Smoking a hookah is smoking tobacco.
What is a Hookah and Shisha?
• A hookah is a water pipe used to smoke tobacco through cooled water. The tobacco is
heated in the bowl at the top of the hookah and the smoke is filtered through the water in the
base of the hookah.
• Alternate names for hookahs include: water pipe, goza, hubble-bubble, borry, arhile, and
narghile.
• Shisha is the tobacco smoked in a hookah. It is a very moist and sticky tobacco that has
been soaked in honey or molasses.
• There are a variety of shisha flavors including apple, plum, coconut, mango, mint, and
strawberry.
History of Hookahs?
• The hookah tradition, dating back at least 500 years, originated in the Middle East regions of
the world. Countries cited for the first use include Egypt, India, and Turkey.1
• Smoking the hookah is one of the oldest, most popular Turkish traditions.
• The tradition has traveled to the United States and today there are more than 300 hookah
establishments in the U.S.2
Myths and the Truths
MYTH #1: Hookah smoke is filtered through water so it filters out any harmful ingredients.
TRUTH #1: Smoking tobacco through water does not filter out cancer-causing chemicals.
Water-filtered smoke can damage the lungs and heart as much as cigarette smoke.3
MYTH #2: Inhaling hookah smoke does not burn the lungs, so it is not unhealthy.
TRUTH #2: The hookah smoke does not burn the lungs when inhaled because is cooled
through the water in the base of the hookah. Even though the smoke is cooled, it still contains
carcinogens and it is still unhealthy.1
MYTH #3: Smoking hookahs are healthier than smoking cigarettes.
TRUTH #3: Hookah smoke is just as dangerous as cigarette smoke. Hookahs generate smoke
in different ways: cigarette smoke is generated by burning tobacco, while hookah smoke is
produced by heating tobacco in a bowl using charcoal. The end product is the same—smoke,
containing carcinogens.4
MYTH #4: Smoking a hookah is not as addictive as smoking a cigarette because there is no
nicotine.
TRUTH #4: Just like regular tobacco, shisha contains nicotine. In fact, in a 60-minute hookah
session, smokers are exposed to 100 to 200 times the volume of smoke inhaled from a single
cigarette.5
MYTH #5: Herbal shisha is healthier than regular shisha.
TRUTH #5: Just like smoking herbal or “natural” cigarettes, herbal shisha exposes the smoker
to tar and carcinogens.
MYTH #5: Shisha tobacco contains fruit, so is healthier than regular tobacco.
Top Facts: Hookahs
TRUTH #5: Tobacco is tobacco, no matter how you look at it. Shisha is often soaked in
molasses or honey and mixed with fruit, but it still contains cancer-causing chemicals and
nicotine. Stick to traditional methods of getting fruit—eat an orange.
Quick Facts
• Compared to a single cigarette, hookah smoke is known to contain:
• Higher levels of arsenic, lead, and nickel1
• 36 times more tar6
• 15 times more carbon monoxide4
• Smoking a hookah requires taking longer and harder drags, increasing levels of inhaled
nicotine and carcinogens in the lungs.
• The longer the hookah session, the more nicotine and toxins one takes in.
• A 45 to 60 minute hookah session exposes the smoker to approximately the same amount
of tar and nicotine as one pack of cigarettes. 3
• Sharing mouthpieces without washing them can increase the risk of spreading colds, flu,
and infections—even oral herpes.7
• Health risks of smoking hookahs include cancer, heart disease, lung damage, and dental
disease.5
• Do not think that if you are just visiting a hookah bar, that you are in the clear. There are still
high levels of damaging secondhand smoke to all who are present.
1 Hookahcompany.com. (2006). Retrieved December 6, 2006 from
http://www.hookahcompany.com/hookah_history.htm
2 Mel Hovell, PhD., M.P.H. Smokefree Families & RWJ. (October, 2006). What we know about
interventions to reduce children’s exposure to environmental tobacco. Retrieved December 6, 2006 from
http://www.helppregnantsmokersquit.org/news/capstone2006/Hovell.ppt.
3 Asotra, Kamlesh, Hooked on hookah? Research for a healthier tomorrow. (July 2006). Tobacco-Related
Disease Research Program. Retrieved August 30, 2006 from
http://www.helppregnantsmokersquit.org/news/capstone2006/Hovell.ppt.
4 Knishkowy, Barry; Amitai, Yona. Water-pipe (Narghile) smoking: An emerging health risk behavior.
Pediatrics. (July 2005). Retrieved September 1, 2006 from
http://pediatrics.aapublication.org/cgi/content/full/116/1/e113
5 Mayo Clinic staff. Hookah smoking: Is it safer than smoking cigarettes? (February 7, 2006). Retrieved
September 5, 2006 from http://www.mayoclinic.com/health.com.health.hookah.AN01265
6 Hookah. Wikipedia. Retrieved August 31, 2006 from http://en.wikipedia.or/wiki/hookah#tobacco
7 Levin, Tamar. Collegians smoking hookahs…filled with tobacco. The New York Times. (April 19, 2006).
Retrieved September 5, 2006 from
