Wednesday, January 17, 2007

Hooked on Hookah - the latest Ask Dr. Peg column

Dear Dr Peg,

Some friends introduced me to Hookah smoking a few months ago, and we’ve been getting together to smoke a couple of times a week. It’s fun to hang out, and the smoke smells nice. I know cigarette smoking is dangerous, so I’ve never done it, but hookah smoking is safe, right? Doesn’t the water filter out all the bad stuff from the smoke? And isn’t hookah tobacco healthier than the tobacco in cigarettes?

-Hooked on hookah

Dear Hooked,

I’m sorry to disappoint you, but you are wrong on all counts. As usual, I’ll start with the basics.

What is a hookah? A hookah is a water pipe. Other names for hookah include nargile, sheesha, okka, kalyan and hubbly-bubbly. It is a device for smoking a flavored tobacco mixture. The mixture is placed in a small bowl at the top of the device. From the bowl, a hollow pipe leads straight down into a chamber called the base, which is partly filled with water. The pipe extends below the surface of the water. From the side of the base, above water line, a hose leads to a mouthpiece. To smoke a hookah, you light a piece of charcoal, place it on top of the tobacco mixture, put the mouthpiece in your mouth, and suck hard. The smoke goes down the pipe, bubbles up through the water into the air at the top of the base chamber, up the hose and into your lungs. Hookahs can be quite ornate and beautiful, and can cost hundreds of dollars.

Hookahs have been around for centuries, probably originating in the Middle East or India, where it is a common social custom for men to gather, smoking and chatting for hours. In the US, the hookah has become very popular in recent years, especially with young people of both sexes. Hookah smoking is promoted as an aesthetic social activity, touting the sweet smell of the tobacco and the bubbling sound of the water as pleasant, relaxing influences. A typical hookah session lasts 2 or 3 hours and involves several friends smoking from the same pipe. Commercial Hookah bars have sprung up all over the country. There are at least five here in Albuquerque, where you can go just to smoke.

What does one smoke in a hookah? Typically, the mixture is 1/3 tobacco and 2/3 flavorings. The flavorings may include molasses, dried fruit, honey and other ingredients. The resulting aroma was likened to a baking apple pie by one hookah-selling website. Sounds pretty benign, doesn’t it? It isn’t. Like many fads, it has been hyped with false claims in order to increase its popularity and profits.

What are the dangers of hookah? Tobacco is tobacco, no matter how you get it, and tobacco smoke is hazardous. In fact, hookah smokers get more smoke than cigarette smokers, and here’s why. Cigarette smoke is uncomfortably hot if you inhale it deeply. Hookah smoke has been cooled by its passage through the water. In addition, you have to inhale hard to pull the smoke through the hookah. The result is cooler smoke going farther into your lungs. Add to that the duration of a typical hookah session, and the result is huge volumes of smoke being deposited into your lungs. A study done by the World Health Organization showed that one hookah session of a mere few hours can deliver as much smoke into your lungs as 100 cigarettes. Five packs! It’s a rare cigarette smoker who gets that much in one day.

Tobacco smoke contains nicotine, a highly addictive substance that is not filtered out by the water in a hookah. In addition to nicotine, you are pulling other dangerous substances through that hose. Tar is not water-soluble, so it comes on through the pipe, the same amount in one session as in a whole pack of cigarettes. Tar causes cancer. Other carcinogens (cancer-causing agents) also make it through, like heavy metals and carbon monoxide. In fact, because of the charcoal which is burned on top of the tobacco mixture, hookah smoke has a higher level of heavy metals and carbon monoxide than cigarette smoke. Hookah smokers risk cancer of the lung, lip, tongue and bladder.

As you doubtless know by now, tobacco smoke affects the cardiovascular system, causing an increased blood pressure and heart rate, and increasing the risk of heart attack and stroke. Smoke of any kind is also a lung irritant, which can trigger asthma and allergies. And of course, there are all the second hand smoke issues to consider.

In addition to the tobacco, there are the smoked flavorings to consider. Unfortunately, nobody has yet studied the effects of inhaling dried apricots, but I would bet they aren’t all good.

Finally, think about sharing the mouthpiece. It’s like kissing everyone in the group. Hookah pipes can spread herpes, flu, strep throat, a cold, even tuberculosis. And wiping it on your sleeve doesn’t sterilize it.

I’m a big believer in social gatherings and relaxation time. By all means, gather away, and relax like crazy. But if you are concerned with the health of your young lungs, think about gathering around a cup of tea, or relaxing with exercise and a bath instead of a water pipe. And if you are already addicted to any form of tobacco, I strongly urge you to quit. The Student Health Center has people and programs to help you.


connery said...

Way to spread the word on educating people on things they think are "okay," because all their friends do it, and dispelling myths.

These should be posted on your campus and every other one around the country.

"Strong work," Dr. Peg, as a colleague of mine used to say as he patted us on the back.

dr peg said...

Thank you, connery! I appreciate your kudos. I learned a lot researching and writing this article. The one thing I didn't do was actually try smoking sheesha. Couldn't quite bring myself to go that far.

dribear said...

and don't forget the risk of pneumothorax by smoking from a water pipe. heh

dr. ibear

moo said...

Well I read your article and thought you made some good points but you seemed to not look that deepinto your research. Although the sheesha (hookah tobbaco, not the actual hookah) does contain tobbaco, studies show that this tobbaco does not contain tar and is 0.05% nicotine by volume (9.5% less than a cigarette). So before you go slandering something you haven't researched deeply about and just decided to google "hookah and the effect on your lungs" why don't you actually look into rather than copying someone elses article.


Trizzle said...


Hemperor said...

and ??? Are you telling me that UnWaterFiltered Nicotine-Poisin iz SAFER ??? But it don't "feel" as good or safe to me in ME. I perfer my home-made 16oz glass-pickle jar with lamp-bolt's and surgical-rubber intake "straw". Drill two hole'z and nut it up and ? get nutty ??? "Hemp for Victory" from USDA 1942 WW2 movie was a LIE ??? That EVIL GOD WEED that make's US hunger and thirsty iz ? BAD ??? Say'z WHO ??? Columbus ??? My GrandFather'z Doktor ???

1938PopularMechanics said...

I saw on CIA'z New'z Network or CNN'z "New'z to Me" show an example of what would/could/should be in YOUR LUNG'z if you $MOKE. "They" water-filtered 20 carton'$ or 400 cigarette'$ and then boiled the black water down and said that the tar they had would be in your lung'z ..... BUT, they didn't test the $moke that wa$ water-filtered. Duh. DUH. Tar $tay in WATER-PIPE for me in ME and I breath in filtered nicotine poison .... from pipe tobacco

1938PopularMechanic's said...

The TAR in water that "they" u$ed and the boiled down would go in LUNG'$ if NOT water filtered out ??? WOW. Wierd Old World. WOW. I LOVE MY HOLY-WATER and/AND USDA or U$DA WW2 movie "Hemp for Victory" from Columbu$'$ CANVA$, NOT in OUR

Anonymous said...

There is now a new quit smoking drug available in the market. This latest breakthrough is known as Chantix. It is able to help smokers snub out their addiction by working on the brain.

Jesse said...

You don't actually share a mouthpiece when you smoke hookah at a hookah bar. Everyone smoking receives an individually wrapped plastic tip to put between their lips and the nozzle of the hose.
I'm not so sure about your numbers regarding the amount of tar being equal to that of 100 cigarettes, I would appreciate if your talked about your sources.

Gabriel said...

Would it be advised to take nicotine patches, I feel the need for nicotine... But im not sure if its a crave ive created psychologically for myself or not? Ive smoked ciggarettes and used hookah as an alternative..

Clarice Fullington said...

Hookah does not in any way burn the tobacco. It vaporizes it. Think of it as a vaporizer that lets you inhale the herbs' therapeutic properties. It also does not encourage combustion; the smoke does not contain any by-products of burning. Hookah is for social gatherings as in the Middle East cultures, and as far as quitting smoking goes, vaporizers offer alternative premises.

Quit Smoking Hypnotherapy said...

Hookah smoke contains high levels of toxic compounds, including tar, carbon monoxide, heavy metals and cancer-causing chemicals (carcinogens). In fact, hookah smokers are exposed to more carbon monoxide and smoke than are cigarette smokers.

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