Hookah (aka hubbly bubbly or shisha) can be addictive and harmful, though
many dabblers may not realise the dangers, according to a new review.
"The cooled and sweetened flavour of
hookah tobacco makes it more enticing to kids and they falsely believe it's
less harmful," Tracey E. Barnett from the University of Florida in
Gainesville told Reuters Health.
Barnett has studied the recent rise in teen
hookah smoking. She was not involved in the new review, published in
"One-time use can lead to carbon
monoxide poisoning or other diseases, including but not limited to
tuberculosis, herpes, respiratory illnesses including the flu, and long-term
use can lead to heart disease and many cancers," Barnett said.
bubblies make you sick
Smoking with a hookah, or
"shisha", device has become increasingly common in Europe and the
Western Hemisphere in recent years. The practice rose to prominence on the
Indian subcontinent among Hindus in the 15th Century and subsequently spread
through the Ottoman Empire. According to one estimate, about 100 million people
worldwide smoke hookah each day.
Though the water-pipe device with its
series of tubes and mouthpieces looks nothing like a cigarette, it is almost
always used to smoke tobacco, and as such carries many of the dangers inherent
in cigarette smoking. "While water is a filter, it does not filter out any
of the toxins," Barnett said.
100 or more cigarettes
The new review brings together the results
of several studies on addiction, lung damage and health dangers associated with
According to the World Health Organisation,
one hookah session typically lasts 20 to 80 minutes and a hookah user may
inhale as much smoke during one session as a cigarette smoker would from
smoking 100 or more cigarettes.
The review authors, led by Dr Ruben
Blachman-Braun of Universidad Anahuac in Huixquilucan, Mexico, cite another
study which found nicotine levels in the urine of daily hookah smokers were
equivalent to levels in people smoking 10 cigarettes per day, more than enough
to spark addiction.
produce poison gas
A number of health issues
In the existing scientific literature, hookah
has been linked with health problems including chronic bronchitis, lung cancer,
oral cancer, prostate cancer, heart disease and pregnancy complications similar
to those seen with cigarette smoking. It has also been tied to the hepatitis C
virus and herpes from sharing mouthpieces.
In one 2013 study in Nicotine & Tobacco
Research, researchers treated cells from the lining of human lungs with tobacco
and non-tobacco smoke from a water pipe smoking machine. They found that smoke
from a hookah pipe slows down and stunts lung production regardless of whether
the smoke came from a tobacco or tobacco-free product.
People don't generally seem to understand
just how dangerous hookah smoking can be, said Adrienne J. Heinz. She studies
alcohol and drug use patterns at the Stanford University School of Medicine in
California and was not involved in the new review."In casual conversations
with friends and patients – folks often appreciate that smoking anything comes
with risks," Heinz said.
"However, hookah is certainly viewed
as more benign, and when you share general facts about toxin exposure in one
hookah session, it often shocks and surprises them.
women smoking hookahs
More socially acceptable
"Results of an online survey of more
than 5000 college students, also published in Nicotine & Tobacco Research
in 2013, indicated that more than 10 percent of college students had recently
smoked hookah, which was the most widely used of non-cigarette tobacco
A similar study using online questionnaires
of college students found 13% of them tried hookah for the first time in one
seven-month period, and those who had less apprehension about the dangers were
more likely to try it.
It's easy to see why people might be
surprised at the dangers of hookah, since there haven't been public health
campaigns to raise awareness of hookah risks the way there have been campaigns
about cigarette smoking, Heinz said.
"There is also the misconception that
because hookah sessions tend to be less frequent than smoking a cigarette, and
because hookah is smoked through a water chamber, that the practice is
safer," she said.
Hookah is deemed more socially acceptable
than other forms of smoking, Barnett said. But people should not think of
hookah as a safe alternative to smoking cigarettes, she said.
Hookahs are bad
no safer than cigarettes
hookahs not harmless fun