Using a hookah to smoke tobacco poses serious health risks to smokers and others exposed to the smoke from the hookah.
The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals. Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents. Shisha smoke contains several toxic agents known to cause lung, bladder, and oral cancers.
Other Health Effects of Shisha Smoke
Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart disease.
Infections may be passed to other smokers by sharing a hookah. Babies born to women who smoked water pipes every day while pregnant weigh less at birth (at least 3½ ounces less) as compared to babies born to non-smokers.
Babies born to hookah smokers are also at increased risk for respiratory diseases.
Hookah Smoking Compared With Cigarette Smoking
While many hookah smokers may think this practice is less harmful than smoking cigarettes, hookah smoking has many of the same health risks as cigarette smoking. Water pipe smoking delivers nicotine—the same highly addictive drug found in other tobacco products. The tobacco used in hookahs is burned (exposed to high heat) and the smoke is at least as toxic as cigarette smoke. Because of the way a hookah is used, smokers may absorb more of the toxic substances also found in cigarette smoke than cigarette smokers do. An hour-long hookah smoking session involves 200 puffs, while smoking an average cigarette involves 20 puffs. The amount of smoke inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500–600ml inhaled when smoking a cigarette. Hookah smokers may be at risk for some of the same diseases as cigarette smokers.
- Oral cancer
- Lung cancer
- Stomach cancer
- Cancer of the esophagus
- Reduced lung function
- Decreased fertility
- Secondhand smoke
Secondhand smoke from hookahs can be a health risk for nonsmokers. It contains smoke from the tobacco as well as smoke from the heat source (e.g., charcoal) used in the hookah.
Non-tobacco Hookah Products
Some sweetened and flavored non-tobacco products are sold for use in a hookah. Labels and ads for these products often claim that users can enjoy the same taste without the harmful effects of tobacco. Studies of tobacco-based shisha and “herbal” shisha show that smoke from both preparations contain carbon monoxide and other toxic agents known to increase the risks for smoking-related cancers, heart disease, and lung disease.