Toward understanding the health effects of waterpipe or 'hookah' smoking

September 8, 2013

With water pipes or hookahs gaining popularity in the United States and other countries, scientists today described a step toward establishing the health risks of what has been termed "the first new tobacco trend of the 21st century."

In a study that they said provides no support for the popular notion that hookahs are safer than , they reported that hookah tobacco and smoke contain lower levels of four than and smoke. It was part of the 246th National Meeting & Exposition of the American Chemical Society (ACS), the world's largest scientific society, being held here this week.

"Any form of is dangerous, and our studies on toxic metals in hookah smoke are taking the first steps toward the necessary animal and human studies that will establish a clearer picture of the relative dangers of hookah and cigarette smoking," said Joseph Caruso, Ph.D., who led the study. "It is very difficult to compare hookah smoking with cigarette smoking because they are done so differently."

He explained that use specially prepared tobacco, sometimes called shisha—a moist, gooey concoction that may include molasses, honey and flavoring agents. Burning embers or charcoal heat the shisha, producing smoke that bubbles down through a container of water and into a long hose-like tube with a mouthpiece for inhaling.

Caruso and colleagues, who are with the University of Cincinnati, think that the lower levels of arsenic, lead, cadmium and chromium they detected in hookah smoke are not due to filtering of the smoke through water. That's part of the basis for the popular belief—disputed by the U.S. Centers for Disease Control and Prevention, the American Lung Association and other authorities—that hookah smoking is safer than cigarettes. Rather, it seems that shisha itself may contain lower levels of those metals, since Caruso's team did not detect excess amounts of those metals in the hookah water.

Other differences in hookah vs. cigarette smoking complicate any interpretation of the health implications of the lower levels of toxic metals in hookah smoke, noted Caruso and graduate student Ryan Saadawi, who presented on the research at the meeting.

Studies have shown, for instance, that a typical hour-long hookah smoking session involves 200 puffs, while an average cigarette is 20 puffs. The World Health Organization estimates that an hour-long hookah session is equivalent to smoking 5-10 packs of cigarettes. However, many people who smoke shisha smoke less frequently than cigarette smokers.

"All of these things make different from cigarette smoking, and it also makes it difficult to compare the two, which is partly the reason why there are so few studies on the topic," said Saadawi.

Caruso and Saadawi studied unsmoked shisha, as well as shisha smoke, with a sensitive instrument called an inductively coupled plasma mass spectrometer. They also removed the additives from the shisha and found little difference before and after, thus the tobacco is the likely source of the metals, they said. Whether the smoke went through the water in the hookah also didn't affect the metal levels.

Explore further: After tobacco, Turkey bans hookah in public places

More information: Abstract:

Total analysis in hookah tobacco formulation and hookah tobacco smoke

Various studies have been performed on cigarette, cigar, and pipe tobacco while virtually no studies have been performed on hookah tobacco. It is well documented the former tobacco is known to contain toxic metals such as As, Cd, Cr, and Pb. However, little is known about the metal content in hookah tobacco. Hookah has been popular in the Middle East and surrounding regions for ages and its use is emerging rapidly in Western cultures making it imperative to study.

Microwave assisted digestion in combination with ICP-MS was utilized to elucidate the toxic metal content in an array of different brands/flavors of hookah tobacco formulations as well as hookah tobacco smoke. A water extraction was done on the hookah tobacco formulation to remove water soluble glycerin, molasses/honey, colorants and flavorings. Polycyclic aromatic hydrocarbons were extracted from hookah tobacco smoke using an organic solvent and analyzed by HPLC florescence detection.

Related Stories

After tobacco, Turkey bans hookah in public places

January 28, 2013
After banning smoking in public places, the Turkish government has gone one step further by clamping down on an ancient tradition—the hookah, or water pipe.

Smoking from hookah not a harmless alternative to cigarettes

April 18, 2013
(Medical Xpress)—Smoking tobacco through a hookah is a pastime gaining popularity among the college crowd, but many of them mistakenly believe that using the fragrant water pipe is less harmful than smoking cigarettes.

Hookah smoking increasingly common among first-year college women

July 18, 2012
Nearly a quarter of college women try smoking tobacco with a hookah, or water pipe, for the first time during their freshman year, according to new research from The Miriam Hospital's Center for Behavioral and Preventive ...

More smoke water pipes -- family habits significant

April 7, 2011
The number of people smoking water pipes is rising dramatically throughout the world. A large proportion of new users are young, and many believe – contrary to facts – that water pipe smoking is less dangerous than ...

Researchers alarmed at rise in hookah use among California youth

August 19, 2011
Hookah use among California youth ages 18 to 24 is rising rapidly according to a study conducted by researchers at University of California, San Diego School of Medicine. The study appears in the "First Look" online version ...

Recommended for you

Expert: Be concerned about how apps collect, share health data

October 20, 2017
As of 2016 there were more than 165,000 health and wellness apps available though the Apple App Store alone. According to Rice University medical media expert Kirsten Ostherr, the Food and Drug Administration (FDA) regulates ...

More teens than ever aren't getting enough sleep

October 19, 2017
If you're a young person who can't seem to get enough sleep, you're not alone: A new study led by San Diego State University Professor of Psychology Jean Twenge finds that adolescents today are sleeping fewer hours per night ...

Across Asia, liver cancer is linked to herbal remedies: study

October 18, 2017
Researchers have uncovered widespread evidence of a link between traditional Chinese herbal remedies and liver cancer across Asia, a study said Wednesday.

Eating better throughout adult years improves physical fitness in old age, suggests study

October 18, 2017
People who have a healthier diet throughout their adult lives are more likely to be stronger and fitter in older age than those who don't, according to a new study led by the University of Southampton.

Global calcium consumption appears low, especially in Asia

October 18, 2017
Daily calcium intake among adults appears to vary quite widely around the world in distinct regional patterns, according to a new systematic review of research data ahead of World Osteoporosis Day on Friday, Oct. 20.

New study: Nearly half of US medical care comes from emergency rooms

October 17, 2017
Nearly half of all US medical care is delivered by emergency departments, according to a new study by researchers at the University of Maryland School of Medicine (UMSOM). And in recent years, the percentage of care delivered ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.