Hookah pipe use is on the rise in New Jersey, especially among young adults. But few are aware of its potentially lethal effects.

A hookah pipe is a water pipe that produces of vapor from a variety of burning herbs and tobacco.  Dr. Diane Calello, medical director of the New Jersey Poison Control Center, says the burning of charcoal creates carbon monoxide, which, in small amounts, is not a big deal if it's a well ventilated space.

But when it builds up and it's not able to ventilate, it creates a hazard.

Calello says according to recent medical literature, approximately 100 cases of carbon monoxide poisoning from hookah pipes have been reported both nationally and internationally. The number of cases in New Jersey is unclear but what prompted the alert here is that, "we had several cases that were significant enough to need hyperbaric oxygen, which is the treatment for very ill carbon monoxide patients."

Carbon monoxide, also known as "The Silent Killer," is a gas that gives no warning. You cannot see it, smell it or taste it.

Calello says symptoms of carbon monoxide often overlap with symptoms of the flu, such as headaches, fatigue, dizziness, loss of appetite, nausea and vomiting. If left untreated, Calello says it can lead to heart attack, brain damage, impaired vision and coordination, falling into a coma and death.

The risk of carbon monoxide poisoning increases depending on the size of the space you are smoking in, the number of people smoking in that space and how well ventilated that space may be.

To lessen the risk of carbon monoxide poisoning, Calello says individuals should not smoke hookah in small, poorly ventilated spaces and there should not be too many hookah pipes going at once within that space.

You should get help immediately if you suspect you or someone has been exposed to carbon monoxide. If the person is unconscious or not breathing, call 911. Otherwise, call the Poison Control Center at 1-800-222-1222.