Hookah FAQ

Ben, if you’re concerned about your health and don’t want to smoke a hookah, then don’t.

But don’t fall into the alarmist trap of tobacco haters. In fact, the anti-tobacco groups are notoriously amongst the biggest liars in the field of public health, and yes, you should look skeptically at claims made by them in a populist public health forum.

Nobody is saying that hookah-smoking is harmless. The question is, how bad is is, and specifically, how bad is it compared to conventional cigarette smoking? As a point of reference, the average American cigarette smoker smokes 20 cigarettes every day. The “average” American hookah user is probably smoking a few times per month.

There is actually plenty of scientific research on the effect of chronic hookah use in the Middle East in places where this form of smoking is highly popular, and on the chemical constituents of hookah smoke (which can vary fairly dramatically based on type of shisha used, and even from pipe to pipe).

Without re-hashing all of it (way beyond the scope of a short post like this) in short: Hookahs do make more smoke in absolute terms than cigarettes. . .of course they do. . .they’re burning a solid brick of charcoal for an hour, and their loaded with substantially more tobacco mix than a cigarette. But to the point, most of these products of combustion are not actually inhaled.

In terms of what actually *IS* inhaled, since the tobacco leaf in shisha is heated not burned like in cigarettes, the QUALITY of the inhaled shisha smoke isn’t as bad as cigarette smoke. The worst consituents of cigarettes smoke are products of combustion, something that isn’t supposed to happen in a properly set-up hookah. With a hookah in particular, at least some of the visible “smoke” is actually relatively low-risk glycerol vapor, not high-risk tobacco combustion product. In short, a hookah functions a bit more like a modern “e-cigarette” vaporizer than a classical stem tobacco pipe.

Although the idea that hookahs “filter out all the toxins” is most certainly false. . .chemically speaking, hookah smoke contains nicotine, tars, heavy metals, and carcinogens (some of these things from the charcoal. . .not the shisha). . .the absolute levels of exposure through a hookah are less (not more) than conventional cigarette smoke. For example, testing has been done to see how much nicotine hookahs smokers have in the bloodstream after an hour session. The answer is that they typically have nicotine levels comparable to smoking 2 cigarettes. . .not dozens of cigarettes, and certainly not 100 cigarettes, as is widely reported by credulous anti-smoking organizations.

More to the point, fairly good longitudinal studies on long term smokers in the middle east have been done. Instead of guessing about what long term hookah use “might” do, we can actually look in the real world and see what it DOES do to people. When you do that, you find that long term hookah smokers do get all the same types of bronchitis, chronic obstructive lung disease, etc, as smokers do. . .just to a considerably lesser extent.

Bottom line, yes hookah smoking is bad for you, and the more you do it, the more you can expect to increase your risk for chronic bronchitis, emphysema, cardiovascular disease and cancer, just like conventional smokers. But ultimately like any toxic exposure, its a question of how intense and how often. . .the dose makes the poison. If you can keep your use infrequent, you can probably moderate (though not eliminate) the risk.