Hookah: Worse for you than cigarettes?

October 10, 2008

“The waterpipe smoker may therefore inhale as much smoke during one session as a cigarette smoker would inhale consuming 100 or more cigarettes.”
-World Health Organization Advisory

Hookah. It’s a pastime. You can sit down; relax with a group of friends for an hour or so and smoke some sweetly flavored steam…. Right?

Well, no. That’s the pretty side of the issue. Here’s the dirty end:

Hookah is purported to have been invented by an Indian physician, Hakim Abul Fath, around the 1600’s as an alternative and safer method for smoking tobacco. He believed that the smoke, once passed through water, would be rendered harmless. (1)

Subsequently, this belief has spread and is often used to support hookah use over cigarette or other forms of tobacco use.

From a World Health Organization advisory on the health effects of water pipe smoking:

“A waterpipe smoking session may expose the smoker to more smoke over a longer period of time than occurs when smoking a cigarette. Typically, a cigarette smoker will take 8-12, 40-75ml puffs over about 5-7 minutes and inhale 0.5 to 0.6 liters of smoke.

In contrast, waterpipe smoking sessions typically last 20-80 minutes, during which the smoker may take 50-200 puffs which range from about 0.15 to 1 liter each. The waterpipe smoker may therefore inhale as much smoke during one session as a cigarette smoker would inhale consuming 100 or more cigarettes.” (1)

Water does absorb a small amount of the nicotine, yet, as the WHO advisory states, “it is likely that the reduced concentration of nicotine in the waterpipe smoke may result in smokers inhaling higher amounts of smoke and thus exposing themselves to higher levels of cancer-causing chemicals and hazardous gases.” (1)

Due to the nicotine, heavy metals and carbon monoxide (and various other toxic chemicals) that are in hookah smoke even after it passes through the water, hookah smokers are at a heightened risk of developing cancer, hearth disease, respiratory disease and problems with pregnancy. (1)

Some studies show that hookah smoke contains 802mg of tar, compared to 22.3mg for cigarettes. Hookah smoke also contains 145mg of carbon monoxide compared to 17.3mg for cigarettes. That means, regardless of the nicotine intake, there is about 36 times the tar and 8 times the carbon monoxide in hookah than in cigarettes. (2)

Studies on hookah’s health effects are lacking, and more need to be performed. Current science shows that hookah is just as dangerous for a person’s health as cigarettes.

Personally, I feel that outlawing psychoactive drugs is an uphill battle, at best. It’s extremely hard to impose and expensive to fund the law enforcement.

Hookah is considered to be a fairly healthy alternative to cigarettes, and most people who would not ever consider smoking a cigarette smoke hookah regularly. This misconception has contributed to more hookah users who are unaware of the toxicity involved in this smoking pattern.

Moral of the story: More people need to be educated on the severe dangers of hookah and the misconceptions about it and more research needs to be done to support this educational initiative.

1. http://www.who.int/tobacco/global_interaction/tobreg/Waterpipe%20recommendation_Final.pdf

2. Alan Shihadeh and Rawad Saleh, Polycyclic Aromatic Hydrocarbons, Carbon Monoxide, “Tar”, and Nicotine in the Mainstream Smoke Aerosal of the Narghile Water Pipe, American University of Beirut, 2005, 7.


Can honey kill you? Well, yes actually. It can.

September 5, 2008

“[Botulism] is caused by neurotoxic proteins so poisonous that one-millionth of a gram of them can kill a man and one pint would be enough to kill everyone on earth.”

-New York Times

Honey contains spores from the deadly bacterium that causes Botulism

Honey contains spores from the deadly bacterium that causes Botulism

Honey has always been remarked for the length of time which it can be stored without spoiling. It is a unique substance in that it has many antimicrobial and antifungal properties to it. For example, it is so high in sugars that very little water exists in it, thus most microorganisms cannot grow in this ‘hypertonic’ environment. It likely could be stored forever if its container is kept airtight and in a cool area.

So how could this un-spoilable substance cause as deadly an illness as Botulism? The secret lies in the bees. Bees, while collecting pollen, are continually in contact with soil and dust particles, which inevitably make it back to the hive and into the honey being produced. These particles nearly always contain spores of the common bacteria Clostridium botulinum, the causative agent of Botulism.

Now, on their own, these spores never cause illness. Spores are a dormant form of the bacterium, but when these spores are put into ideal conditions (with sufficient nutrients, water, etc) they germinate. The bacteria itself will not hurt you either. Yet, when in a low oxygen environment like your stomach, they begin to produce a protein called botulin. This is a neurotoxin, meaning it is a substance known to be poisonous to nerve tissue.

The neurotoxin affects the body by interfering with the way nerves tell muscles to contract, and thus move. This limpness is termed ‘flaccid paralysis.’ Death typically occurs via respiratory failure, when the neurotoxin causes the diaphragm muscle in the chest to no longer move. Without the diaphragm, the lungs can no longer fill with air and thus one becomes unable to breathe.

Yet, if Botulism is so bad, then why do we eat honey and never become ill? The answer is in our immune system and our digestive system. In a healthy individual, the stomach and immune system will destroy the botulism spores before they germinate and begin to produce the toxin. However, those whose immune systems are compromised, such as HIV/AIDS patients or infants, are unable to combat the Botulism spores. These individuals are highly susceptible to being infected with the bacteria.

Botulism spores

Botulism spores

Botulism is not only contracted through eating honey, either. Often the soil that contains botulism spores ends up on the outside of some fruits and vegetables commonly used in canning. Due to the low oxygen environment in a can, botulism spores often germinate and produce large amounts of the botulin neurotoxin, which when ingested, cause the botulism illness. This can be prevented with proper sterile technique during the canning process.

Of all botulism cases, only 25% are food born, but 72% are infantile botulism. This is indicative of how many parents are unaware that honey can be highly toxic to infants.

The fundamental message here is that honey could kill you, but only under the right circumstances. It is important to be aware of the dangers botulism spores pose to individuals with weakened immune systems. Because babies are so often afflicted with infantile botulism, it becomes aparant that this awareness of botulism in honey is not widespread enough.  Botulism is nearly extinct in modern countries, and these cases of infantile botulism are highly preventable via dissementation of this simple lesson: don’t feed honey to babies.

What you don’t know…

September 5, 2008

The most exciting phrase to hear in science, the one that heralds the most discoveries, is not “Eureka!” but “That’s funny…”  ~Isaac Asimov

Science. Whether or not we know much about the enigmatic subject, it has shaped and helped define our natural world. Researchers the world over have labored over books and magnifying glasses, tables and charts, to give us essential information about the workings of the Earth, our universe, and ourselves.

Yet, unfortunately even in this ‘information age,’ the average American knows little more about science than what his doctor tells him if something goes wrong. The average American student’s ability to apply scientific reasoning in real life concepts is ranked 17th in the world, behind countries like Finland, Canada, Japan and Korea.

How many Americans know not to mix ammonia with bleach? How many know not to feed honey to infants? How many know mice droppings can contain Hanta virus? Aside from the major reform needed in the education system, what can we do to protect ourselves from those biological dangers which we know very little about?
It comes down to better dissemination of pertinent information to the public, in formats a non-microbiologist can understand.

As a junior Microbiology major, I’ve found myself learning a variety of things in my studies which should, by necessity, be common knowledge. My intention with this blog is to discuss health issues that are little known to the American public, yet pose a danger to all of us.

I am an aspiring researcher and plan to continue on to graduate school for my doctorate. I have been working in a research laboratory for 3 years now, mentoring under a microbiology professor and continuing my own research project under a grant awarded me by the American Society for Microbiology.

In this blog, I will attempt to translate the scientific jargon and I will post in general terms the straightforward information everyone ought to know about little known microbial dangers.