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Published on April 06, 2015

Is Smoking Hookah Safe?

In recent years, smoking hookah and hookah bars’ popularity has skyrocketed. While hookah use came about centuries ago in ancient Persia and India, their use has recently grown over the past several years in the U.S. among youth and college students.

A study published in Pediatrics found that one in five high school seniors in the U.S. has smoked hookah in the past year. And another study published in Nursing Research discovered that the majority of young adults ages 18 to 30 who smoke hookah think it’s safe.

But is it?

“I would not advise them to go and try smoking hookah,” said Dr. Rajesh Patel, an Abington - Jefferson Health pulmonary physician. This, he said, is because hookah smoking can lead to addiction.

“The amount of nicotine is definitely less in hookah, but you must consider the quantity smoked over an hour,” he said. Smoking a cigarette typically lasts about five minutes, whereas hookah smoking tends to be a more social activity that typically lasts about an hour or more.

The way a hookah works is that charcoal-heated air is passed through a (typically flavored) tobacco mixture, then through a water-filled chamber and through a pipe that allows users to inhale the vapor. It usually doesn’t taste or smell like smoke from a cigarette. That, coupled with the notion that the water in the pipe filters out harmful ingredients, fuels the belief that hookah smoking is safe.

As hookah use has grown increasingly popular, there has been more research into its health effects. But that research, like hookah’s popularity, is still relatively new.

“There is no evidence that smoking hookah can negatively impact someone’s health – there have not been enough studies on it. There are some studies from Asian countries (where hookah smoking has gone on for years) that show smoking hookah is as bad as smoking cigarettes,” Dr. Patel said, noting that hookah use “might” be harmful, but there isn’t enough definitive evidence yet.

With that said, Dr. Patel reiterated that he would not advise the younger population to try smoking hookah. Hookah smoke does contain addictive nicotine. This could lead a hookah user to become addicted to something more harmful, such as cigarettes or marijuana, Dr. Patel said.

The popularity of hookah smoking among the younger population in the U.S. is concerning to him.

“That’s the age where an addiction can take a strong hold. The brain is not fully developed and an addiction at that age may cause even more problems,” he said.

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