Don’t believe the hookah hype: Cardiologists warn that it’s more harmful than cigarettes

Smoking tobacco through a water pipe, or more commonly known as hookah smoking, has been practiced for centuries. Today, it has become a trend, especially among young people. It is perceived by many as a safer alternative to traditional cigarette smoking, but researchers say otherwise.

A team of medical researchers headed by Dr. Aruni Bhatnagar at the University of Louisville Diabetes and Obesity Center in Kentucky released a statement warning that hookah is actually more harmful than cigarettes. With just 30 minutes of smoking, hookah smokers are more likely to inhale higher levels of toxic chemicals than cigarette smokers.

One hookah smoking session generates, on average, 70 times greater levels of tar, 2.5 times higher levels of phenanthrene, and 11 times greater levels of carbon monoxide than cigarettes. These chemicals can cause cancer and reduce the heart’s ability to pump blood, leading to an increased risk of cardiovascular disease. In addition, an hour of hookah session exposes users to the same amount of smoke as 100 cigarettes. Evidence also shows that hookah smoking is addictive, which could lead to the use of other tobacco products like cigarettes. (Related: Smoking shisha, hookah for one hour the equivalent of smoking 100 cigarettes, claims WHO.)

The warning, which was published in the American Heart Association’s (AHA) journal Circulation, came after a survey revealed that 4.8 percent of American high school students and 13.6 percent of those aged 18 to 24 have tried hookah. The AHA “strongly recommends avoiding the use of tobacco in any form.”


Hookah’s popularity among young people

Bhatnagar and his colleagues worry about the continuously increasing popularity of hookahs among the youth. A hookah typically consists of a bowl that holds tobacco and is attached to a hose that leads from a body of water to a mouthpiece.

Hookah tobacco is sweetened and flavored, making it appealing to young adults. Some of the most common flavors include fruits, mint, and cola. It’s also often sold in colorful packaging, making it yet even more appealing.

Wood, coal, or charcoal is burned in the pipe to heat the tobacco and produce the smoke. The fruit syrup or sweetener makes the tobacco damp, masking its taste. This may make it easier for users to inhale tobacco smoke and lead them to believe that hookahs don’t cause much damage. Some users also mistakenly believe that it is less harmful because the tobacco is filtered through water.

In addition, hookah smoking is seen as a social activity rather than an everyday habit. Users are also likely to be exposed to secondhand smoke from the product itself and smoke exhaled by users. Moreover, tobacco marketed to hookah users does not have a health warning. Social media further promotes this practice.

Hookah smoking and cardiovascular health

A study published in the American Journal of Cardiology revealed that just one session of hookah smoking can harm your cardiovascular health. In this study, researchers from the University of California Los Angeles (UCLA) looked at the cardiovascular effects of hookah smoking in 48 healthy young adults who don’t smoke traditional cigarettes.

To do so, they measured the participants’ heart rate, blood pressure, arterial stiffness, and aortic enlargement index score. The UCLA researchers also measured their blood levels of nicotine and exhaled carbon monoxide.

Arterial stiffness is an indicator of stroke, while aortic enlargement is a condition that can be deadly if left untreated. Both conditions can increase the risk of heart attack and other cardiovascular events.

The researchers found that after only 30 minutes of hookah smoking, the participants’ heart rates spiked by 16 beats per minute, as well as their blood pressure. In addition, hookah smoking increased their arterial stiffness to a degree comparable with the damage caused by smoking one traditional cigarette. These findings raise concern given that the study examined only the effects of a 30-minute hookah smoking session, whereas people typically smoke hookahs for several hours.

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