Don't Get Hooked on Hookah!

Health Professional, Medical Reviewer

A fairly new wave of tobacco smoking has infiltrated the lives of many of our young people at a time when almost half of U.S. states have banned smoking in most public places. It's called Hookah smoking and there are now more than 400 Hookah bars across America, mostly around college campuses and in urban cities.

"It's relaxing and encourages more socializing with others," some young people have said. Many of the youngsters (typically aged 18 to 25) believe Hookah tobacco is harmless or safer than cigarettes.

But they'd be wrong.

Studies have shown Hookah smoke contains tar, nicotine and heavy metals. Some of the same carcinogens found in cigarettes are in Hookah smoke. Hookah smokers may inhale more carbon monoxide (CO) than cigarette smokers and reports show that Hookah smoking more than doubles the risk of becoming a cigarette smoker.

The Origins of Hookah

The origin of Hookah is not clear. Some reports trace it back as far as Africa in the 14th century, while other accounts place early use in the Middle East from where is spread across Europe. Specially prepared tobacco "shisha," which often included molasses, honey or dried fruit, was used for smoking. Today, shisha can be imported from the Middle East in a variety of flavors (including kiwi, strawberry, passion fruit, grape, pineapple and vanilla). There are also some companies in the U.S. that provide tobacco for Hookah bars.

Hookah is the name of the water pipe device used for smoking. Other names are narghile or narghila, and hubbly-bubbly. The hookah itself has four parts:

The bowl: holds the tobacco

The base: usually filled with water

The pipe: a rubber hose connecting the bowl to the base

The hose: connects to the base above the water level at one end and holds the mouthpiece at the other

Typically, one reserves a table or space (or makes reservations online) for 2 to 10 people. Charges are usually per person. A session may last from 20 to 90 minutes. There may be one or two hoses connected to the Hookah, but only one person may draw the smoke at a time. The smoker places the mouthpiece in their mouth and inhales, creating a vacuum in the glass base, which draws the smoke from the bowl through the pipe and bubbling through the water in the glass base. The smoke then passes up the hose through the mouthpiece.

Is Hookah really safer than smoking cigarettes?

The answer, according to research, is a resounding No.

A study quoted by the American Lung Association (ALA), noted that nicotine levels in a hookah smoker's blood increased up to 250% and cotinine levels up to 120% percent after one 40 to 45 minute session of Hookah smoking..

According to another report by the ALA, Hookah smoke contains byproducts associated with the charcoal or wood cinders used to heat the tobacco. The heating element may contribute additional toxic chemicals, carbon monoxide and metals. A study on Hookah smokers in the Journal of the American Medical Association (Vol. 299 No. 1 p36) measured exhaled carbon monoxide (CO) levels in 32 college students at an American university. The Hookah smokers had higher exhaled CO levels, on average, compared to levels previously reported in pack-a-day cigarette smokers.

That shoots down the belief that the water in the Hookah base filters out all the toxins. In fact, it is unclear whether the water does anything other than humidify and cool the smoke, likely making it more tolerable. Unfortunately, that may lead hookah smokers to breathe the smoke deeper and longer, greatly increasing the harmful effect of tobacco smoke.

Hookah Bars and Smoking Bans

Hookah bars have managed to escape through legal loopholes in many states because they don't serve alcohol or food. Many states allow for smoking in public places where a certain percentage of the revenue comes from smoking. In Illinois, 80% of revenue and 90% of the floor space of the business must be connected with tobacco smoking to be legal. Our young teenagers may be highly attracted to these bars without fear of being turned away because of their age.

To sum up, Hookah smoking, like cigarettes, increases the risk of lung cancer, oral cancer, emphysema, heart and blood vessel disease. People that have asthma should steer clear of Hookah bars and avoid any unnecessary exposure to tobacco smoke of any form.

Do you know any Hookah smokers?

Are there any Hookah bars in your community?