The vast amount of research on smoking has been done on the harms of cigarettes, presumably because they’re the most common form of tobacco use and probably the most harmful. Recently, hookahs have become more popular, especially amongst college age people. In addition, in the Middle East and other parts of the world, hookahs are very popular. Some people are under the impression that hookahs are a safe alternative to cigarettes. They believe that the water filters out a lot of the harmful chemicals in hookahs and that whatever the water doesn’t get, the charcoal will get rid of.
Unfortunately, there aren’t too many studies done on the health effects of hookahs. Although it’s generally agreed that the volume of smoke per hookah session is quite high (in fact, one 40 minute session can result in inhaling as much smoke as dozens upon dozens of cigarettes), the fact that the tobacco is not heated to as high of a temperature as in a cigarette may result in a lower amount of exposure to toxic compounds.
A recent study in Cancer Epidemiology, Biomarkers & Prevention compared the amount of nicotine and various carcinogens inhaled via hookah versus cigarettes, and found that while those who used hookahs had significantly less exposure to nicotine and certain carcinogens, levels of carbon monoxide and carcinogens such as benzene were higher. Benzene exposure for example is linked to the development of leukemia.
The study didn’t measure hard outcomes (i.e. it didn’t compare rates of cancer, heart disease, etc. between hookah users to those that smoke cigarettes). In fact, there aren’t any good, long-term head to head studies addressing this.
A 2010 review from the International Journal of Epidemiology did show that hookah smokers had more than double the risk of developing lung cancer, respiratory infections, and low birth weight babies, and 3 to 5 times the risk of having periodontal disease compared with nonsmokers. Of note, risks of throat and bladder cancers were not higher (which is the case in cigarette users).
The bottom line is that at this time, it’s unclear if hookah smoking is any better than smoking cigarettes. And even if it is, it certainly isn’t a safe habit, exposing the body to many harmful substances and increasing the risk of developing lung cancer and other diseases.
So if you do currently smoke a hookah as a safe alternative to cigarettes, quit, and take up a healthier habit (join a gym, play sports, take up gardening etc.)
(Image credit: Psych Central)