MONDAY, July 7, 2014 (HealthDay News) -- While American teenagers have increasingly been saying "no" to cigarettes over the past decade, almost one in five high school seniors now say they have smoked a hookah pipe, a new survey shows.

A form of smoking that has been a fixture throughout the Middle East and South Asia for centuries, the hookah pipe, with its relatively exotic mechanics, has become trendy among kids who are relatively well-off, the researchers report.

"I actually didn't find the results very surprising," noted study author Joseph Palamar, an assistant professor in the department of population health at NYU Langone Medical Center and the NYU Center for Drug Use and HIV Research in New York City. "Cigarette use has decreased so much in recent years. We should have expected another drug or form of the drug to pop up in place of cigarettes."

"But what we find most interesting is that students of higher socioeconomic status appear to be more likely to use hookah," Palamar added. "Specifically, students with more educated parents or higher personal income are at high risk for use."

Palamar and his colleagues report their findings online July 7 in the journal Pediatrics.

To get a snapshot of current hookah use among American teens, the study authors sifted through the results of a poll that was conducted from 2010 to 2012 among more than 5,500 high school seniors who were enrolled at 130 different high schools across the country.

Participants were about equally divided between boys and girls, and more than 60 percent were white. About 45 percent were under the age of 18, while nearly 55 percent were 18 or older.

About 18 percent of the teens said they had used hookahs in the past year.

But while hookah use was just 14 percent among those whose weekly job brought in $10 or less, that figure rose to nearly 23 percent among those whose weekly earnings topped $51 or more.

Hookah use was also found to be slightly higher among teens from relatively well-educated families, as well as among boys, whites and those living in cities.