It’s not that dangerous.
Everybody’s doing it.
I can quit at any time.
Those three beliefs are prevalent among many hookah smokers and help illustrate why the ancient water pipe’s surging popularity is a growing health threat, according to the American Lung Association.
The word “hookah” may bring to mind hazy images of Cheech and Chong or the groovy smoke-ring puffing caterpillar from Disney’s 1951 classic “Alice in Wonderland.” Yes, that’s the kind of hookah we’re talking about, though today’s stash of smoking material usually is legal.
Hookah lounges, where smokers can legally partake of the pipe, are mushrooming throughout the country. Locally, most are in areas frequented by young people, such as the Bardstown Road. They offer live music and open mic nights, festive food and drinks, and even discounts with a student ID. Alongside those trappings of traditional bars and restaurants, hookah lounges feature smoking menus, with dozens of flavored blends that can be fired up on the spot.
Customers select a blend, which is loaded into the bowl of a hookah, also known as a narghile, shish, argileh or goza. The material is heated with charcoal, and smoke or vapor passes through water and into a flexible hose linked to a mouthpiece, which is typically shared by a group of smokers.
The social aspect, coupled with enticing flavors such as Fuzzy Navel and Chocolate Temptation, lure in young smokers, say researchers from the American Lung Association, who frequently hear the misconception that smoke filtered through a hookah isn’t as potent as regular cigarette smoke, and that it isn’t as addicting.
Not so, according to the U.S. Centers for Disease Control and Prevention (CDC). In fact, a typical one-hour hookah session involves about 200 puffs, while an average cigarette is consumed in 20 puffs, the CDC reports. The volume of smoke inhaled during a typical hookah session is about 90,000 milliliters, compared with 500 to 600 milliliters inhaled through one cigarette, according to the CDC.
Some hookah enthusiasts point out that they don’t smoke tobacco or other substances that contain nicotine, which has been found to be highly addictive. However, CDC researchers warn that even hookahs stuffed with herbs and flavors are still fired by charcoal and release carbon monoxide, metals and other chemicals during smoking.
Among U.S. high school seniors, about one in five boys and one in six girls reported they had used a hookah in the past year, and as many as 40 percent of college students reported the same, according to a joint federal report by the CDC, the U.S. Surgeon General and the U.S. Department of Health and Human Services.
The report warns that hookah users may be at risk for some of the same diseases and adverse health effects as cigarette smokers. These include:
- Oral, lung, stomach, bladder or esophagus cancer
- Reduced lung function
- Decreased fertility, or babies born with low birth weights or increased chances for respiratory diseases
- Clogged arteries and heart disease
A 2013 study by the University of California San Francisco (UCSF) showed that hookah smoke contained different kinds of harmful toxins than regular cigarettes. These toxins expose hookah smokers to added risk for heart or respiratory conditions, and to higher levels of benzene, long associated with leukemia risk, the study showed.
“People want to know if it is a lesser health risk if they switch from cigarettes to smoking a water pipe on a daily basis. We found that water-pipe smoking is not a safe alternative to cigarette smoking, nor is it likely to be an effective harm-reducing strategy,” UCSF research chemist Peyton Jacob said in a statement.
Second-hand smoke from hookahs can put nonsmokers at risk too, as it contains toxins from the smoking material as well as smoke from the water pipe’s charcoal heat source, the joint federal study noted.
Researchers point to a study of California adults, published in the American Journal of Public Health, as an indicator of how hookah usage has skyrocketed. Between 2005 and 2008, California adults reported a 40 percent increase in hookah smoking, and many of those surveyed were college educated.
— Mickey H. Gramig