Thursday, September 1, 2011

Is Hookah smoking a safe alternative to smoking cigarettes?

A hookah also known as a waterpipe or arghile, is a single or multi-stemmed (often glass-based) instrument for smoking in which the smoke is cooled by water. The tobacco smoked is referred to as shisha (sheesha) in the United Kingdom, United States and Canada. The practice of smoking tobacco through elaborate water pipes emerged centuries ago, in the palaces and harems of the Middle East. But experts say hookahs are now almost as popular in Denver as they are in Damascus, with the current fad for water-pipe use growing among U.S. college students. Hookahs became very popular in the U.S., but they are also coming back in the Middle East. The popularity is on the rise even on the relatively new markets, like Germany, Brazil, or Thailand -- where they were recently outlawed. While cigarette use has largely fallen out of favor with the college crowd, the exotic allure of hookahs -- and the misperception that hookah smoke is filtered and safer -- may be driving the trend.

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The hookah, also called nargile, is comprised of four parts -- the head, where burning charcoal heats a bed of tobacco; the body, through which inhaled smoke is drawn into the third section, a water-filled bowl at the hookah's base, and the hose, a flexible pipe through which the user inhales the smoke after it has bubbled through the water.

Hookah Components

Hookah consists of a number of components, four of which are essential for its operation.

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Also known as the head of the hookah, the bowl is a container, usually made out of clay or marble, that holds the coal and tobacco during the smoking session. The bowl is loaded with tobacco then covered in a small piece of perforated aluminum foil or a glass or metal screen. Lit coals are then placed on top, which allows the tobacco to heat to the proper temperature.

There is also a variation of the head which employs a fruit rather than the traditional clay bowl. The fruit is hollowed out and perforated in order to achieve the same shape and system a clay bowl has, then it is loaded and used in the same manner.

Bowls have evolved in recent years to incorporate new designs that keep juices in the tobacco from running down the stem. The Tangiers Phunnel Bowl and Sahara Smoke Vortex Bowl are two examples of such bowls.


A Hookah Cover windscreen is a cover which sits over the bowl area, with some form of air holes. This prevents wind from increasing the burn rate and temperature of the coal, and prevents ash and burning embers from being blown onto the surrounding environment. This may also offer some limited protection from fire as it may prevent the coal from being ejected if the hookah is bumped.


Technically if the pipe has a hose it is not "hookah"—the term historically referred to a straight-neck tube. Today the hose (one or more) is a slender flexible tube that allows the smoke to be drawn for a distance, cooling down before inhalation. The end is typically fitted with a metal, wooden, or plastic mouthpiece of various shape, size, color or material type.

Purge valve

Many hookah are equipped with a purge valve connected to the airspace in the water jar to purge stale smoke which has been sitting unused in the jar for too long. This one-way valve is typically a simple ball bearing sitting over a port which seals the port by gravity alone and will open if positive pressure is created by blowing into the hose. The bearing will be held captive with a screw-on cover. The cover should be opened and the bearing and seat cleaned of residue and corrosion regularly to ensure proper sealing.

Water jar

The body of the hookah sits on top of the water jar, or sometimes referred to as vase, or base. The downstem hangs down below the level of the water in the jar. Smoke passes through the body and out the downstem where it bubbles through the water. This cools and humidifies the smoke. Liquids such as fruit juice may be added to the water or used in substitution. Pieces of fruit, mint leaves, and crushed ice may be added.


A plate or ashtray sits just below the bowl to catch ashes falling off the coals.


Grommets in a hookah are usually placed between the bowl and the body, the body's gasket and the water jar and between the body and the hose. The grommets, although not essential (the use of paper or tape has become common), will help to seal the joints between the parts, therefore decreasing the amount of air coming in and maximizing the smoke breathed in.


A piece attached to the bottom of the stem, usually made of plastic and in a grid pattern, to make a smoother smoke and a subdued noise. By breaking the naturally larger bubbles coming up the water from the pipe into smaller ones, it lowers the amount of suction or "pull" needed to continue bringing smoke to the chamber. This also cools the smoke down more efficiently. It is used as a luxury item for a premium smoking experience and is not a required component.

Flavors of hookah tobacco

Hookah tobacco comes in many types of flavors, such as fruit, candy, dessert, and spice flavors. Some of the fruit flavors include: apple (caramel, double, green, red, or sour), apricot, banana, blueberry, cantaloupe, cherry, cherry banana, coconut, grape, guava, kiwi, lemon, lemon-lime, mandarin, mango, melon, mixed fruit, oranges, passion fruit, peach, pear, pineapple, pomegranate, raspberry, strawberry, strawberry kiwi, and watermelon.

Candy/dessert/spice flavors include: banana split, bubble gum, candy, cappuccino, caramel, chocolate mint, cinnamon, coffee, cola, frappucino, honey, jasmine, licorice, mint, molasses, orange soda, pistachio, red tea, root beer, rose, and vanilla.

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Differences between hookah smoking and cigarette smoking

Many differences are apparent when comparing waterpipe to cigarette smoking.  In general, compared to cigarette smoking, waterpipe smoking is characterized by less frequent exposure (one to four sessions per day) but with a much more intense exposure per session which varies between 15 and 90 minutes. The uptake of tobacco nicotine is equivalent to 2–12 cigarettes per portion of tobacco used (hagar). A regular user of waterpipes usually smokes several hagar per session and on average hagar smokes 2–3 sessions per day. This translates into an intake of nicotine equivalent to more than one pack of cigarettes per session for most waterpipe smokers.  However, it is known that waterpipe smoking produces more smoke than cigarette smoking, and it has been estimated that smoke exposure could be as much as 100–200 cigarettes per session. Therefore the types and magnitudes of health hazards of waterpipe smoking are likely to be different from those of cigarette smoking, and there is a need to standardize exposure measurements for the proper assessment of health hazards related to this particular kind of tobacco exposure.

In addition, the temperature of burning tobacco in waterpipes is much lower than that in cigarettes, and the force needed to pull air through the high resistance of the water pathway permits the smoke to be inhaled very deeply into the lungs. Therefore the sites and patterns of cell injury in the oral and respiratory tracts are likely to be different from those due to cigarette smoking. This area requires further toxicological and pathological investigation and needs expanded research support. Indeed, the entire field of the health effects of waterpipe smoking is ripe for new and comprehensive research, including interdisciplinary approaches.

There is little research on waterpipe smoking and health; for example, waterpipe smoking is a known source of heavy metal exposure to consumers, and evidence suggests that waterpipes concentrate these metals in the water chamber of the device. Biological markers of tobacco harm, such as carbon monoxide poisoning, have been scarcely studied in waterpipe users, and many questions remain to be explored in detail.

While many hookah smokers may consider this practice less harmful than smoking cigarettes, hookah smoking carries many of the same health risks as cigarettes.
  • Water pipe smoking delivers the addictive drug nicotine and is at least as toxic as cigarette smoke.
  • Due to the mode of smoking—including frequency of puffing, depth of inhalation, and length of the smoking session—hookah smokers may absorb higher concentrations of the toxins found in cigarette smoke.
  • A typical 1-hour-long hookah smoking session involves inhaling 100–200 times the volume of smoke inhaled from a single cigarette.
  • Hookah smokers are at risk for the same kinds of diseases as are caused by cigarette smoking, including oral cancer, lung cancer, stomach cancer, cancer of the esophagus, reduced lung function, and decreased fertility.

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Health Effects

Hookah Smoke and Cancer

  • The charcoal used to heat tobacco in the hookah increases the health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals.
  • Even after it has passed through water, the smoke produced by a hookah contains high levels of toxic compounds, including carbon monoxide, heavy metals, and cancer-causing chemicals.
  • Hookah tobacco and smoke contain numerous toxic substances known to cause lung, bladder, and oral cancers.
  • Irritation from exposure to tobacco juices increases the risk of developing oral cancers. The irritation by tobacco juice products is likely to be greater among hookah smokers than among pipe or cigar smokers because hookah smoking is typically practiced (with or without inhalation) more often and for longer periods of time.

Other Health Effects of Hookah Smoke

  • Hookah tobacco and smoke contain numerous toxic substances known to cause clogged arteries and heart disease.
  • Infectious diseases may be transmitted by sharing a hookah.
  • Babies born to women who smoked one or more water pipes a day during pregnancy have lower birth weights (were at least 3½ ounces less) than babies born to nonsmokers and are at an increased risk for respiratory diseases.

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Sources and Additional Information:

1 comment:

  1. Hookahs are marketed as being a safe alternative to cigarettes.

    Sahara Smoke


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