Cite this Response
Alice! Health Promotion. "How does smoking hookah compare to smoking cigarettes?." Go Ask Alice!, Columbia University, 07 Oct. 2024, https://goaskalice.columbia.edu/answered-questions/how-does-smoking-hookah-compare-smoking-cigarettes. Accessed 10, Nov. 2024.
Alice! Health Promotion. (2024, October 07). How does smoking hookah compare to smoking cigarettes?. Go Ask Alice!, https://goaskalice.columbia.edu/answered-questions/how-does-smoking-hookah-compare-smoking-cigarettes.
Dear Alice,
My friends and I occasionally (once a week or so) like to smoke the "Hookah" or sometimes referred to in Arabic as an "argeelay." The tobacco that it comes with smells really good and comes in all kinds of flavors, such as apple, mango, mixed fruit, etc. Anyway, I consider myself to be pretty healthy in that I have never experimented with drugs, never smoked cigarettes, and rarely drink alcohol. My question is about the health effects of smoking a hookah. The rewards are mostly relaxation after a long day of studying for law school. The hookah provides this through smell, flavor, and sound of the water that filters the tobacco when you puff on it. However, I don't know what the health risks are. How does it compare to cigarettes? People say that it's much safer than cigarettes... and according to the packaging that comes with the tobacco, there are far fewer harmful ingredients... in fact, it's mostly tobacco and molasses. It's a very popular trend these days. It's time we get a good source of information. So what's the verdict?
— Moose & Co.
Dear Moose & Co.,
Hookah smoking has grown in popularity over the years, and there are many places people can enjoy it throughout the United States and around the world. Hookah (also known as waterpipe, shisha, narghile, arghile, oriented pipe, qalyan, and hubble bubble) originated in the Middle East as a social activity. Both hookah and cigarettes contain tobacco, nicotine, and other dangerous chemicals. Some people believe that hookah smoking is safer than other methods of smoking as they think it can filter out harmful compounds before inhaling the smoke. However, hookah smoking has similar health risks compared to cigarettes. In fact, longer smoking sessions combined with deeper inhalations can increase the impact of hookah smoking on your body.
What is hookah?
A hookah is a device used to smoke tobacco by passing charcoal-heated smoke through a water-filled chamber. Users inhale the smoke through a tube and (optional) mouthpiece. The burning of charcoal and tobacco in hookah exposes users to carbon monoxide, nicotine, and other dangerous chemicals. Despite what people may think, the water-filled chamber doesn’t remove these chemicals from the smoke.
E-hookahs have also grown in popularity recently as they don’t use charcoal and instead use electronic components to heat tobacco. While research is still developing on the potential effects of e-hookah, e-devices in general have toxic components that can harm human health. They also still expose users to nicotine, which is harmful regardless of how it’s consumed.
What substances are you exposed to when smoking hookah?
Hookah smoke has higher levels of carbon monoxide and has 80 times more toxic substances than cigarette smoke. These substances, including nicotine, tar, and heavy metals can accumulate in the body and lead to cancer. Ninety-eight percent of the toxic metals found in traditional tobacco are also found in flavored tobaccos used in hookah. You noted that the hookah tobacco listed molasses as an ingredient. While it can be flavored with molasses or honey to give it a sweeter smell and taste, it also contains additives and other flavoring agents. These additives contain metals which can increase the absorption of harmful substances—including nicotine—when smoking and are harmful to human health.
What are the health risks associated with hookah use compared to cigarette use?
Like cigarette use, hookah use can lead to various cancers and heart disease as well as lung damage. Even short-term use has been linked to health effects in the heart and lungs and can lead to carbon monoxide poisoning. Compared to cigarette smoking, hookah smoking exposes users to more smoke in one sitting. While cigarette breaks are shorter and may include eight to ten puffs, hookah sessions tend to be longer and may include up to 100 puffs. What’s more, one hookah session lasting more than an hour can expose users to nicotine levels greater than those of smoking 100 cigarettes per day.
People who use hookah can have 1.7 times more nicotine exposure and nine times more carbon monoxide exposure than cigarette users. This increased exposure to nicotine and carbon monoxide can cause blood pressure to rise. Because of this, hookah smoking can increase the risk of stroke almost three times more than cigarette smoking.
Hookah smoking is also tied to more inactivity and food consumption due to how it’s used and the length of sessions. This can make people more susceptible to obesity, diabetes, and metabolic syndrome, which increases the risk of heart disease. The greater volume of smoke from hookah use also has a greater impact on the heart and brain. Even an occasional hookah session can cause harm to your body. E-hookahs have also been tied to higher impact on the heart, and developing research shows that health risks are still present even without charcoal.
How can you replicate the relaxation from hookah?
As you mentioned, hookah smoking can be a way to relax and connect with friends. However, even social smoking can impact your health. Finding healthier ways to relax can be key to supporting your health. To that end, as you consider some of the harmful effects of hookah use, you may want to consider other ways to find relaxation and seek social connection. What would it look like to connect with your friends in other ways? Could you all find ways to relax together without smoking hookah? Many people find that regular forms of movement and activity can help them relax and connect with others. This could include going to the gym or joining an exercise group or class. Yoga and meditation or going on a hike can also be a great ways to relax, and you could even invite your friends to join.
Unfortunately, hookah smoking can be just as harmful as cigarette smoking. Exploring other forms of relaxation and socializing with your friends may help you all reduce potential harmful effects to your health.