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NIDA. (2016, February 9). Hookah Isn’t Harmless. Retrieved from

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The NIDA Blog Team
February 9 2016
CDC promo saying Hookahs are not safe
Photo credit: Centers for Disease Control and Prevention

Think smoking hookah is safe? Or at least safer than cigarettes? Think again.

A hookah is a type of water pipe. It uses charcoal to burn a tobacco mixture, then pulls the tobacco smoke through water and into a mouthpiece for users to inhale.

A recent study found that a typical hookah session delivers approximately 125 times the smoke, 25 times the tar, 2.5 times the nicotine, and 10 times the carbon monoxide as smoking a cigarette. Let’s break that down:

  • 125 times the smoke – Hookah smokers aren’t just inhaling water vapor. They also inhale smoke and all the chemicals that come with it.
  • 25 times the tar – “Tar” is a name for the cancer-causing chemicals in cigarettes that build up in smokers’ lungs and prevent the lungs from cleaning themselves, leading to diseases and breathing problems.
  • 2.5 times the nicotineNicotine is the chemical that gets people addicted to smoking.
  • 10 times the carbon monoxide – Carbon monoxide is a dangerous gas found in smoke and car exhaust. In large amounts, it can cause poisoning and even death. There have been cases of people having to go to the hospital for carbon monoxide poisoning after smoking too much hookah.

Tobacco by any other name…

Does this mean that smoking hookah is worse than smoking cigarettes? Maybe, maybe not; researchers are still looking into that. Part of the reason the toxins are so much higher in a hookah session is that people spend a longer time smoking the hookah in one sitting than it takes to smoke a single cigarette.

But people who smoke cigarettes tend to smoke more often, so it’s hard to compare how hookah and cigarette smoking habits affect a person overall. Keep in mind that water pipes don’t require the same kind of labeling that cigarettes do, so you have no way of knowing what you’re smoking.

The bottom line is that smoking hookah isn’t safe. Some people think that the water in a hookah somehow filters out the dangerous chemicals in tobacco, but that’s not true. Hookah smoke is still tobacco smoke.

Also, even if you aren’t taking puffs from the hookah yourself, there is no safe level of exposure to secondhand smoke, whether from cigarettes or water pipes.

Know before you smoke

Cigarettes are becoming less popular with teens, but some studies indicate that other types of tobacco—including hookah—are becoming more popular. In the annual Monitoring the Future survey, about one out of every five 12th graders continues to say he or she has smoked hookah in the past year.

The World Health Organization and other health groups say that more should be done to educate people about the dangers of hookah smoking. So, here’s our bit: Hookahs are full of chemicals, and they’re addicting, just like cigarettes. They’re just not safe.