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August 4th, 2008
10:19 AM ET

The smoky truth on hookahs

By Sabriya Rice
Medical Associate Producer

Over the weekend, I went to a Greek bistro with friends and immediately noticed the lovely, fruity smell filling the room. That's when I saw an oddly shaped, smoky gadget passing from person to person. The hookah. I'm not a smoker, and really didn't think twice about it until the hookah passed by my table and several people adamantly insisted I have a puff.  When I mentioned I am training for a half-marathon and, for the sake of my lungs, I would have to decline, I was told "Relax!"  Followed unanimously by, "It's healthy and it doesn't do damage like smoking cigarettes!" Since the aroma didn't jar in me the same "ick" reaction cigarette smoke often does, I was tempted to believe them. I declined but the journalist in me naturally wanted more information.

The hookah has been used for centuries, particularly across regions of North Africa, the Middle East and Asia, as a means of smoking tobacco. It is essentially a water pipe, and many believe the water helps filter out the toxins from the tobacco.  Some historians believe the myth of the healthy hookah started more than 500 years ago, when an Indian physician offered the idea, essentially, as a means of boosting sales for his new device. Alas, despite its alluring, fruity aroma, the truth is, smoking the hookah is no safer than smoking cigarettes. 

According to the Centers for Disease Control, hookah use carries many of the same risks as cigarette smoking including: exposure to high levels of toxic compounds, increased risk of oral, esophageal and lung cancers, reduced lung function and decreased fertility.  In fact the World Health Organization estimates the typical one-hour session of hookah smoking exposes a person to almost 200 times the volume of smoke inhaled from a single cigarette. And sharing the hookah puts smokers at greater risk for transmission of diseases including tuberculosis and viruses like herpes and hepatitis. And yes, secondhand smoke from hookahs poses an equally serious risk to non-smokers like me.

I guess the moral of the story is, don't believe everything you hear. If you're going to smoke, no matter what the fashion, it's best to be aware of the consequences. As for me, if I'm going to choose my poison, as they say, I suppose I'll just stick to my chocolate addiction and to my own personal myth that eating tons of chocolate is actually good for me. The good thing though, is that my lungs will be healthy enough to actually run my half-marathon, and, I hope, curtail some of the negative effects of my vice.

Has this ever happened to you? Are there any practices people tell you are healthy, but you're not entirely convinced?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


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soundoff (101 Responses)
  1. Zach

    Yes the moral of the story is that you shouldn't believe everything you hear cause the person who wrote this has no clue what they are talking about. First off there's really only one scientific journal paper out regarding hookahs and if you claim anything else such as this hear-say as scientific, then you have no right to be in the medical debate.

    Most importantly there is no smoke in hookah. The billowy clouds are fog clouds made the same way a fog machine works, by heating glycerin. So NO hookah does not equal the smoke of 200 cigs. Do any of these people making these claims understand the concept of the conservation of matter??? Tobacco burnt makes smoke and tobacco baked dry of its juices is the same weight that it started as meaning that you can't get smoke out of nothing. And yes, anyone who's cleaned a hookah bowl out after a session can verify that all the tobacco is still there. This also means that there is no tar in hookahs and any hookah smoker can attest that they are never wheezing and out of breath because of smoking hookah.

    Secondly I'd like to focus on the study that was done. The only test group that showed any statistically significant increase in blood carcinogen levels were the subjects in the heavy smoking group. This group had to smoke 120g of shisha a day which is almost 10 times the average bowl size. On top of that the test was Middle East base who's shisha is 60% tobacco and our American brands are about 15%, so to "smoke" the same amount of tobacco you would have to smoke about 40 "American type" bowls a day (there is not enough time in a day, not even close to be able to do that). Even most importantly, in this study and in the Middle East the coals are placed directly onto the shisha and not separated by foil like in American culture. When you take this fact it may be entirely possible that the American version of hookah has no carcinogens because we are truely baking it and not burning it in the least bit..

    So remember if a site starts talking about smoke volume, they have absolutely no clue what they are talking about (this includes the Mayo Clinic who had a doctor do google searches instead of looking at scholarly articles). I fell for the same crap at first too; I didn't smoke for the first two years that i knew about hookah. I now have degrees in Biology pre-Medicine and in Chemistry and am in the health care field, so I don't it likely when I argue that something isn't bad for you.

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    Hookah is good for your lungs

    August 28, 2013 at 19:18 | Report abuse | Reply
  4. Scott-ish

    I work at a hookah lounge and I don't necessarily disagree with the information discussed in this article. I do however believe it can be a better alternative to many cigarettes if kept within reason. As I've heard that many brands of cigarettes have chemical additives. As I stated this is what I've heard and not something I've investigated myself. I personally do not care for cigarettes and do prefer smoking hookah. From what I've been able to discern about the various brands and forms of shisha they tend to remain relatively chemical free which is something does appeal to me. I also find that smoking does help me calm down (likely due to the decreased oxygen intake due to smoking and other potential factors). I'd rather smoke hookah than spend my time in a major city breathing in all the fumes from car exhaust.

    December 16, 2013 at 17:24 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.