The Perils of Hookah Smoking: Results of New Study

Light-use, Hookah Only Smokers Have Symptoms and Reduced Lung Function

Background: The hookah, also called a waterpipe, shisha, or narghile, is used for smoking fruit-flavored tobacco by millions of people worldwide. Tobacco is placed in a bowl surrounded by burning charcoal. When the smoker inhales, air is pulled into the bowl holding the tobacco. The resultant smoke is bubbled through water, carried through a hose, and inhaled. It typically includes tobacco products equivalent in a single bowl waterpipe session over 45 – 60 minutes to one pack of cigarettes together with carbon monoxide and charcoal components.

Hookah in restaurtant in Nepal

Hookah in restaurtant in Nepal

Components of a hookah

Components of a hookah

While hookah smoking is commonly associated with the Middle East, the use of waterpipes is becoming more common in the United States. For example, 9 – 20% of young adults in the US report that they have used waterpipes, and hookah “bars” are common in many US cities. Many smokers believe that the water filters “toxins” from the smoke, making it safer than smoking cigarettes. However, this is a myth.

Study: Researchers from the Weil Cornell Medical College studied 19 never smokers and 21 self-reported hookah smokers only from the general population of New York City by posting advertisements in local newspapers, eletronic bulletin boards, and waterpipe bars. All subjects answered questions, performed breathing tests, had a high-resolution CT scan of the chest, and had samples obtained from the lower breathing tubes by bronchoscopy (having a scope passed into the mouth and deep into the lungs). The study was published in the September 1, 2016, issue of the American Journal of Respiratory & Critical Care Medicine.

Findings: Compared with nonsmokers (average age = 33 years), the waterpipe smokers (average age = 25 years) had: more cough and sputum (mucus); reduced transfer of gas across the air sacs and blood vessels (called the diffusing capacity); and abnormal cells in the lower lung.

Conclusions: Young. light-use, hookah only smokers have multiple lung abnormalities suggesting that even limited use can have serious consequences.

My Comments: Two factors have increased  the popularity of hookah or waterpipe smoking among school-aged children and young adults throughout the world. One is the introduction of different flavors (lemon, apple, orange, cherry, etc.). Two is as the belief that waterpipe smoking is safe as it filters all noxious substances because it passes through water.

Studies have compared the effects of a single session of waterpipe smoking with smoking one cigarette. The inhaled smoke volume is 123 times greater with hookah smoking and is associated with 2.3 times more inhaled nicotine and 25 times more inhaled tar.

Once again, any type of smoking can damage the lungs and should be avoided for lung health.