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Hookah Can be More Dangerous than Cigarettes, Study Reveals

Update Date: Apr 23, 2013 09:09 AM EDT

An increasing number of people are casting cigarettes aside and turning to hookah, but researchers are warning people that the Middle Eastern water pipe shouldn't been viewed as a safer alternative to cigarettes.

A new study conducted at the University of California San Francisco reveals that just because the toxins in shisha smoke are different from toxins in cigarette smoke, it doesn't make smoking hookah any less harmful than smoking cigarettes.

"Water-pipe smoking at 'hookah bars' has become popular with young people in the United States, and some believe that it is less harmful than cigarette smoking," research chemist Peyton Jacob said in a news release.

"We report for the first time that toxicant exposures from water-pipe and cigarette smoking differed in pattern, with higher exposure to some toxicants like carbon monoxide and benzene in water-pipe smokers," he said.

Researcher compared the levels of exposure to various tobacco toxicants by conducting a randomized study of 13 healthy volunteers.  Researchers explained that because different individuals excrete different amounts of toxic chemicals even if they inhale the same amounts, they conducted a "cross-over" study, where the same person smoked cigarettes and a water pipe on different days.

Participants either smoked cigarettes or a water pipe exclusively during the day for four days.  After a week or more, each individual was switched to the other product for the next four days.

Researchers said that on average, participants smoked three water-pipe sessions or 11 cigarettes per day.  Researcher then measured levels of toxins in the blood, breath and urine during and at the end of each type of smoking session.

The results were astounding. While hookah smoking resulted in about half the amount of total nicotine compared to cigarette smoking, hookah smoking exposed participants to significantly higher levels of carbon monoxide, which is especially dangerous for people with heart risks, and benzene, which has been higher leukemia risk, compared to cigarette smoking.

Researchers found that the total amount of carbon monoxide in the breath measured during a 24-hour period was more than 2.5 times higher than while smoking cigarettes.  Carbon monoxide exposure increases a person's risk for acute events such as a heart attack, stroke or sudden death in people who have cardiovascular or lung diseases.

After analyzing urine samples, researchers found that the amount of a metabolite of benzene in the urine of hookah smokers was twice the amount of levels detected in cigarette smokers. 

Researchers found that other toxins participants inhaled when smoking hookah include acrylamide, (linked to nervous system damage), acrolein (which can irritate the eyes, throat and nose) and naphthalene (which can damage red blood cells).

"People want to know if it is a lesser health risk if they switch from cigarettes to smoking a water pipe on a daily basis," said Jacob. "We found that water-pipe smoking is not a safe alternative to cigarette smoking, nor is it likely to be an effective harm reduction strategy."

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