Hookah smoking is as harmful as cigarette smoking, delivering nicotine and toxic substances through a water pipe. The CDC highlights that hookah sessions involve significantly higher smoke volumes, with a typical session producing around 90,000 milliliters of smoke compared to 500-600 milliliters from a cigarette. Users face similar health risks, including various cancers and respiratory diseases. The discussion also emphasizes the dangers of indoor air pollution from solid fuel use, which contributes to millions of premature deaths annually.
PREREQUISITESPublic health professionals, tobacco control advocates, individuals concerned about smoking-related health risks, and anyone interested in the impacts of indoor air pollution.
Compared with Cigarettes
While many hookah smokers may consider this practice less harmful than smoking cigarettes, hookah smoking carries many of the same health risks as cigarettes.1,2
Water pipe smoking delivers the addictive drug nicotine and is at least as toxic as cigarette smoke,2 and some users of hookah report being dependent on hookah and having difficulty quitting.4
The tobacco in hookahs is combusted (exposed to high heat).1
Due to the mode of smoking—including frequency of puffing, depth of inhalation, and length of the smoking session—hookah smokers may absorb higher concentrations of the toxins found in cigarette smoke.1,2
A typical 1-hour-long hookah smoking session involves 200 puffs, while an average cigarette is 20 puffs. The volume of smoke inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500–600 ml inhaled when smoking a cigarette.4
Hookah smokers are at risk for the same kinds of diseases caused by cigarette smoking. These include oral cancer, lung cancer, stomach cancer, cancer of the esophagus, reduced lung function, and decreased fertility.3,4
Key facts
Around 3 billion people cook and heat their homes using open fires and leaky stoves burning biomass (wood, animal dung and crop waste) and coal.
Nearly 2 million people die prematurely from illness attributable to indoor air pollution from household solid fuel use.
Nearly 50% of pneumonia deaths among children under five are due to particulate matter inhaled from indoor air pollution.
More than 1 million people a year die from chronic obstructive respiratory disease (COPD) that develop due to exposure to such indoor air pollution.
Both women and men exposed to heavy indoor smoke are 2-3 times more likely to develop COPD.
Indoor air pollution and household energy: the forgotten 3 billion
Around 3 billion people still cook and heat their homes using solid fuels in open fires and leaky stoves. About 2.7 billion burn biomass (wood, animal dung, crop waste) and a further 0.4 billion use coal. Most are poor, and live in developing countries.
Such cooking and heating produces high levels of indoor air pollution with a range of health-damaging pollutants, including small soot particles that penetrate deep into the lungs. In poorly ventilated dwellings, indoor smoke can be 100 times higher than acceptable levels for small particles. Exposure is particularly high among women and young children, who spend the most time near the domestic hearth.
Impacts on health
Nearly 2 million people a year die prematurely from illness attributable to indoor air pollution due to solid fuel use (2004 data). Among these deaths, 44% are due to pneumonia, 54% from chronic obstructive pulmonary disease (COPD), and 2% from lung cancer.