Is Hookah Smoking Safe?

Person using a hookah

No. Hookah smoking is no safer than smoking a cigarette.

That is the short answer to a question that is growing in importance as hookah bars are sprouting up like weeds in cities across the US, including Buffalo. These establishments are located near college campuses and along major streets in Buffalo and Niagara Falls. Between 2000 and 2011, consumption of alternative tobacco products, such as hookahs, increased by 123 percent while at the same time cigarette use is down 33 percent.

There are so many misperceptions about hookah smoking, they are difficult to count. People need to understand that hookah smoking is not safe. Roswell Park Comprehensive Cancer Center recently participated in a study with the New York University School of Medicine to evaluate air samples in eight hookah bars in New York City. The results of this study were published in the Journal of Tobacco Control.

In our study we found that levels of indoor air pollution increased with the number of hookahs being smoked to levels more than twice as high as in bars when cigarette smoking was permitted. While hookah lounges may claim that they only use herbal products without tobacco, this study found airborne nicotine present at all the locations studied. This study also found that hookahs generated levels of secondhand smoke potentially hazardous to the health of patrons and employees.

What is a Hookah?

Hookahs are water pipes used to smoke a mixture called shisha. This mixture is heated with charcoal, travels through water at the bottom of the pipe and is inhaled through a hose on the side of the device. The water serves to humidify the smoke and make it feel less harsh; giving the false impression that it is not harmful. On the contrary, the smoke is loaded with all kinds of toxicants and cancer-causing compounds. Shisha comes in hundreds of flavors including cherry and chocolate, which are enticing to young people. Hookah bars are places where smoking is done socially in groups, sometimes with the same mouth piece passed from one person to another.

Health Hazards of Hookah Smoking

When compared to cigarettes, a hookah session delivers twice the nicotine, seven times the carbon monoxide, 30 times the formaldehyde and 80 times the lead to the user. Exposure to secondhand smoke from hookah can exceed the air quality standards set by the Environmental Protection Agency (EPA) as hookahs emit smoke, not just from tobacco, but also the charcoal used to heat the shisha. These exposures can cause heart disease, respiratory disease and cancer. Even smoke from “herbal” shishas that do not contain tobacco or nicotine is still loaded with the same harmful carcinogens.

This study, along with others, demonstrates the need to properly educate the public and policymakers on the public health hazard posed by hookah bars and smoking hookahs.