Hi Alice!

I'm a teenage girl looking into hookah and I'm searching the internet on health risks. A common set I'm finding is the charcoal and the tobacco. I'm curious if they make hookah without having charcoal or tobacco. I have a few health risks already, so I want to be sure that it's 100% safe for me before I jump in and smoke with my friends. So, what I'm asking is, can I find charcoal and tobacco free hookah? I've found tobacco free, but so far, no charcoal free. Another thing I'd like to know is if there are any other risks to this that I might have missed? I'm perfectly fine with skipping this all together, but I think it'd be fun. Anyway, help?

Dear Reader,

Sometimes, actions that seem to be fun in the short-term may cause problems in the long-term. Smoking hookah, a water pipe through which tobacco is inhaled, is one of these actions. While a substance with fun flavors like strawberry and sour apple doesn’t seem like it could possibly do a lot of harm, smoking hookah does come with risks. In fact, many of the risks of smoking hookah are similar to that of smoking cigarettes. While there are both tobacco-free and charcoal-free hookah smoking products, not much is known about risks involved with use (more on that in a bit). The only way to ensure that there's absolutely no risk is to not use it. Keep on reading to learn more about hookah as a whole!

Shisha, the term most often used to refer to flavored hookah tobacco, produces tar when burned, which may cause a range of health problems similar to those that cigarette smokers face. In addition to the tar, hookah smokers are exposed to a number of other health risks. This includes carcinogens such as cobalt, chromium, and lead, as well as high levels of carbon monoxide. In fact, smoking through a hookah can be more risky than smoking cigarettes for two reasons: the water that cools down the heated tobacco doesn’t act as a filter, as opposed to cigarettes that often come with filters attached, and hookah sessions tend to last an hour or more, as opposed to the five or so minutes it takes to smoke a cigarette. Another aspect to consider is the presence of nicotine within the shisha. The delivery method of the tobacco smoke doesn't change the fact that nicotine has addictive properties. Smoking tobacco through hookah also doesn't reduce the amount of nicotine that's consumed. You’re right that non-tobacco shisha is an alternative; however, a charcoal- or wood-free hookah pipe doesn't exist, so you'll still be exposed to the carcinogenic properties from burning those materials. 

However, there are hookah alternatives that are tobacco-, nicotine-, and charcoal-free, in the form of an electronic shisha pen. Unfortunately, much like e-cigarettes, not much is known about the safety and health effects of smoking an electronic shisha pen, especially since they aren’t regulated by the Food and Drug Administration. These pens, known as e-hookah, are battery operated and function like e-cigarettes, vaporizing the liquid they contain for inhalation. Many brands of e-hookahs don’t contain nicotine, but some do, so check labels carefully if this is what you decide to do. And while shisha pens allow you to avoid the known harmful substances contained in typical hookah, they're a relatively new product and haven’t yet been proven safe to use.

Another potential drawback to e-hookahs is that they don’t imitate the vibe of an actual hookah pipe, which lends itself to sharing with friends — as it sounds like you want to do. While they can be passed around in a group, buying refills and recharging the battery might get tedious and expensive. Also, keep in mind the risk of sharing something on which you put your mouth, whether it be an e-hookah or a traditional hookah setup — both hepatitis and meningitis can be spread through saliva. 

Reader, kudos to you on trying to discover what these risks are before deciding to test it out — you’re a step ahead of the “try before you buy” crowd.

Alice!

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