah was popular in the 1960s and 1970s, although in this era they used open flames rather than coals. In recent years hookah use has increased dramatically in the United States and Canada. There is a growing hookah bar and café industry, especially in inner cities and near universities and colleges where youth and young adults gather. and located near
college campuses or cities with large Middle-Eastern communities. This activity continues to gain popularity within the post-secondary student demographic. According to a 2018 study, 1.1% of students with some college but no degree, an associate degree or an undergraduate degree reported waterpipe or pipe tobacco product use either every day or some days. As of November 2017, at least 2,082 college or university campuses in the U.S. have adopted 100% smokefree campus policies that attempt to eliminate smoking in indoor and outdoor areas across the entire campus, including residences. However, since then the
US Department of Health and Human Services has stated that older teens have decreased their use of hookahs in recent years. The most recent research, from 2014 to 2018, shows that the percentage of high school seniors who had used a hookah in the last year decreased from 20 percent to 8 percent. Among adolescents and young adults, hookah use is highest among those aged 19–20, and those who live in cities. It is less common in suburban and rural areas. In 2011, 18.5% of 12th-grade students reported having smoked a hookah in the past year. ==Health effects==