Hookah, a type of waterpipe that's been used to smoke tobacco for centuries, has recently gotten some traction among the American teenage set. According to a new NYU study, almost 20 percent of high school seniors admit to using a hookah.

The report, which was published in Pediatrics, analyzed 15,000 high school seniors at 130 public and private schools over the course of two years. The results reveal that 18 percent of high school seniors smoke from hookahs, and that hookah-usage is more popular among teens in big cities.

Via TIME:

"What we find most interesting is that students of higher socioeconomic status appear to be more likely to use hookah," said study author Joseph J. Palamar, an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). "Surprisingly, students with more educated parents or higher personal income are at high risk for use."

Though the CDC reports that cigarette smoking is down among teenagers, there is apparently fear with parents that alternatives like hookah e-pens could become a popular replacement.

"These nifty little devices are likely to attract curious consumers, possibly even non-cigarette smokers," Palamar told Time.

Teens smoking hookah e-cigs, what will they think of next?

[Image via AP]