While smoking cigarettes is increasingly regarded as a bad, unattractive habit, there's still something pretty exotic and sexy about hookah. Hookah originated about 500 years ago as a way to smoke flavored tobacco using a decorative water pipe through a mouthpiece at the end of a hose. It's still a popular social pastime today, with many people going to hookah lounges to imbibe with a group of friends, with each session lasting about an hour.
Though it may invoke images of glamorous ancient Persia, a new study by scientists at the University of Pittsburgh School of Medicine has found that smoking hookah has an incredibly ugly side. Their results, published in Public Health Reports, indicates that the exposure to dangerous toxins is much higher than the average person would expect.
"Our results show that hookah tobacco smoking poses real health concerns and that it should be monitored more closely than it is currently," lead author Brian Primack explained in a news release.
In order to describe the amount of harmful chemicals involved with smoking hookah, the researchers compared it with the amount that comes from cigarettes. They found that one hookah session exposes the smoker to 2.5 times the nicotine, 10 times the carbon monoxide, 25 times the tar, and a staggering 125 times the amount of smoke compared to smoking one cigarette.
The researchers also note one huge caveat to those stark numbers: they're not exactly comparing apples to apples.
The relative exposure to toxins come from looking at smoking a single cigarette to one hookah session, which is where the problem lies. The amount of tobacco consumed while smoking hookah is greater, but the average cigarette smoker uses tobacco more often. Therefore, it doesn't perfectly communicate the comparative risk between the habits.
"It's not a perfect comparison because people smoke cigarettes and hookahs in very different ways," Primack explained. "We had to conduct the analysis this way — comparing a single hookah session to a single cigarette — because that's the way the underlying studies tend to report findings. So, the estimates we found cannot tell us exactly what is 'worse.' But what they do suggest is that hookah smokers are exposed to a lot more toxicants than they probably realize."
The Centers for Disease Control has already noted that hookah smokers are at risk for developing the same diseases as cigarette smokers, but more information is needed to determine which type of smoker has the greater risk.
The next step to this research will be to understand how often hookah users smoke and compare it to the number of cigarettes the average smoker consumes in a day. This will make it a lot easier to compare the risks of each product. Scientists also need to gain a better understanding of how prevalent hookah is, particularly with young people who are at the greatest risk of beginning a lifelong habit.
While there are still many questions that need to be answered to put these new figures into better context, having a better understanding of the amount of cancer-causing and addictive chemicals in hookah is crucial for promoting public health.