As others have said, the definition really varies. I think some companies use the term hookah to refer soley to fruity flavors. For them, an e hookah is just a low or no nic flavored vape pen. For others the term hookah refers to taste as in trying to replicate the tast of hookah, which is not just fruity flavors. I realized this the other day when ordering some prefilleds from South Beach smoke. I saw the word "grape" and went "yee haw, prefilled grape!" and ordered. I failed to notice it was actually grape *hookah*. I tried to cancel my order to no avail (I don't like tobacco flavors). Surprisingly, I am really happy with the flavor...it is for sure grape, with a hint of tobacco, but you can also taste the molasses sweetness and I find it very pleasurable. Prefilled cartrdges are not known for strong flavors, and it is not, but I think if it were too strong it would be a problem for me. Anyway, I noticed that South Beach has a few Hookah flavors and I think some of the other cig a likes have them too, though I cannot vouch for their taste. The same is true for e juices I believe, some "hookah" flavors will be purely sweet fruit, some will try to replicate a true hookah flavor. Be sure you are getting the one you really want.