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

September 8, 2013, American Chemical Society

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 ...

Hookah use widespread among college students

April 5, 2011
Despite a growing number of cities instituting smoking bans across the country, hookah bars are cropping up everywhere – from chic downtown cafes to locations near college campuses, where they've found a loyal customer ...

Recommended for you

Study compares athlete and truck driver, identical twins

July 20, 2018
When it comes to being fit, are genes or lifestyle—nature or nurture—more important? Researchers at San Francisco State University, CSU Fullerton and Cal Poly, Pomona removed the nature part of the equation by studying ...

Secondhand smoke causing thousands of still births in developing countries

July 20, 2018
The study reveals that more than 40% of all pregnant women in Pakistan are exposed to secondhand smoke—causing approximately 17,000 still births in a year.

Eating iron-fortified grain improves students' attention, memory

July 18, 2018
Adolescent students in a rural school in India who consumed an iron-biofortified version of the grain pearl millet exhibited improved attention and memory compared to those who consumed conventional pearl millet, according ...

Vaping tied to blood clots—in mice

July 18, 2018
A new study involving mice raises another concern about the danger of e-cigarettes in humans after experiments showed that short-term exposure to the device's vapors appeared to increase the risk of clot formation.

Lowering hospitals' Medicare costs proves difficult

July 18, 2018
A payment system that provides financial incentives for hospitals that reduce health-care costs for Medicare patients did not lower costs as intended, according to a new study led by Washington University School of Medicine ...

People who tan in gyms tan more often, and more addictively, than others, new research shows

July 18, 2018
Gyms are places people go to get healthier. But nearly half the gyms in the U.S. contain a potentially addictive carcinogen—tanning beds, report UConn researchers in the July 18 issue of JAMA Dermatology.

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.