Healthy Living

Hookah Health Facts: Is It Safe?

Hookah Health Facts: Is It Safe?

What is a hookah?

Hookahs are basically water pipes that are used for smoking. Specially made tobaccos for hookah smoking are available in various flavors such as chocolate, watermelon, apple, mint, coconut, cherry, and licorice. Even though others feel that smoking hookah is a safer alternative to cigarette smoking, the truth is, it has its own health risks that are quite similar to cigarette smoking.

Hookahs are available in various shapes, sizes, and styles. Hookahs are called by other names such as hubble-bubble, narghile, shisha, goza, and argileh. A modern day hookah has a head that has holes in the bottom. The body is made up of metal. There is also a water bowl present or a bowl to hold tobacco, a pipe, and a flexible hose attached to a mouthpiece. There can be one or more hoses for smoking.

Hookahs are sold all around the world. There are some individuals who prefer smoking using a hookah due to few of its advantages. However, there are health risks associated with hookah smoking. Hence, before trying hookah, you should weigh down both the pros and cons of hookah smoking.

Hookah smoking is usually carried out in groups and the same mouthpiece is passed from one person to another in the group. Certain flavors such as sweetened non-tobacco are available for hookahs. The labels and hookah ads claim that any user can enjoy the same taste without any harmful side effects of tobacco. In one study, shisha and the herbal shisha were carried out and reported that smoke from both of these preparations is known to contain carbon monoxide and other toxic agents. Such toxicity is known to increase the risk for smoking-related lung problems, heart diseases, and certain forms of cancer.


The use of hookah began centuries ago in ancient India and Persia. Today, it has gained a lot of popularity in the form of hookah cafes opened at certain locations. The popularity of hookah has been seen in various countries such as Russia, France, United States, Britain, and the Middle East. It is seen to be more popular among the younger population, which are mostly college students. There are also new age electronic hookahs available in the form of hookah pens and steam stones, which are recently introduced. All of these electronic products run on battery and turn the liquid, which contains nicotine, other chemicals, and flavorings into vapor. This vapor is then inhaled by the individual. There are still studies being conducted on the health risks of electronic hookahs.

A hookah session usually lasts longer than cigarette smoking since hookah smokers tend to puff more frequently along with deep inhalation. In one study, it was reported that the amount of smoke inhaled during one hookah session is nearly 200 times the amount inhaled on cigarette smoking. It was found out that hookah smoking raised the levels of nicotine in urine as much as 73 times.

Pros of Hookah Smoking

1. Less Teeth Staining 

When it comes to oral health, hookah smoking is found to be beneficial when compared to cigarette smoking. This is due to the differences found in the way hookah or shisha is manufactured. It does not lead to staining of the teeth, which mostly a cause for concern in cigarette smoking. Hence, it makes a more sensible alternative for individuals who want to maintain a set of white and shiny teeth.

2. Smells Fresh

The smell from cigarette smoking is quite odd and offensive. It tends to leave people smelling as ashtrays with an odd smell coming from their mouth. In the case of hookah smoking, the tobacco used is prepared with a combination of tobacco, a type of sweetener, and fruits, which produce a pleasant scent than the smell of cigarette smoke.

The Effects of Hookah Smoking 

1. Cancer

Similar to cigarette smoking, hookah smoking is also associated with an increased risk of cancer. The charcoal used to heat up the tobacco can lead to health risks by producing increased levels of carbon monoxide, cancer-causing chemicals, and metals. Even though it has passed through the water in the bowl, the smoke produced from the hookah contains high levels of toxic agents, which are not good for the body. The tobacco and smoke in hookahs are also known to contain several toxic agents that can cause oral cancer, lung cancer, and bladder cancer. Also, the juices of the tobacco produced from the hookah tend to irritate the mouth leading to an increased risk of having oral cancer.

2. Nicotine Dependency 

Whether smoked in cigarettes or hookahs, nicotine will always remain as an addictive chemical. It is not true that hookah smoking is nicotine-free. According to one study, it was found out that hookah smoking involves almost the same amount of nicotine in cigarette smoking. Hence, it also puts hookah smokers at risk of nicotine dependence the same way as cigarette smokers. 

3. Risk of Passing Infections

Hookah smoking promotes the transmission of certain infections from one person to another. Since hookah is mostly carried out in groups, and the same mouthpiece is used throughout the session, there is definitely an increase in the risk of passing infections to other smokers. However, such risks can be minimized by using disposable plastic hookah tips.

4. Affects Pregnancy

Smoking hookah can harm an unborn child during pregnancy. One study found out that women who smoked hookah on a regular basis had an effect on the child, wherein the weight of the child during delivery was lesser when compared with babies of mothers who were non-smokers. Babies born to women who are hookah smokers were at an increased risk of developing respiratory tract infections or respiratory disorders.

5. Heart Disease Risk

Hookah smoke also contains various toxic agents, which can clog the arteries leading to various heart-related problems.

Hookah and Cigarette Smoking

The reason why hookah smoking has gained popularity is due to the misconception that it is less harmful than cigarette smoking. The truth is, smoking through hookah has many health risks similar to cigarette smoking.

  • Water pipe smoking has the same level of nicotine, which is a highly addictive chemical also found in the other tobacco products such as cigarettes.
  • The tobacco in hookah is exposed to high levels of heat due to charcoal burning. Moreover, the smoke generated is as toxic as cigarette smoking.
  • A one-hour session of hookah smoking would involve around 200 puffs, whereas smoking cigarettes usually involve 20 puffs.
  • The amount of smoke inhaled during a typical hookah session is about 90,000 mL while cigarette smoking has an average of only 500-600 mL.
  • Hookah and cigarette smokers are both at risk of getting the same diseases such stomach cancer, oral cancer, infertility, lung cancer, a reduction in lung function, and cancer of the esophagus.
  • Second-hand smoke from hookahs is also a cause for concern for non-smokers similar to cigarette smoking. 

Benefits of Quitting Hookah Smoking

By now, it's probably clear that hookah or shisha smoking is not good for the health. It is good to break this habit as early as possible to avoid dependence. Below are few of the health benefits from quitting hookah smoking:

1. Live Longer and Healthier

When a person smokes, every cell of the body is compromised and becomes an open invitation for a number of health problems. Moreover, as mentioned earlier, since the mouthpiece is commonly shared within a group of smokers, it makes one vulnerable to a lot of diseases such as hepatitis and tuberculosis, among other viruses. When you quit hookah smoking, it keeps you away from all of these ill effects and lets you enjoy the quality of your life. 

2. Increases Quality of Life

Hookah smoking involves increased amounts of carbon monoxide, which is as good as directly breathing carbon monoxide fumes from the exhaust of motor vehicles. This is due to the burning of coal, which happens while smoking hookah. But when you quit smoking, the amount of carbon monoxide would return back to normal levels within a span of a day. Also, within just a few months, the individual would experience a sense of quality life with an improvement in one's circulation and lung function.

3. Improves Finances

One of the biggest rewards of quitting hookah smoking is an immediate improvement in the finances. The money spent in smoking hookah and socialization can be used for something worthy. There are endless opportunities of using the finances saved rather than wasting them on such bad habits, which would put one's life at risk.

4. Prevents Heart Disease

Smoking tends to harm each and every cell present in the body. However, when this bad habit is stopped, it reverses most of the damage caused. Hence, it is important to remember that it is never too late to stop the habit of hookah smoking. After quitting, there would be an improvement in the ability to taste foods and drinks along with an improved sense of smell. After ten years of quitting smoking, there is almost a 50 percent less chance of developing lung cancer when compared to a smoker. A year later, the risk of heart attack and any other heart conditions is reduced by 50 percent. Moreover, after 5-10 years of quitting, the risk of stroke would be reduced compared to smokers.

5. Decreases Carbon Footprint

Quitting hookah smoking is considered to be a good sign for both the individual and its family members. It is also considered to be good for the environment. Due to high volumes of carbon monoxide released while smoking, hookah, in particular, raises the level of pollution in the air. By quitting, one would significantly offset carbon footprints.