The hook in hookahs

Just last month my 15-year-old son, Daniel, mentioned that some of his friends were smoking hookahs (also known as shisha, narghile, goza, and hubble bubble). Daniel ticked off its advantages: It's not addictive (like alcohol), not illegal (like pot), and safe from the health hazards of cigarettes. His friends' parents think that it's cool, he said, and someone he knew even had her Sweet 16 party at a hookah bar (before they became illegal in New York City).

Daniel and his friends were parroting the myths that are being perpetuated by many other teens and young adults in the U.S. As our reporting of the recent research reveals, 15 percent of freshmen surveyed at my alma mater, Johns Hopkins, admit to smoking water pipes. Although many Hopkins students are future doctors, they're ignoring the facts. Last year  the American Lung Association reported evidence that hookah smoking carries many of the same health hazards as cigarette smoking—heart disease, clogged arteries, and lung cancer. And because the mouthpieces are shared with others, users are also at risk for infectious diseases, such as TB, hepatitis, and herpes. 

Furthermore, evidence suggests that an average 45-minute hookah session raises levels of nicotine in the blood up to 250 percent. It also delivers the equivalent of 100 times the smoke of a cigarette (with its related toxic agents such as carbon monoxide), contributing to a growing concern in the medical community that the practice may lead to regular cravings and addiction to cigarettes. 

As the February 2008 journal Nicotine & Tobacco Research illustrates, it seems that hookah users don't have a clue! Data analyzed from 201 hookah smokers revealed that 79 percent felt that cigarettes were more addictive than water pipes, 67 percent felt cigarettes were more harmful, and more than 65 percent believed that cigarettes have more nicotine. 

So far, the part about germs has been enough to deter Daniel. But the battle is far from over. When I told him that I was writing this, he insisted, "They wouldn't make something legal if it were so unsafe." —Orly Avitzur, M.D., medical adviser to Consumers Union