GENEVA - Smoking from a water pipe may pose the same health risks as cigarettes, the World Health Organization said Tuesday, adding that there's a need for more research into the link between hookahs and a number of fatal illnesses.

The hookah, used for centuries in North Africa, the Middle East and Central and South Asia, has become increasingly popular in the West, particularly among college students and young adults. Hookah bars have sprung up in cities across the United States, and groups of people often visit them to relax and talk while smoking from the water pipes.

WHO, however, warned that using the water pipe to smoke tobacco is "not a safe alternative to cigarette smoking.'' In a seven-page document on the practice, the UN health agency said the rising popularity of hookahs is partly due to "unfounded assumptions'' of safety and misleading commercial marketing.

"Contrary to ancient lore and popular belief, the smoke that emerges from a water pipe contains numerous toxicants known to cause lung cancer, heart disease and other diseases,'' said WHO, which also issued a 50-page report Tuesday urging all countries to ban smoking in public buildings.

WHO warned that using water pipes to consume shisha -- a mixture of tobacco, molasses and fruit flavours -- usually exposes a person to more smoke over a longer period of time than do cigarettes.

The health agency said a person can inhale more than 100 times more smoke in a hookah session than in a single cigarette. By delivering nicotine, the water pipe can cause addiction. Preliminary research also indicates that hookah smoking may involve "some unique health risks,'' WHO said.

A hookah typically consists of a bowl connected to a vase of water with a long tube and mouthpiece. The tobacco sits inside the bowl with a layer of foil and a hot coal on top. The shisha is not lit, instead heated by the charcoal, which users say produces a vapour different from smoke.

"None of the accessories have been demonstrated to reduce smokers' exposure to toxins or risk of tobacco-related disease and death,'' WHO said.

While further research is required, the health body said those exposed to second-hand hookah smoke appeared to be at risk of the same diseases as those exposed to cigarettes. WHO warned that hookah smoke could also increase the risk of adverse effects during pregnancy.

Also Tuesday, WHO issued its strongest policy recommendations yet for controlling tobacco use, urging all countries to ban smoking at indoor workplaces and in public buildings.

Tobacco use is the world's leading cause of preventable death, accounting for 10 per cent of adult fatalities, according to WHO. It is responsible for 5.4 million deaths each year, a figure that is expected to rise to 8.3 million by 2030, the agency says.

Increasing numbers of non-smokers will also die unless governments take action, WHO said. It said governments of both rich and poor countries should declare all public indoor places smoke-free, by passing laws and actively enforcing measures to ensure that "everyone has a right to breathe clean air, free from tobacco smoke."