Smoking Hookah May Be More Harmful Than Smoking Cigarettes

(June 7, 2012) One in three college students has smoked hookah. The hookah is a beautiful, decorative piece of polished brass. It is used for smoking when friends get together, and to relax and socialize.

Hookah is also known as narghile, shisha, and goza. It is a water pipe with a smoke chamber, a bowl, a pipe, and a hose. Specifically-made tobacco is heated, and the smoke passes through water and is then drawn through a rubber hose to a mouthpiece. The tobacco is no less toxic in a hookah pipe, and the water in the hookah does not filter out the toxic ingredients in the tobacco smoke. Hookah smokers may actually inhale more tobacco smoke than cigarette smokers do because of the large volume of smoke they inhale in one smoking session, which can last as long as 60 minutes.

Hookah bars have become popular around the country for the last decade. “It usually attracts 18-20 year olds”, says Lance Freeman, of The Egyptian Café and Hooka Bar in Indianapolis, Indiana. “We are a place to come for people who can’t go to bars.”

The problem is that smoking hookah is still dangerous because it delivers the same chemical compounds as smoking cigarettes. One session (from 45-60 minutes) delivers about 100 times the smoke as a single cigarette, with 40 times the tar and 10 times the carbon monoxide. While research about hookah smoking is still emerging, evidence shows that it poses many dangers.

Hookah smoke contains high levels of toxic compounds, including tar, carbon monoxide, heavy metals, and cancer-causing chemicals (carcinogens). In fact, hookah smokers are exposed to more carbon monoxide and smoke than are cigarette smokers.

As with cigarette smoking, hookah smoking is linked to lung and oral cancers, heart disease, and other serious illnesses.

Hookah smoke delivers about the same amount of nicotine as cigarette smoking does, possibly leading to tobacco dependence. Hookah smoke poses dangers associated with second hand smoke. Hookah smoking by pregnant women can result in low birth weight babies.

Hookah pipes used in hookah bars and cafes may not be cleaned properly, risking the spread of infectious diseases.

Dr. Brian Primack conducted a study which was published in the June issue of the journal Nicotine and Tobacco Research, which found that 1 in 3 current college students has smoked hookah at some point; more than 50% of those students were not cigarette smokers.

Primack said that while he was giving a lecture on the dangers of smoking at the University of Pittsburgh School of Medicine, a student interrupted him. “He said, ‘No offense, but nobody really smokes anymore – we all do this hookah thing instead.’” That very moment started Primack’s research into the hookah world. “It’s a very interesting public health puzzle. The same chemicals – in one form are reviled by many people; but the same people will go across the street and take it in this difficult format.”

Better education is needed, Primack has said, to show similarities between hookah smoking and cigarette smoking. In a previous study, the research found 92% of videos on You Tube showed hookah in a positive light, compared to just 24% of cigarette videos. The population that participates in hookah smoking tends to be younger, male and white, but is found across all characters.

The researchers do not know yet if hookah is addictive. Smokers inhale twice the amount of nicotine in one hookah session as they do with a single cigarette, but long-term studies need to be done to see if it interferes with their life in the same way.

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