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Hookah and Waterpipe Smoking

You may be hearing a lot about hookah, or waterpipe smoking (it’s also called nargile or shisha). Traditionally used by elderly men in India, South Africa, Persia, and Ethiopia, today hookah is found in restaurants and hookah bars across Alberta.

You may also hear that it’s safe but that’s not true. Research tells us that it’s not a safe alternative to smoking. Often described as herbal and advertised as tobacco-free, there are many messages about this product that are misleading.

What is hookah?

Traditional hookah is a mix of tobacco, glycerin, and/or honey. It has varying amounts of nicotine in it. While hookah is sometimes tobacco-free, testing shows that even products that say tobacco-free may have tobacco (and therefore nicotine) in it. Nicotine is a very addictive drug. Once exposed to nicotine, it can be hard for people to stop using without having the unpleasant symptoms. Over the last 20 years, hookah has become commercialized and flavouring has been added to some products to make it more appealing. Sometimes hookah is marketed as “washed”. This doesn’t affect the nicotine level or make it safer.

Is hookah safe?

Anytime a product is burned, harmful chemicals are released. Smoke from hookah has been linked to diseases that are usually seen when you smoke cigarettes, such as cancer, heart disease, lung disease, and complications in pregnancy. A lot of people believe that hookah is safer than using other tobacco products because of the water in the base of the pipe. Again, research tells us that this isn’t true. The water doesn’t act as a filter. In fact, the World Health Organization found that a hookah user may inhale as much smoke in a 1-hour session as someone who inhaled 100 or more cigarettes!

Another concern is about sharing the mouthpiece. Diseases like herpes and other communicable diseases can also be spread because people are sharing the same mouthpiece.

Burning hookah, including hookah that is tobacco free, still creates cancer-causing chemicals. In fact, both the mainstream and second-hand smoke produced by herbal shisha contained these known cancer-causing agents at levels equal to or greater than that of tobacco products. That means that people who are around the hookah smoke, including those who work in hookah bars, are at risk of the health problems seen from being exposed to the second-hand smoke.

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Current as of: May 15, 2018

Author: Tobacco Reduction Program, Alberta Health Services