Everyone knows that cigarettes and smokeless tobacco are strongly associated with cancer and other illnesses. However, many mistakenly believe that smoking a flavored tobacco through a hookah — also known as a waterpipe or a narghile — is a safer alternative.

Researchers at the University of California, San Diego School of Medicine discovered a surprising rise in prevalence of the hookah, especially among young, educated adults in the state.

"Though public indoor cigarette smoking is banned throughout California, hookah use is permitted in designated lounges. This may create the impression that hookah is a safer alternative to cigarettes, which is simply not true," said researcher Wael Al-Delaimy, M.D., Ph.D.

The research team found that between 2005 and 2008, hookah use grew by 40 percent among adults. Use by men and women in their late teens and early 20s rose by 25 percent and 10 percent, respectively.

Authors of the study noted that another unexpected finding was use of the pipe by college-educated individuals, since this subset is considerably less likely to smoke cigarettes than their less educated counterparts.