The use of hookahs – pipes that bubble tobacco smoke through water before you puff – doubled among middle- and high-schoolers in just one year. Now it's on par with cigarette use in school-age kids, a troubling new Centers for Disease Control and Prevention report reveals. Fueling the craze: peer pressure, of course, plus the dangerous myth that these exotic pipes are harmless.

The truth: Hookahs are dangerous. Research shows that they deliver 100 times more lung-clogging tar, four times more nicotine – tobacco's most addictive chemical – and 11 times more heart-threatening carbon monoxide than one cigarette. Hookah-users also are exposed to high levels of carcinogens, including benzene and acrolein, according to researchers from the University of California San Francisco.

These scientists are leading the way in uncovering hookahs' hidden health risks. In one remarkable study, they convinced 55 hookah users to abstain for a week. They then analyzed their urine the morning after they spent one evening in the hookah bar of their choice. In this real-world study, smokers' nicotine levels increased 73-fold after their hookah night, and levels of cancer-causing compounds increased 41 to 93 percent! But surveys show that teens mistakenly believe that the water in these pipes filters out the toxins in tobacco smoke. Truth is, these water pipes may make the smoke less irritating, but that just encourages users to smoke more!

Typically shared with several others, a hookah user sucks in the smoke through a mouthpiece and tube attached to a pipe. A session may last a half-hour to an hour or longer, leading to inhaling as much smoke as you'd get from up to 100 cigarettes (that's five packs), the World Health Organization warns. The charcoal used to keep the tobacco burning also poses substantial health risks.

The manufacturing and marketing of hookah tobacco (and the charcoal) currently is not regulated by the Food and Drug Administration. That leaves the door open for sales of flavored hookah tobaccos – also called shisha, narghile and hubble-bubble – that are especially attractive to young users. We agree with experts who are calling on the FDA to approve a pending rule to regulate these and other new tobacco products. We also want to see more states and communities close legal loopholes that allow hookah bars, lounges and cafes to open their doors to underage smokers. Until that happens, here's what you should know about this dangerous new craze:

Hookahs can hook you on tobacco for life. At this point, 9 percent of teens say they smoke cigarettes, and an equal number say they've used a hookah at least once in the past month! And 13 percent "vape" or puff on electronic cigarettes. We've warned you about those before. But a recent Dartmouth College School of Medicine survey of 1,050 young smokers, age 15-23, found that within two years, 39 percent who had smoked a hookah had graduated to cigarettes. The young and impressionable get hooked at a more than 30 percent rate.

Share a pipe, and you're sharing disease-causing germs. Sharing saliva means sharing herpes or the flu. Health groups warn that hookahs may even spread chronic diseases such as hepatitis and tuberculosis, as well as acute infections!

Hookah smoke contains an alarming variety of harmful chemicals. Yes, hookah smoking is an ancient tradition. It dates back at least 600 years. And so does the falsehood that it's a healthy way to smoke. There's nothing healthy or natural about it. We mentioned a bunch of the risks already. Others toxins in the smoke include heavy metals, formaldehyde and a nasty radioactive compound called "Po." Short for polonium-210, this radioactive stuff concentrates in the delicate airways of the lungs and can course its way throughout the body, causing genetic damage, and early and premature aging. Not a good situation!

Don't use e-cigs, snus or other "alternative tobacco products," either. Plenty of the same risks are present in those, too.

Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. To live your healthiest, tune into "The Dr. Oz Show" or visit (c) 2015 Michael Roizen, M.D. and Mehmet Oz, M.D. Distributed by King Features Syndicate, Inc.

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