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.