Experts say hookah smoking more dangerous than cigarettes

By Lizzie Johnson

DALLAS – Clouds of sickly sweet blackberry smoke are billowing out of Isaac Doss’ mouth. He takes a long draw from the bubbling hookah and passes the pipe to Kara Brick.

They are sprawled on cushioned wicker chairs on the patio at Kush Hookah Lounge on Greenville Avenue in Dallas. The two are celebrating the return of Kara’s sister, Savannah Brick, from an au pair job in Europe.

“This is kind of cheating,” Kara Brick, 28, says. “We are all ex-smokers. With cigarettes, you really have to push through smoking it the first time. Hookah is actually enjoyable. This has a social feel and is something we can do together.”

Hookah bars are a relaxed gathering place for customers to socialize as they smoke tobacco through water pipes. It’s a hot trend among young adults. Nearly one in five U.S. students smoked hookah in the last year, according to a study published in the journal Pediatrics.

But hookah, which comes with few warning labels or health notices, can be more dangerous than smoking cigarettes. A study funded by the National Institutes of Health notes that a single hookah session delivers 1.7 times as much nicotine, 6.5 times as much carbon monoxide and 46.4 times as much tar as a single cigarette.

“There is no reason to believe that a water pipe is less dangerous than a cigarette,” says Dr. Thomas Eissenberg, a Virginia Commonwealth University professor who has conducted numerous studies on water pipe smoking.

Doss, 25, smoked hookah regularly at the University of the Ozarks in Clarksville, Ark., without realizing the health risks.

“I was 18 the first time I smoked,” he says. “I smoked every weekend. I never considered how bad it would be for me. Now I smoke occasionally enough that it really can’t affect me. It’s something I consider before I go to the hookah bar.”

Eissenberg says many young people do not realize they are inhaling tobacco, charcoal smoke and other carcinogens with each breath.

“The problem is, if you go into a water pipe bar and look at the pipe you are being served, there is nothing on that pipe or on the tobacco or in that charcoal that tells you it’s dangerous,” Eissenberg says.

With hookah, smoke passes from a head containing flavored tobacco and charcoal, through a water bowl and into a hose for inhalation.

Hookah smoke is known to contain higher levels of lead, nickel and arsenic than cigarettes, research in the Journal of Cancer Epidemiology, Biomarkers & Prevention shows.

This is because smoking a hookah requires taking harder and longer drags, increasing the levels of inhaled carcinogens and nicotine in the lungs.

“When they take a puff, the smoke is very cool and the draw resistance is very low, so it is easy to inhale and it tastes good,” Eissenberg says. “They take dramatically larger puffs, about 500 milliliters per puff. We are talking about an entire cigarette’s worth of smoke in a single puff.”

A 45- to 60-minute hookah session can expose the smoker to about the same amount of nicotine and tar as one pack of cigarettes, Eissenberg says.

“If you aren’t a cigarette smoker because you know cigarettes are dangerous and lethal, then there is absolutely no reason to be smoking a water pipe and every reason to avoid it for the same reason,” he says.

Dr. Mark Millard, a medical director at Baylor Martha Foster Lung Care Center, has practiced medicine in the Middle East, an area where water pipe smoking has been prevalent for more than 400 years. On one trip, he treated a woman from Saudi Arabia with a hacking cough.

“She was smoking every night for an hour,” he says. “That is quite a lot of inhalants. I told her to get rid of her hubbly bubbly. (Nicotine) makes people want to come back for more. People can get addicted to hookahs, and it does affect your health.”

Five years ago, Farhad Ata opened Kush Hookah Lounge.

Ata has smoked hookah his entire life. He says he likes the nicotine buzz and the chill environment. He knows smoking is not healthy, but he has accepted the risks. It’s something he says he hopes clients are aware of, too.

“I don’t really sit down and talk with them about the health risks,” Ata says. “I think some people are already schooled, and they just accept it. Other people don’t care.”

Eissenberg says: Know the risks.

“As a package deal, it’s a dangerous thing to do,” he says. “Educate yourself. Then make the decision.”