In recent decades, smoking tobacco through a water pipe, or hookah, has gained popularity worldwide, including in the U.S. – especially among young adults. Research finds that around one in five college students in the U.S. has smoked a water pipe, and its use is growing among high school students and even some middle school students, according to youth tobacco survey data.
“Everything we know about hookah smoking suggests that it is at least as dangerous as cigarette smoking and potentially more dangerous,” says Thomas Eissenberg, a professor of psychology at Virginia Commonwealth University and co-director of the Center for the Study of Tobacco Products, who has extensively researched hookah risks.
Unfiltered Risks
Much of the misperception about its associated risks – as well as the very real safety concerns linked with hookah smoking – relate to the smoking process itself. Hookah smoking involves using charcoal to heat specialized tobacco, which produces smoke. As a person puffs on the hookah, that smoke then bubbles through water in the pipe to reach the user.
Long-term Risks
One thing that’s clouded cigarette-hookah comparisons is a lack of data on long-terms risks for hookah tobacco smoking. In contrast, the long-term risks for cigarette use have been well studied. “We can almost literally count the bodies of people who die every year in the U.S. from cigarette smoking,” Eissenberg says.
These types of tiny particles, which are measured in units equal to a billionth of a meter called nanometers, can worsen underlying lung problems like asthma, COPD and chronic bronchitis. Those that contain cancer-causing chemicals put a person at risk for lung cancer. In addition, inhaling particulate matter can lead to permanent lung damage, especially in individuals in their teens or early 20s.
It May Lead to Cigarette Smoking
One defense of hookah smoking is that it’s an occasional activity. But experts note that lurking in each inhalation is the same addictive chemical that has hooked so many on cigarettes: nicotine. So with every hookah smoking session there’s a greater risk that a person will become addicted to nicotine.
That dependency can open the door to cigarette use. Research shows that hookah use doubles one’s risk of smoking cigarettes, Maziak says. That’s one more reason not to give hookah a try – even occasionally.