Hookah - A Healthier Option?

According to the Cancer Council of Australia, in 1945, approximately 72% of Australian men smoked. Since then, the rate has dropped significantly, with 2010 survey data indicating that only 16.4% of Australian males and 13.8% of Australian females smoke cigarettes. Regardless, smoking is the largest preventable cause of death and disease in Australia, with a tobacco-related death occurring about once every 28 minutes.

While some of those intending to quit manage to turn away from cigarettes entirely, many turn to other addictive behaviours to fill the void left in their lives. One alternative is smoking tobacco preparations in a water pipe (hookah, shisha). This practice is widespread in many places of the world and is perceived by many as a relatively safe alternative to cigarettes. I myself have, in the past, experimented with smoking water pipe, lulled under a false sense of security.

However, a recent comparison of nicotine and carcinogen exposure with water pipe and cigarette smoking found evidence to explain where added concerns may lie with the former.

The researchers ascertained that, when smoking an average of 3 water pipe sessions compared with smoking 11 cigarettes per day, water pipe use was associated with a significantly lower intake of nicotine however, a greater exposure to carbon monoxide, and a different pattern of carcinogen exposure compared with cigarette smoking, which included greater exposure to benzene and high molecular weight polycyclic aromatic hydrocarbon. 

On the other hand, there was less exposure to tobacco-specific nitrosamines, 1,3-butadiene, acrolein, ethylene oxide, and low molecular weight polyciclic aromatic hydrocarbons.

In short, it appears that water pipe smoking is not benign but, rather that use of the hookah may result in a different pattern of carcinogen exposure which may result in a entirely different cancer risk profile. For example, high levels of benzene exposure have been associated with leukemia.

Another reason to shun smoking entirely is the research suggesting that water pipe smoking negatively affects lung function and could be as harmful as cigarette smoking in this regard. As such, it is likely to be a cause of COPD (chronic obstructive pulmonary disease), which is the fourth leading cause of mortality in the United States.

Reference:

Jacob III, P., et al. (2013). Comparison of nicotine and carcinogen exposure with water pipe and cigarette smoking, Cancer Epidemiol Biomarkers Prv, 22, 765.

Raad, D., et al. (2011). Effects of water-pipe smoking on lung function: A systematic review and meta-analysis, Chest, 139(4), 737-738.