The effects of hookah smoking on health: myths and scientific facts

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Many people, especially young ones, consider hookah smoking a harmless pastime. At first glance, hookah smoking seems harmless — the smoke passes through water, which is supposed to dissolve all harmful substances.

There is a strong public opinion that hookah does not harm health, or its harm is negligible and incomparable to the harm of cigarette smoking. Most likely, it is this mistaken belief that serves as the starting point for deciding to try hookah and continue smoking it in the future.

This viewpoint is discussed in the study “Young Adult Perception of Various Tobacco Products Compared to Cigarettes: Results from a National Youth Health Survey”. Here is a quote in translation:

“...Young people perceive regular cigarettes as more risky, while electronic cigarettes and hookahs as less risky...”

Although public opinion is more lenient towards hookah use than cigarette smoking, nevertheless, hookah smoking, like other forms of tobacco smoking, forms addiction and further dependence. Studies show that many people who start smoking hookah eventually switch to cigarettes.

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The study “Hookah Smoking: A Popular Alternative to Cigarettes” states:

“Hookah smoking has become a popular alternative to cigarette smoking, especially among young adults. The belief that hookah smoking is less harmful than cigarette smoking, although not true, opens the prospect of its widespread use. Hookah tobacco mix is a potent substance causing addiction, providing higher levels of carbon monoxide than a cigarette, and also containing many carcinogens similar to those found in cigarette smoke. Hookah smoke poses the same risks associated with passive smoking as cigarette smoke. Group hookah smoking increases the risk of infection transmission. Transitioning from group hookah use to individual use is an important step towards nicotine addiction and switching to cigarettes.”

In fact, hookah smoking is not a harmless alternative to cigarettes, and its consequences are associated with various pathologies. A hookah smoker inhales about 180 mg of carbon monoxide per session, while smoking one cigarette results in approximately 12 mg.

A hookah smoking session usually lasts from half an hour to an hour and a half. During this time, the hookah smoker inhales a volume of smoke equivalent to the amount of smoke from more than five packs of cigarettes!

In various Eastern countries, where hookah smoking is common (Iran, Pakistan, India, etc.), scientific studies have been conducted to study the impact of this practice on human health. Observations show that hookah use, along with passive smoking, is a risk factor for many diseases, including various types of cancer, lung diseases, cardiovascular diseases. Pregnant women experience fetal development disruptions, which subsequently lead to various pathologies in newborns.

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Hookah smoke contains carcinogenic components that contribute to the development of cancer.

Studies show significantly higher levels of free radicals in hookah smokers compared to regular smokers. This leads to inflammation and damage to the respiratory organs. For example, chronic bronchitis is more common in hookah smokers than in cigarette smokers.

Spirometry (lung function testing) in hookah smokers shows significantly worse results compared to non-smokers and indicates that inhaling hookah smoke can be a factor in the development of obstructive lung disease.

Usually, hookah smoking takes place collectively. Personal and disposable mouthpieces are rarely used. Such collective use of the smoking device creates a risk of transmission of various infections through saliva.

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The presence of moisture and a comfortable temperature is conducive to the development of various microorganisms. The water in the device is not always replaced after each smoking session, and the shape of the hookah makes it difficult to clean.

Thus, tuberculosis, herpes, Helicobacter pylori, hepatitis C, and some other viral and fungal infections can be transmitted through hookah.

The harmful effects of hookah are not limited to direct smoking but also affect passive smokers present in the room.

Compared to cigarette smoke, hookah smoke contains 4 times more polycyclic aromatic hydrocarbons, 4 times more aldehydes, 5 times more ultrafine particles, and 35 times more carbon monoxide, and also contains such toxic substances as arsenic, lead, etc.

Thus, hookah smoking is far from a harmless pastime and poses a serious health threat.