A Review of Trends, Health Implications, Regulatory Responses, and Socio-Cultural Factors of Hookah Smoking Among Young Adults in the United States

Hookah smoking has become a persistent social phenomenon among young adults in the United States, despite decades of tobacco control efforts. Moreover, hookah smoking presents unique public health challenges due to its strong social appeal, cultural relevance, and widespread use in urban centers and college communities. This paper provides a broad review of recent trends, health implications, regulatory responses, and sociocultural factors influencing hookah smoking. A narrative literature review was conducted using peer-reviewed articles and grey literature sources published between 2019–2025. Electronic databases included PubMed, CINAHL, and Google Scholar, along with reports from professional organizations and government agencies including CDC, FDA, WHO, and health department agencies, to review current public health recommendations and practice guidelines. Review materials were selected that focus on prevalence, health implications, and regulations of hookah smoking. Findings were synthesized to identify key applications, challenges and concerns, and future directions. This review provided a rapid and broad review of the current trends, health implications, regulatory responses, and sociocultural factors of hookah smoking among young adults in the United States. Interdisciplinary research and policy innovation are necessary to address the ongoing public health burden of hookah smoking among young adults in the United States.