February 2008
Hookah smoking: A dangerous trend
HOOKAH USE Could inhale as much smoke in one session as puffing on 100 cigarettes.
Photo by Dan Kelleher/Dreamstime.comYou've given your kids the "cigarettes can kill" lecture, but what about the lecture on water pipes? You might not even know
what a water pipe—also known as a hookah, shisha or hubble-bubble—is, but most college students do. In fact, a recent study
at Johns Hopkins University found that 15 percent of college freshmen surveyed there currently use one.
That might not sound like a lot, so let's put that in perspective: Of Hopkins' 411 freshmen surveyed, about 60 of them smoke water pipes on a regular basis. Equally scary, the researchers found that 37 percent of those students perceive water pipes to be less harmful than cigarettes. Yet the process, in which the smoker draws air from heated coals and flavored tobacco, with the smoke finally bubbling up through water, could be just as hazardous. An advisory from the World Health Organization warns that a water-pipe smoker could inhale as much smoke during one session as a cigarette smoker would inhale through 100 or more cigarettes.
A list of water-pipe-related concerns includes the use of charcoal as a heat source, the inhalation of nicotine, tar, and heavy metals, and the exposure to carbon monoxide, or CO. A study published in a January 2008 issue of the Journal of the American Medical Association examined the latter. Though CO exposures experienced by water-pipe smokers aren't quite at the levels that are known to kill coal miners, the increase in exposure is still quite notable. "We saw an increase of about 40 parts per million," said the study's lead author, Wael El-Nachef, "which poses particular risks to pregnant women and people with cardiovascular conditions." Inhaling that much carbon monoxide could lead to chest pains, a decreased ability to engage in prolonged exercise, drowsiness, and difficulty concentrating.
And that's not all that has doctors worried. "The real danger of this trend is the nicotine addiction and the downhill effect that will come 20 and 40 years down the road," said pulmonologist Edward Rosenow III, M.D., of the Mayo Clinic. Rosenow is concerned that because hookah smoking is more of a social activity, users will turn to cigarettes to get their nicotine high between hookah sessions. That could lead to more incidences of emphysema and cancer.
When asked which was worse—cigarettes or water pipes—El-Nachef and Rosenow were in agreement: "They're both bad," said El-Nachef. While the study of water pipe use in the U.S. is at a very early stage, the little we know certainly seems persuasive enough to support advice to steer clear.
That might not sound like a lot, so let's put that in perspective: Of Hopkins' 411 freshmen surveyed, about 60 of them smoke water pipes on a regular basis. Equally scary, the researchers found that 37 percent of those students perceive water pipes to be less harmful than cigarettes. Yet the process, in which the smoker draws air from heated coals and flavored tobacco, with the smoke finally bubbling up through water, could be just as hazardous. An advisory from the World Health Organization warns that a water-pipe smoker could inhale as much smoke during one session as a cigarette smoker would inhale through 100 or more cigarettes.
A list of water-pipe-related concerns includes the use of charcoal as a heat source, the inhalation of nicotine, tar, and heavy metals, and the exposure to carbon monoxide, or CO. A study published in a January 2008 issue of the Journal of the American Medical Association examined the latter. Though CO exposures experienced by water-pipe smokers aren't quite at the levels that are known to kill coal miners, the increase in exposure is still quite notable. "We saw an increase of about 40 parts per million," said the study's lead author, Wael El-Nachef, "which poses particular risks to pregnant women and people with cardiovascular conditions." Inhaling that much carbon monoxide could lead to chest pains, a decreased ability to engage in prolonged exercise, drowsiness, and difficulty concentrating.
And that's not all that has doctors worried. "The real danger of this trend is the nicotine addiction and the downhill effect that will come 20 and 40 years down the road," said pulmonologist Edward Rosenow III, M.D., of the Mayo Clinic. Rosenow is concerned that because hookah smoking is more of a social activity, users will turn to cigarettes to get their nicotine high between hookah sessions. That could lead to more incidences of emphysema and cancer.
When asked which was worse—cigarettes or water pipes—El-Nachef and Rosenow were in agreement: "They're both bad," said El-Nachef. While the study of water pipe use in the U.S. is at a very early stage, the little we know certainly seems persuasive enough to support advice to steer clear.
