Fact Sheet
Hookahs
(updated April 2007)
Hookah (or water pipe) smoking has been practiced extensively for approximately 400 years1, most typically as a social activity often practiced in special cafes.1 Hookah is known by a number of different names, including narghile, argileh, shisha, hubble-bubble, and goza.1 Over recent years, there has been a resurgence of use around the world, most notably among youth.1
Hookah tobacco is available in a variety of flavors, such as apple, mint, and cappuccino,1 and is typically practiced in groups, with the same mouthpiece passed from person to person.1
Hookahs vary in size, shape, and composition.1 A typical modern hookah is composed of a head (with holes in the bottom to allow smoke to pass into the body's central conduit), a metal body, a water bowl, and a flexible hose with a mouthpiece.2
To use the hookah, smokers fill the water bowl halfway with water and submerge the metal body in it. The hose is attached to the top of the water bowl; at the other end of the hose is a mouthpiece, from which the smoker inhales. Moist tobacco is placed in the head, and a lighted charcoal is placed on top. When the head is loaded and the charcoal is lighted, the smoke passes through the water before being inhaled through the mouthpiece.2
Health Effects
- Using a hookah to smoke tobacco poses a serious potential health hazard to smokers and others exposed to the smoke emitted.2
- Hookah tobacco and smoke contain numerous toxicants known to cause lung cancer, heart disease, and other diseases.2
- 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.2
- While many hookah smokers may consider this practice less harmful than smoking cigarettes,1 water pipe smoking delivers the addictive drug nicotine and is at least as toxic as cigarette smoke.1
- 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.1
- A typical 1-hour-long hookah smoking session involves inhaling 100–200 times the volume of smoke inhaled with a single cigarette.2
- Hookah smokers are at risk for the same kinds of diseases as are caused by cigarette smoking, including oral cancer, esophageal and gastric carcinoma, lung cancer, reduced pulmonary function, and decreased fertility.3
- Irritation from exposure to tobacco juices increases the risk of developing oral cancers. The irritation by tobacco juice products among hookah smokers is likely greater than with pipe or cigar smoking because it is typically practiced more often and for longer periods of time with or without inhalation.4
- 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.2
- Sharing a hookah may increase the risk of transmission of tuberculosis, viruses such as herpes or hepatitis, and other illnesses.1
- Babies born to women who smoked one or more water pipes a day during pregnancy have lower birth weights (were at least 100 grams less) than babies born to nonsmokers and are at an increased risk of respiratory diseases.3
- Secondhand smoke from hookahs poses a serious risk for nonsmokers.2
References
- Knishkowy, B., Amitai, Y.
Water-Pipe (Narghile) Smoking: An Emerging Health Risk Behavior. Pediatrics. 2005:116:113–119 [cited 2007 April 13].
Available at:
http://pediatrics.aappublications.org/cgi/content/abstract/116/1/e113
- WHO study group on tobacco product regulation. Advisory note on
water pipe tobacco smoking: health effects, research needs and recommended actions by regulators
.
(PDF–550KB)
[cited 2007 April 13]. Available at:
http://www.who.int/tobacco/global_interaction/tobreg/Waterpipe
recommendation_Final.pdf.
- Nuwayhid, I, Yamout, B., Ghassan, and Kambria, M.
Narghile (Hubble-Bubble) Smoking, Low Birth Weight and Other Pregnancy Outcomes.
American Journal of Epidemiology. [1998]:148:375 [cited 2007 April
13]. Available at:
http://aje.oxfordjournals.org/cgi/content/abstract/148/4/375
- El-Hakim Ibrahim E., Uthman Mirghani AE. Squamous cell carcinoma and keratoacanthoma of the lower lips associated with “Goza” and “Shisha” smoking.
International Journal of Dermatology. 1999:38:108-110 [cited 2007
April 13].
For Further Information
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Phone: 1-800-CDC-INFO
Media Inquiries: Contact CDC's Office on Smoking and Health press line
at 770-488-5493.
Page last modified 04/13/2007
= Link to a PDF document