Dear Dapeet,

Thank you for the positive feedback and your question. Occasional Hookah smoking is likely no better than occasional cigarette smoking. I believe the longer sessions associated with Hookah, compared to the 5-10 minute period of smoking one cigarette, suggests more nicotine exposure with the former. For this reason the risk of subsequent addiction following occasional smoking would be higher for Hookah smokers. 

I would strongly encourage family or friends to stop smoking Hookah (as well as any other tobacco forms) completely.

Again Thank You,

J. Thompson, MD

Hi Tyler,

Thank you for your reply. It is difficult to accurately measure how much nicotine is inhaled when analyzing cigarettes and hookah. You may be right about the amounts of nicotine, starting out, in these combusted substances. You make an argument for cigarettes being more of a health risk than Hookah.

My major source of information was from JAMA (Journal of American Medical Association) and the American Lung Association. According to what I have read there is tar as well as nicotine and many other chemical compounds in hookah smoke. Since all hookahs are not the same, regarding the product and its ingredients, the amount of water, the vessel, the amount of charcoal, depth of inhalation, duration of smoking etc., it is almost impossible to discuss comparisons with any degree of accuracy.

That said, both hookah smoking and tobacco smoking are health hazards that can contribute to the top 4 leading causes of death in this country (heart attacks, cancer, strokes and chronic respiratory disease). If you want to validate hookah smoking by proving it is not as risky as cigarette smoking, you are not on stable ground. You may be right. Some occasional hookah smoking may not be nearly as bad as cigarette smoking but remember studies have shown that hookah smokers have an increased risk of taking up cigarette smoking.

My readings have cast great doubt on there being any filtering effect of water on hookah smoke. You are getting perhaps cooler smoke, but not cleaner smoke.

Whether flaming heat or charcoal heat, you still get combustion and smoke. With charcoal heated hookah you have the added residue from the charcoal.

Tyler, a better choice, for preservation of health, is to avoid smoking anything. Any form of smoke inhalation poses a risk to your well- being, as well as others (that will passively inhale your combusted chemicals). The decisions you make now, regarding what you inhale, eat and drink, may have far reaching consequences later in life. Avoid having regrets in future years because of bad decisions of today. Smoking hookah, cigarettes, or anything is unhealthy and unnecessary.

Best of Luck Tyler,

J. Thompson, MD

Dear Sheila,

Thank you for sharing your thoughts on Hookah smoking. I would support a law prohibiting minors from tobacco (including Hookah) smoking. We know that such a law is very unlikely in this country.

I don't have to tell you how challenging it is to protect our teenagers and young adults from activities that have long-term health risks.

Good Luck,

J. Thompson

Hi Ms. Mineri,

The fact you have been smoking for so many years suggests an addiction. You and those who are in their late adolescent years are obviously not doing anything illegal. Doctors and the American Lung Association are trying to alert parents and young people about the health risks associated with hookah smoking.

You have likely already suffered considerable damage to your lungs. No doubt your hookah smoking has been enjoyable but at what price? You see, the human lung is so well constructed that years of smoke damage may go unnoticed until you reach a damage level that cannot be compensated for by intrinsic repairing mechanisms. By time you recognize this it is often too late to recapture most of your lung function. Many cigarette smokers experience the same thing.

For women unfortunately, the rate of decline in lung function after 15-20 years of smoking tends to be worse than men. You should stop smoking Ms. Mineri. It is not a matter of legality or denial of rights, it is purely a matter of avoiding ill health. Just as in cigarette smokers, hookah smoking may not result in perceivable lung problems such as bronchitis, emphysema and lung cancer in every long-term smoker. But why play Russian roulette with a six shooter that contains more than one bullet? Yes, you do have a choice. I hope you make the healthy one from this point.

Best Wishes,

J. Thompson, MD

Hi H.U.,

Thanks for tuning in.

I have not seen any data on the risks of smoking herbal substances. As you already stated, smoking anything is probably not a good thing. I am familiar with soex and I am aware that there are claims that it has no tar or nicotine. My question is: What substances are produced as a result of the combustion of soex?

 I tend to have more fear of the unknown when it comes to potential carcinogens, combustion and inhalation. It is assumed that the lack of nicotine and tar (and I wonder if this is true regarding tar) means it is safer than tobacco. But there is no evidence supporting this assumption. It may be more dangerous based on other ingredients or additives, quantity and duration (in time) of smoking. Who really knows?

Hookah smoking has been enjoyed by many because of the socializing aspect. Perhaps other healthy activities can be considered to replace this one. It starts with the individual thinking and deciding for him or herself, that they do not want to take unnecessary health risks. If you haven't arrived at this point yet, perhaps one day you will.

I appreciate your comments. Please share more in the future.

The Best to You,

J. Thompson, MD

Hi Craig,

Thanks for sharing your comments. The fact that you reached out about this vital topic as it relates to your personal experience is commendable. If you stop smoking completely you will:

• 1- Allow your lungs to immediately begin the healing process to repair lung tissue already damaged (damage that you don't feel at all).

• 2- You will immediately eliminate an activity that is the number one cause of lung cancer which leads to 1.3 million deaths annually, worldwide.

• 3- You will immediately reduce your chances of having chronic bronchitis or emphysema later in life. I have had patients that smoked for ten or more years, quit smoking for several years, then develop severe chronic breathing problems for the rest of their, often shortened life. The sooner you stop, the better your chances of not doing permanent, irreversible damage.

• 4- You will be taking a great step towards reaching your maximum potential in exercise and sports because smoking reduces your ability to have good lung function over time. This also impacts your heart and blood vessels which also play important roles in physical activity.

• 5- There is plenty more I could add but I'll just say that by quitting you will display a level of maturity and determination that you may be able to call on in future life circumstances, and just might spark a similar action in another friend, relative or acquaintance.

Ultimately Craig, you have a chance to save your own life by quitting (not just cutting back). If you can overcome what most people your age encounter, peer pressure, you can change the outlook of your future life in an almost unimaginable way. I don't know you, but I have confidence in you.

Good Luck!

J. Thompson, MD