Is hookah smoking safer than smoking cigarettes?
Answers from J. Taylor Hays, M.D.
Hookah smoking is not safer than cigarette smoking.
Also known as a narghile, shisha or goza, a hookah is a water pipe with a smoke chamber, a bowl, a pipe and a hose. Specially 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 than in a cigarette, 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.
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 smoking delivers about the same amount of nicotine as cigarette smoking, possibly leading to tobacco dependence.
- Hookah smoke poses dangers associated with secondhand 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.
June 17, 2015
J. Taylor Hays, M.D.
See more Expert Answers
- El-Zaatari ZM, et al. Health effects associated with waterpipe smoking. Tobacco Control. 2015;24:i31.
- Shihadeh A, et al. Toxicant content, physical properties and biological activity of waterpipe tobacco smoke and its tobacco-free alternatives. Tobacco Control. 2015;24:i22.
- Noonan D. A descriptive study of smoking tobacco using a waterpipe among college students. Journal of the American Association of Nurse Practitioners. 2013;25:11.
- Hookah smoking: A growing threat to public health. American Lung Association. http://www.lung.org/stop-smoking/tobacco-control-advocacy/reports-resources/. Accessed June 2, 2015.
- Hookahs. Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm. Accessed June 2, 2015.
- Kumar SR, et al. A review of air quality, biological indicators and health effects of second-hand waterpipe smoke exposure. Tobacco Control. 2015;24(suppl):i54.