Study: Hookah Different, Not Safer than Cigarette Smoking

Hookah smoking, a recent trend that many falsely believe offers a healthier alternative to traditional cigarette smoking, is dangerous, but in different ways, a new study shows.

Hookahs, also known as water pipes or shishas, are, in fact, dangerous, according to a study published in the journal Cancer Epidemiology, Biomarkers and Prevention, said The Los Angeles Times. A popular social activity in the Middle East, hookah smoking has made its way to the United States and, according to a 2011 study, more than 40 percent of college students had used a hookah and most of those students believed hookah smoking to be safer than cigarette smoking.

“The tobacco is no less toxic in a hookah pipe,” according to the Mayo Clinic, “and the water in the hookah does not filter out the toxic ingredients in the tobacco smoke. Hookah smokers may actually inhale more tobacco smoke than cigarette smokers do.” But people continue to believe that the hookah is a safer alternative, said The Los Angeles Times.

UC San Francisco conducted a randomized study involving 13 volunteers—eight men and five women—who were very familiar with the so-called tobacco arts, said The Los Angeles Times. The group individually smoked one way for four days; one week later, they smoked the other way for four days. Participants smoked an average of either 11 cigarettes or three water-pipe sessions per day.

People can excrete different amounts of toxins, even if smoking identical quantities, which amounts to a type of secretion fingerprint. Because of this, explained The Los Angels Times the test subjects would have to have smoked both ways so that the researchers could achieve data to make an accurate comparison. The researchers measured the participants’ blood nicotine levels and discovered that hookah smoking led to about half of the total level of nicotine seen in cigarette smokers, noting that even at lower levels nicotine can lead to an addiction.

The scientists also found that carbon monoxide levels in participants’ breath were some 2.5 times greater for water-pipe than cigarette smokers, a very serious finding given that carbon monoxide can increase risks for heart attacks, stroke, and sudden death in people with cardiovascular or lung illnesses, said The Los Angeles Times. The team also found that hookah smokers’ urine levels showed significantly higher levels of benzene, a toxin linked to leukemia.

“A different pattern of carcinogen exposure might result in a different cancer risk profile between cigarette and water pipe smoking,” the researchers wrote. “Of particular concern is the risk of leukemia related to high levels of benzene exposure with water pipe use,” they noted, according to The Los Angeles Times.

According to research lead, research chemist Peyton Jacob III, PhD, and UCSF tobacco researcher Neal Benowitz, MD, both based at San Francisco General Hospital and Trauma Center, not only is hookah smoking an unsafe alternative to smoking cigarettes, using a hookah pipe is not an effective reduction strategy to smoking. Benowitz also noted that, when compared to non-smokers, a regular hookah smoker is likelier to experience increased cancer risks, said Science World Report.

In fact, according to reports in Nature World, smoking a water pipe for one hour involves inhaling 100-to-200 times more smoke volume than what is inhaled from one cigarette, said Science World Report.  “In addition to delivering toxic substances from the charcoal and tobacco, the heat causes chemical reactions in the mixture which produce toxic volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs). Some PAHs are highly carcinogenic and can cause lung cancer, stated Jacob.

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