A new study found people who smoked hookah but not tobacco had an increased risk of turning to cigarettes within a period of two years.

Researchers followed 2,541 adolescents and young adults for a period of two years, and found that smoking hookah tended to make people in this age range more likely to pick up the habit of smoking cigarettes, according to the Norris Cotton Cancer Center Dartmouth-Hitchcock Medical Center.

"We found hookah smoking increased the probability of trying cigarette smoking over the next two years by 19 [percent]," said Samir Soneji, PhD, a tobacco regulatory control researcher at Dartmouth and lead author on the study.

The findings suggest that while hookah is generally a social custom, it can lead to tobacco-related addictions down the road. The practice was associated with subsequent "cigarette smoking including initiation of cigarette smoking, cigarette smoking in the past month, and high-intensity cigarette smoking," as well as the smokeless tobacco product Snus.

Manufacturers of both Snus and shisha (which is used in hookahs) increase the products' appeal  by adding flavors and marketing them as such, a practice that has been banned for cigarette products in the U.S. since 1971 after the Public Health Smoking Act of 1969 went into effect.

Recent studies have also found the volume of carcinogenic materials inhaled by a hookah smoker is equivalent to inhaling about 100 cigarettes.

The researchers suggests the Food and Drug Administration restrict adding flavor to all tobacco products as well as the marketing tactics that are used to make them sound more appealing to adolescents and young adults. The team hopes changing the polices could help cut down the rate of cigarette smoking in the country.

The findings were published in a recent edition of the journal JAMA Pediatrics and was supported by an NCI grant.