{"product_id":"hookah-waterpipe-smoking-not-a-safe-alternative-to-cigarettes-what-patients-need-to-know","title":"Hookah (Waterpipe) Smoking: Not a Safe Alternative to Cigarettes — What Patients Need to Know","description":"\u003cp\u003eHookah (waterpipe) smoking is not a safe alternative to cigarettes. Despite many users believing it is less harmful, research shows that waterpipe smoke contains cancer-causing chemicals, delivers significant nicotine, and harms lung function just as much as cigarette smoke. In fact, a single hookah session can expose smokers to as much smoke as 100 or more cigarettes. This patient-friendly article translates the key findings from the American Cancer Society Cancer Action Network (ACS CAN) fact sheet, explaining the health risks, who uses hookah, and what policies are recommended to protect public health.\u003c\/p\u003e\n\n\u003ch1\u003eHookah (Waterpipe) Smoking: Not a Safe Alternative to Cigarettes — What Patients Need to Know\u003c\/h1\u003e\n\n\u003ch2\u003eTable of Contents\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003e\u003ca href=\"#ddn-key-points\"\u003eKey Points\u003c\/a\u003e\u003c\/li\u003e\n\n  \u003cli\u003e\u003ca href=\"#what-is-hookah\"\u003eWhat Is Hookah?\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#who-uses-hookah\"\u003eWho Uses Hookah?\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#study-methods\"\u003eHow This Information Was Compiled\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#health-effects\"\u003eHealth Effects of Hookah Smoke: Key Findings\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#secondhand-smoke\"\u003eSecondhand Hookah Smoke: A Hidden Danger\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#public-health-implications\"\u003ePublic Health Implications and Policy Recommendations\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#limitations\"\u003eStudy Limitations\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#recommendations\"\u003eRecommendations for Patients\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#ddn-faq\"\u003eFrequently Asked Questions\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#source\"\u003eSource Information\u003c\/a\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003c!-- ddn:keypoints:start --\u003e\n\u003ch2 id=\"ddn-key-points\"\u003eKey Points\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003eHookah smoke contains cancer-causing chemicals, delivers significant nicotine, and harms lung function just as much as cigarette smoke.\u003c\/li\u003e\n\u003cli\u003eA single hookah session lasting 20 to 80 minutes can expose a smoker to as much smoke as 100 or more cigarettes.\u003c\/li\u003e\n\u003cli\u003eA meta-analysis of four studies found hookah use equivalent to smoking 2 to 10 cigarettes per day, enough to cause addiction.\u003c\/li\u003e\n\u003cli\u003eSecondhand hookah smoke is at least as harmful as secondhand cigarette smoke; one study found a one-hour session generates toxicants equal to 2 to 10 cigarette smokers.\u003c\/li\u003e\n\u003cli\u003eHookah bars should not be exempt from smoke-free laws, and hookah tobacco should be taxed, age-restricted, and regulated like other tobacco products.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c!-- ddn:keypoints:end --\u003e\n\n\n\u003ch2 id=\"what-is-hookah\"\u003eWhat Is Hookah?\u003c\/h2\u003e\n\n\u003cp\u003eHookah smoking, also known as waterpipe smoking, is a method of smoking tobacco that has been practiced for centuries in the Far and Middle East. The process involves burning tobacco, passing the smoke through a water-filled bowl, and then inhaling it through a long hose.\u003c\/p\u003e\n\n\u003cp\u003eWaterpipes go by many different names around the world. You may hear them called:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003e\u003cstrong\u003eHookah\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eShisha\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eBoory\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eGoza\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eNarghile\u003c\/strong\u003e or \u003cstrong\u003enargile\u003c\/strong\u003e\n\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eArghile\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eHubble bubble\u003c\/strong\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eToday, the most common type of tobacco smoked in a waterpipe is called \u003cstrong\u003eshisha\u003c\/strong\u003e or \u003cstrong\u003eMaassel\u003c\/strong\u003e. This tobacco is sweetened and flavored with options like apple, mint, cherry, or even cappuccino.\u003c\/p\u003e\n\n\u003cp\u003eMany people assume that because the smoke passes through water, it must be cleaner or safer. This is simply not true. The water does not filter out the harmful chemicals in tobacco smoke.\u003c\/p\u003e\n\n\u003ch2 id=\"who-uses-hookah\"\u003eWho Uses Hookah?\u003c\/h2\u003e\n\n\u003cp\u003eWaterpipes are most commonly used in China, India, Pakistan, and the Eastern Mediterranean Region. However, over the years leading up to this report, hookah has been gaining popularity in the United States, particularly among college students and young adults. Several studies cited in the original fact sheet document this growing trend among young people.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eHookah smoking is a social activity.\u003c\/strong\u003e It typically takes place in groups, and hookah bars have been opening with increasing frequency across the U.S., especially in college towns and urban areas. The American Lung Association estimated that there were approximately \u003cstrong\u003e200 to 300 hookah bars in the U.S. in 2006\u003c\/strong\u003e, and that number has likely increased since then.\u003c\/p\u003e\n\n\u003cp\u003eThe visibility of hookah bars has a direct impact on young people. In one study, \u003cstrong\u003emore than one in five high school students (20.9%)\u003c\/strong\u003e first learned about hookah simply by seeing a hookah bar in their community.\u003c\/p\u003e\n\n\u003cp\u003eHookah use is far from rare among teens. Among high school seniors, \u003cstrong\u003e17% reported having smoked hookah in the past year\u003c\/strong\u003e, according to the Monitoring the Future survey.\u003c\/p\u003e\n\n\u003cp\u003eAnother important pattern: many hookah smokers have also tried cigarettes or other tobacco products, and many currently use them. This suggests that hookah is often not a replacement for cigarettes but rather an addition to a person's overall tobacco use.\u003c\/p\u003e\n\n\u003ch2 id=\"study-methods\"\u003eHow This Information Was Compiled\u003c\/h2\u003e\n\n\u003cp\u003eThe original article is a policy fact sheet published in March 2012 by the American Cancer Society Cancer Action Network (ACS CAN). Rather than being a single new study, it is an evidence-based review that compiles findings from dozens of peer-reviewed scientific studies on hookah smoking.\u003c\/p\u003e\n\n\u003cp\u003eResearchers and public health experts reviewed the existing scientific literature on waterpipe use, including:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003eStudies of hookah prevalence among college students and high school students\u003c\/li\u003e\n  \u003cli\u003eLaboratory analyses of the toxic chemicals in waterpipe smoke\u003c\/li\u003e\n  \u003cli\u003eClinical studies measuring nicotine and carbon monoxide levels in hookah smokers\u003c\/li\u003e\n  \u003cli\u003eMeta-analyses comparing lung function in hookah smokers versus cigarette smokers\u003c\/li\u003e\n  \u003cli\u003ePublic health surveys and surveillance data from national and state agencies\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThis type of review is important because it gathers evidence from many different research groups and combines it into a single, reliable picture of the health risks. When multiple independent studies point in the same direction, the conclusions are much stronger than any single study alone.\u003c\/p\u003e\n\n\u003ch2 id=\"health-effects\"\u003eHealth Effects of Hookah Smoke: Key Findings\u003c\/h2\u003e\n\n\u003cp\u003eThe most important message of the entire report is this: \u003cstrong\u003eSmoking waterpipes, as well as breathing secondhand smoke from waterpipes, is at least as harmful as exposure to cigarette smoke.\u003c\/strong\u003e Despite what many hookah smokers believe — and several studies cited in the fact sheet confirm that many users think hookah is less harmful or less addictive than cigarettes — the scientific evidence clearly shows otherwise.\u003c\/p\u003e\n\n\u003ch3\u003eCancer-Causing Chemicals in Hookah Smoke\u003c\/h3\u003e\n\n\u003cp\u003eWaterpipe smoke, like cigarette smoke, contains significant amounts of cancer-causing ingredients. These include:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003e\u003cstrong\u003eArsenic\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eCobalt\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eChromium\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eLead\u003c\/strong\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThese heavy metals and carcinogens are inhaled directly into the lungs. Additionally, hookah smoke contains \u003cstrong\u003ecarbon monoxide (CO)\u003c\/strong\u003e in amounts equal to or greater than the levels found in cigarette smoke. Carbon monoxide is a poisonous gas that interferes with the blood's ability to carry oxygen, putting stress on the heart and other organs.\u003c\/p\u003e\n\n\u003cp\u003eThere is also a unique danger specific to hookah. Unlike cigarettes, hookahs use \u003cstrong\u003echarcoal or wood cinders\u003c\/strong\u003e as the heat source to burn the tobacco. The combustion products from these heat sources add even more cancer-causing and heart-disease-causing agents to the smoke.\u003c\/p\u003e\n\n\u003ch3\u003eLung Function Damage\u003c\/h3\u003e\n\n\u003cp\u003eA systematic review and meta-analysis of existing research found that waterpipe smoking has \u003cstrong\u003ethe same negative effect on lung function as cigarette smoking\u003c\/strong\u003e. This means damage to the airways and lung tissue that is typical of cigarette use also occurs in hookah smokers.\u003c\/p\u003e\n\n\u003ch3\u003eNicotine and Addiction\u003c\/h3\u003e\n\n\u003cp\u003eMany people believe hookah is less addictive than cigarettes. The evidence says otherwise. Waterpipe smokers are exposed to sufficient doses of nicotine to lead to \u003cstrong\u003eaddiction\u003c\/strong\u003e.\u003c\/p\u003e\n\n\u003cp\u003eA meta-analysis of four studies that assessed biomarkers of nicotine and tobacco smoke exposure in hookah smokers found that using a waterpipe was equivalent to smoking \u003cstrong\u003e2 to 10 cigarettes per day\u003c\/strong\u003e. This is a significant amount of nicotine exposure — enough to create a real chemical dependence.\u003c\/p\u003e\n\n\u003cp\u003eFurther supporting this finding, research shows that waterpipe smoke produces \u003cstrong\u003esimilarly increased blood nicotine levels and increases in heart rate\u003c\/strong\u003e as cigarette use. The body's addictive response to hookah is comparable to what happens with cigarettes.\u003c\/p\u003e\n\n\u003ch3\u003eA Single Session Can Equal a Pack or More\u003c\/h3\u003e\n\n\u003cp\u003eOne of the most striking findings in the report is the sheer volume of smoke inhaled during a hookah session. A typical hookah smoking session lasts \u003cstrong\u003e20 to 80 minutes\u003c\/strong\u003e. During that time, a smoker may inhale as much smoke as that from \u003cstrong\u003e100 or more cigarettes\u003c\/strong\u003e.\u003c\/p\u003e\n\n\u003cp\u003eThis is because hookah smoking is not a quick, single inhalation like a cigarette. It involves repeated, deep draws over a long period of time, and the smoke is densely packed with toxins.\u003c\/p\u003e\n\n\u003ch3\u003eDisease Risks\u003c\/h3\u003e\n\n\u003cp\u003eThe cumulative effect of all these exposures adds up to serious health consequences. Waterpipe smoke is associated with an increased risk of:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eCancer\u003c\/strong\u003e (including lung and other cancers)\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eHeart disease\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eLung disease\u003c\/strong\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003cstrong\u003eAdverse effects during pregnancy\u003c\/strong\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eAdditionally, because hookah is typically smoked socially, people often share the mouthpiece. This sharing increases the user's risk for \u003cstrong\u003ecommunicable diseases\u003c\/strong\u003e, including infections that can be passed through saliva.\u003c\/p\u003e\n\n\u003ch2 id=\"secondhand-smoke\"\u003eSecondhand Hookah Smoke: A Hidden Danger\u003c\/h2\u003e\n\n\u003cp\u003eIt is not just the person smoking the hookah who is at risk. Breathing in secondhand smoke from waterpipes is at least as harmful as exposure to secondhand cigarette smoke.\u003c\/p\u003e\n\n\u003cp\u003eOne study found that during a typical one-hour hookah session, a waterpipe smoker likely generates ambient carcinogens and toxicants equivalent to that of \u003cstrong\u003e2 to 10 cigarette smokers\u003c\/strong\u003e. This means that other people in the room — friends, family members, employees at hookah bars, and other patrons — are breathing in a substantial amount of harmful chemicals, whether they are smoking themselves or not.\u003c\/p\u003e\n\n\u003cp\u003eThis finding is a critical reason why hookah bars should not be exempt from smoke-free laws. The health of everyone in the establishment is affected by the smoke in the air.\u003c\/p\u003e\n\n\u003ch2 id=\"public-health-implications\"\u003ePublic Health Implications and Policy Recommendations\u003c\/h2\u003e\n\n\u003cp\u003eBecause the evidence is so clear, the World Health Organization (WHO) issued an advisory on waterpipe tobacco smoking in 2005. This advisory addressed the health effects of hookah smoking and made several key recommendations related to regulating hookah in a manner similar to other tobacco products. \u003cstrong\u003eThat advisory remained in effect at the time of this report and remains the scientific consensus.\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cp\u003eThe American Cancer Society Cancer Action Network (ACS CAN) supports the regulation of all tobacco products and the passage of strong smoke-free laws to protect people from the harms of secondhand smoke from all tobacco products. Specifically, the report makes the following policy recommendations:\u003c\/p\u003e\n\n\u003col\u003e\n  \u003cli\u003e\n\u003cstrong\u003eHookah bars should not be exempt from smoke-free laws\u003c\/strong\u003e that prohibit smoking in public places, including workplaces, restaurants, and bars.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eHookah tobacco should be taxed at an equivalent rate to cigarettes\u003c\/strong\u003e and other tobacco products, using a price-based approach with a minimum tax.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eSales of hookah tobacco should be prohibited to minors\u003c\/strong\u003e under age 18.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eWaterpipe and hookah tobacco retailers and hookah bars should be subject to the same licensing requirements\u003c\/strong\u003e as retailers of other tobacco products in their jurisdiction.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eThe Food and Drug Administration (FDA) should assert its authority to regulate hookah tobacco\u003c\/strong\u003e under the 2009 federal Family Smoking Prevention and Tobacco Control Act.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eFlavored hookah tobacco should be prohibited.\u003c\/strong\u003e Flavors like apple, mint, cherry, and cappuccino make the tobacco appealing, particularly to young people, masking the harsh taste of tobacco smoke.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eQuestions about hookah use should be included on national and state-based surveys\u003c\/strong\u003e, particularly those targeting youth and young adults, to obtain information about the prevalence and patterns of hookah use that can be used to improve tobacco prevention and cessation efforts.\u003c\/li\u003e\n\u003c\/ol\u003e\n\n\u003cp\u003eThese policy recommendations reflect a straightforward public health principle: all forms of tobacco use are dangerous, and they should be regulated consistently. If a product is taxed, restricted by age, and subject to smoke-free laws when it is a cigarette, the same rules should apply when it is a hookah.\u003c\/p\u003e\n\n\u003ch2 id=\"limitations\"\u003eStudy Limitations\u003c\/h2\u003e\n\n\u003cp\u003eIt is important to understand what this type of report can and cannot tell us. The original fact sheet is a review of existing research rather than a single controlled clinical trial. This means it has some inherent limitations:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eNo new original data:\u003c\/strong\u003e The conclusions are drawn from previously published studies, which vary in their methods, sample sizes, and quality.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eLimited long-term outcome data:\u003c\/strong\u003e Because hookah use has only recently become widespread in the U.S., long-term studies tracking hookah smokers over decades are not yet available. The disease risks are inferred from biomarker studies, lung function tests, and comparisons to cigarette smoking.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003ePopulation differences:\u003c\/strong\u003e Studies included in the review were conducted in different countries and among different age groups, which may limit how directly the findings apply to every population.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eSelf-reported data:\u003c\/strong\u003e Some studies relied on survey responses, and participants may not always accurately report their smoking habits.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eEvolving landscape:\u003c\/strong\u003e The number of hookah bars and patterns of use have continued to change since 2012, meaning some statistics (such as the 200–300 hookah bars estimate) may be conservative compared to today's numbers.\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThese limitations do not undermine the core message. The evidence that hookah smoke is harmful is consistent across many different types of studies, and the direction of the findings is clear. However, as with all scientific evidence, ongoing research will continue to refine our understanding.\u003c\/p\u003e\n\n\u003ch2 id=\"recommendations\"\u003eRecommendations for Patients\u003c\/h2\u003e\n\n\u003cp\u003eIf you are a patient or a parent of a teenager, this information has direct, practical relevance. Here is what you should know and what you can do:\u003c\/p\u003e\n\n\u003col\u003e\n  \u003cli\u003e\n\u003cstrong\u003eDo not assume hookah is a safe alternative to cigarettes.\u003c\/strong\u003e It is every bit as harmful — and in some ways, it is worse, because a single session delivers such a large volume of smoke.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eIf you currently smoke hookah, you can become addicted.\u003c\/strong\u003e Hookah delivers nicotine at levels equivalent to 2–10 cigarettes per day. Addiction to nicotine is not limited to cigarette smoking.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eTalk to your children and teenagers about hookah.\u003c\/strong\u003e Nearly 1 in 5 high school seniors reported smoking hookah in the past year, and flavored tobacco products are specifically designed to appeal to young people. Do not let the sweet flavors fool you — these are tobacco products with serious health risks.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eAvoid secondhand hookah smoke.\u003c\/strong\u003e If you are in a hookah bar or at a gathering where hookahs are being used, you are breathing in harmful carcinogens. The same advice that applies to secondhand cigarette smoke applies here: if you can smell it, you are inhaling it.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eIf you are pregnant or planning to become pregnant, avoid hookah completely.\u003c\/strong\u003e The report specifically identifies adverse pregnancy outcomes as a risk of waterpipe smoke exposure.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eDo not share hookah mouthpieces.\u003c\/strong\u003e Sharing increases the risk of communicable diseases transmitted through saliva.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eIf you are trying to quit tobacco, discuss hookah with your healthcare provider.\u003c\/strong\u003e Nicotine replacement therapy and other cessation supports can help with nicotine addiction, regardless of the form of tobacco you use.\u003c\/li\u003e\n\u003c\/ol\u003e\n\n\u003cp\u003eThe bottom line is simple: \u003cstrong\u003eHookah is tobacco. Tobacco is harmful. There is no safe way to smoke it.\u003c\/strong\u003e Understanding the science behind this conclusion is the first step toward making healthier choices for yourself and your family.\u003c\/p\u003e\n\n\u003c!-- ddn:faq:start --\u003e\n\u003ch2 id=\"ddn-faq\"\u003eFrequently Asked Questions\u003c\/h2\u003e\n\u003ch3\u003eIs hookah smoking safer than smoking cigarettes?\u003c\/h3\u003e\n\u003cp\u003eNo. Hookah smoke contains cancer-causing chemicals, delivers significant nicotine, and harms lung function just as much as cigarette smoke. A single hookah session can expose you to as much smoke as 100 or more cigarettes. The water does not filter out harmful chemicals, so hookah is not a safe alternative to cigarettes.\u003c\/p\u003e\n\u003ch3\u003eHow much nicotine do you get from one hookah session?\u003c\/h3\u003e\n\u003cp\u003eA meta-analysis of four studies found that using a waterpipe was equivalent to smoking 2 to 10 cigarettes per day. Waterpipe smokers are exposed to sufficient doses of nicotine to lead to addiction, and hookah produces similarly increased blood nicotine levels and heart rate increases as cigarette use.\u003c\/p\u003e\n\u003ch3\u003eCan you get addicted to hookah?\u003c\/h3\u003e\n\u003cp\u003eYes. Waterpipe smokers are exposed to sufficient doses of nicotine to lead to addiction. A meta-analysis of four studies found that hookah use was equivalent to smoking 2 to 10 cigarettes per day. The body's addictive response to hookah is comparable to what happens with cigarettes, so addiction is not limited to cigarette smoking.\u003c\/p\u003e\n\u003ch3\u003eWhat are the health risks of hookah smoking?\u003c\/h3\u003e\n\u003cp\u003eWaterpipe smoke is associated with an increased risk of cancer (including lung and other cancers), heart disease, lung disease, and adverse effects during pregnancy. It contains cancer-causing chemicals such as arsenic, cobalt, chromium, and lead, plus carbon monoxide. Sharing mouthpieces also increases the risk of communicable diseases transmitted through saliva.\u003c\/p\u003e\n\u003ch3\u003eIs secondhand hookah smoke dangerous?\u003c\/h3\u003e\n\u003cp\u003eYes. Breathing in secondhand smoke from waterpipes is at least as harmful as exposure to secondhand cigarette smoke. One study found that during a typical one-hour hookah session, a waterpipe smoker likely generates ambient carcinogens and toxicants equivalent to that of 2 to 10 cigarette smokers, affecting everyone in the room.\u003c\/p\u003e\n\u003ch3\u003eHow common is hookah use among teenagers?\u003c\/h3\u003e\n\u003cp\u003eAmong high school seniors, 17% reported having smoked hookah in the past year, according to the Monitoring the Future survey. In one study, more than one in five high school students (20.9%) first learned about hookah simply by seeing a hookah bar in their community. Many hookah smokers also use cigarettes or other tobacco products.\u003c\/p\u003e\n\u003ch3\u003eWhat should I do if I smoke hookah or want to quit?\u003c\/h3\u003e\n\u003cp\u003eDo not assume hookah is a safe alternative to cigarettes. If you currently smoke hookah, you can become addicted. If you are trying to quit tobacco, discuss hookah with your healthcare provider. Nicotine replacement therapy and other cessation supports can help with nicotine addiction, regardless of the form of tobacco you use.\u003c\/p\u003e\n\u003ch3\u003eI smoke hookah and think it's safer than cigarettes — when should I get a second opinion about my health risks?\u003c\/h3\u003e\n\u003cp\u003eHookah smoke contains cancer-causing chemicals including arsenic, cobalt, chromium and lead, and delivers nicotine equivalent to 2 to 10 cigarettes daily. A single 20-to-80-minute session can equal 100 or more cigarettes, and lung function damage matches cigarette smoking. If you have symptoms, a new diagnosis, or a treatment plan based on the belief that hookah is harmless, an independent review of your records, imaging and pathology can help confirm whether that assumption is affecting your care. Diagnostic Detectives Network provides independent expert second opinions.\u003c\/p\u003e\n\u003c!-- ddn:faq:end --\u003e\n\n\u003ch2 id=\"source\"\u003eSource Information\u003c\/h2\u003e\n\n\u003cp\u003eThis patient-friendly article is based on the following peer-reviewed and public health source:\u003c\/p\u003e\n\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eOriginal title:\u003c\/strong\u003e \"Not a safe alternative to cigarettes\" (Waterpipes\/Hookahs fact sheet)\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003ePublisher:\u003c\/strong\u003e American Cancer Society Cancer Action Network (ACS CAN)\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003ePublication date:\u003c\/strong\u003e March 2012\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eType:\u003c\/strong\u003e Evidence-based policy fact sheet reviewing peer-reviewed scientific literature\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eKey studies referenced in the original fact sheet include: Fielder, Carey, \u0026amp; Carey (2012) on hookah prevalence among college women; Sutfin et al. (2011) on waterpipe use in North Carolina college students; the American Lung Association (2007) estimate of 200–300 U.S. hookah bars; Smith et al. (2011) on high school students; Johnston et al. (2010) Monitoring the Future national survey data; Maziak et al. (2004) in \u003cem\u003eTobacco Control\u003c\/em\u003e; Fromme et al. (2009) on indoor air contamination; Jacob et al. (2011) on nicotine and carbon monoxide exposure; Eissenberg \u0026amp; Shihadeh (2009) comparing toxicant exposure; Raad et al. (2011) meta-analysis on lung function; Neergaard et al. (2007) meta-analysis on nicotine exposure; Daher et al. (2010) on carcinogen emissions; and the World Health Organization (2005) Advisory Note on waterpipe tobacco smoking.\u003c\/p\u003e\n\n\u003cp\u003eThis patient-friendly article was created to translate the original scientific content into plain language for a general audience. All numerical data, statistics, and conclusions have been preserved from the original source. This content is provided for educational purposes and is not a substitute for professional medical advice.\u003c\/p\u003e","brand":"DiagnosticDetectives.Com","offers":[{"title":"Default Title","offer_id":47709984817308,"sku":null,"price":0.0,"currency_code":"USD","in_stock":true}],"url":"https:\/\/diagnosticdetectives.com\/ar\/products\/hookah-waterpipe-smoking-not-a-safe-alternative-to-cigarettes-what-patients-need-to-know","provider":"DiagnosticDetectives.Com","version":"1.0","type":"link"}