Hookah — also called narghile, shisha and goza — is a water pipe. The device has been used for centuries in the Middle East and Asia to smoke tobacco. Now, hookah bars and cafes are popping up across the United States — fueled by the growing popularity of hookah smoking among teens and young adults.

Although many believe that the water in the hookah filters out all the "bad stuff" in the tobacco smoke, this isn't true.Puffing on a water pipe full of flavored tobacco may sound more glamorous than smoking a regular cigarette, but it's probably just as bad for your lungs, if not even more harmful, a Washington, DC researcher warns. According to a recent World Health Organization (WHO) advisory, a typical one-hour session of hookah smoking exposes the user to 100 to 200 times the volume of smoke inhaled from a single cigarette. Even after passing through the water, the tobacco smoke produced still contains high levels of toxic compounds, including carbon monoxide, heavy metals and cancer-causing chemicals (carcinogens). Hookah smoking also delivers significant levels of nicotine — the very addictive substance in tobacco.

Dr. Christopher Loffredo, director of the Cancer Genetics and Epidemiology Program at Georgetown University Medical Center, has been studying tobacco use in Egypt since 1997. In the past five years, he told Reuters Health, he's seen an increase in the use of hookahs among young people in both the Middle East and the United States.

Loffredo said he had originally thought hookah smoking was a trend limited to big cities like New York, but colleagues at a tobacco conference this July told him hookah use is also on the rise in small college towns in Colorado, Texas, Delaware and the Midwest.

Loffredo has published several studies on hookah use, including a report on how young Egyptian women are picking up the habit, which they see as more socially acceptable and healthier than cigarette smoking. He also found that genetic damage in the mouth tissue of hookah smokers was identical to that seen among cigarette smokers.

Nobody really knows what the risks of hookah smoking are compared to cigarettes, Loffredo noted, but clearly exposure to tobacco in a typical hookah session is substantial.

"The concern is that the session of smoking is very long. There's a social dimension to it. You're sitting with friends, typically," he explained. Sessions can last for up to three hours. "That's a lot of tobacco exposure in that time period."

"We're worried that hookah smokers could become addicted and could either turn to cigarettes or daily use of hookah devices for tobacco," Loffredo added.

Another concern, he noted, is that hookah use may represent a loophole around city and state laws banning smoking in public places.

Much is known about the harmful substances contained in cigarettes, Loffredo said, but there has been virtually no research on the content of tobaccos used in water pipes. "That kind of basic research really needs to be done so we have a better sense of what these health risks might be," he concluded.

"Hookah / narghile / shisha / goza smoking Versus Cigarettes smoking "   User Opinions

MD :   I agree that smoking is bad no matter how you do it, I don't want to give a bias opinion. I smoke shisha almost everyday. Ever since I have started I have stopped smoking cigarettes. Many claim that smoking shisha is equivalent to about 50 cigarettes, that is hardly the case. For starters it contains 0!! tar, one of the most harmful chemicals in cigarettes. .5% nicotine which is extremely low. Also many people are usually sharing the shisha at the same time therefore it is not like you are the only one sitting there smoking it for an hour. There is more smoke but that is a result from the fruits and molasses burning which creates heavy smoke. It is harmful but not as bad as smoking a cigarette. Smoke shisha for an hour and then smoke cigarettes for an hour tell me how you feel after each. Also with cigarettes I find that a person can smoke whenever it's not like with a shisha where need some time and a place to set it up. People find themselves smoking in their cars on the way to wo...

Anon :   Yes, there are few if any studies done specifically on hookah smoking. the fact still remains though that you're smoking tobacco. Hookah is the only thing I enjoy smoking and I do it maybe once or twice every 2 months. The damage is still done, it only does not feel that way because you're not getting super heated air in your throat/lungs (which , when smoking cigarettes, is what can cause it to "feel" like its damaging you). The carcinogens, including lead are still there. In one hookah session, a person probably gets much larger doses due to being able to hold in the air longer and taking fuller breaths. I have been informed that the lead in hookah smoke, partly due to trace amounts in the coal, can be up to 100x more than a cigarettes. This I have not confirmed, but a regular smoker told me it and even if its not true, it says something that a user would admit it. Is hookah smoking bad for you? Indefinitely yes. Is it as bad as cigarettes? Probably, w/o direc...

Walldo :   ive been smoking shisha for a while, I have a nice 4 hose hookah. one alternative to smoking tobacco shish is herbal shisha, they have not found any health issues with smoking herbal shisha. Typical tobacco shish has 0.5% nicotine and 0% tar. the only reason i still smoke tobacco shisha is because i dont have anyplace that i can get to easily to obtain herbal shisha. i find herbal shisha to not only generate more smoke and thicker smoke as well as taste better but just in general is a more enjoyable experience. i am currently trying to find as much information as i can about this topic. so if i find more i will definitely post here for you guys.

M.M. :   i smoked hookah for the first time last weekend. i thought it was quite the social experience; honestly, i felt like i wasnt any damage to my lungs. i have always been dead set against smoking, as my mother is an addicted cigarette smoker, but i didnt feel like i was indulging in something that was harmful to me. so now im not sure if i made the right decision, or if i will even smoke a hookah again. i would appreciate any research done on this subject...

Smoke Til Ya Choke :   I started smoking shisha and i enjoy it, i have not yet read any news articles that provided solid evidence to the health risks of msoking shisha is comparison to smoking a cigrette. If you find anything, then please share...

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