Hookahs vs. Cigarette Smoking: Which One Is Safer and Less Addictive?

Medically Reviewed on 5/25/2022

What is a hookah?

While many believe hookah smoking to be safer than cigarette smoking, it is as dangerous to your health.

A hookah is a water pipe used to smoke specially-made tobacco. Tobacco usually comes in different flavors, such as mint, cola, cherry, lemon-lime, coffee, chocolate, coconut, apple, licorice, and other fruity blends.

Hookahs vary in size, shape, and style. The set-up of a typical hookah water pipe includes a bowl for the coal and tobacco, an ashtray to catch the ashes, a hose with a mouthpiece to draw the smoke into and allow it to cool, and a water bowl to cool and humidify the tobacco smoke.

Hookah smoking is often a social activity in hookah bars, particularly with young adults, with users passing the same mouthpiece around the group.

While many believe hookah smoking to be safer than cigarette smoking, it is just as dangerous to your health, if not more so.

Other names for hookah include shisha, narghi, bute, argileh, shisha, hubble-bubble, and goza.

How many cigarettes equal an hour of hookah smoking?

Hookah smoke that you inhale can contain 36 times more tar than cigarette smoke, 15 times the carbon monoxide, and 70% more nicotine than one cigarette.

Hookah smokers may absorb more toxins and cancer-causing chemicals than cigarette smokers. An hour of hookah tobacco smoking is equal to smoking 40 to 400 cigarettes, depending on the frequency of puffing, the depth of inhalation, and how long the hookah session lasts.


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Are hookahs safer than smoking cigarettes?

Many people who use hookahs believe hookah smoking is safer than smoking cigarettes, thinking that the tobacco smoke is filtered through the water making it cleaner. This is not true. Inhaled hookah smoke contains the same toxins as cigarette smoke such as tar, nicotine, carbon monoxide, heavy metals, and other cancer-causing chemicals.

Like cigarette smoking, smoking hookah has been associated with health effects and problems such as lung cancer, respiratory illness, low birth weight, and periodontal disease.

The World Health Organization (WHO) reports a hookah smoking session can expose smokers to more smoke over a longer period of time than cigarette smoking, exposing the users to possibly higher concentrations of the same toxins and carcinogens as cigarette smoke.

Are hookahs addictive like cigarettes?

Many people think that hookah smoking is safer than cigarette smoking. It's not. Both hookah and cigarettes contain nicotine from the tobacco, which is an addictive drug. Inhaling hookah smoke has the same addictive properties as inhaling cigarette smoke. Hookah is generally not used to get high.

Are hookah smoking and vaping the same thing?

A hookah is not the same thing as a vaping cigarette (e-cigarette, vape), which is a smaller, individual-use device that burns substances at high temperatures to make them into a vapor.

What are the health risks of hookah and cigarette smoking (including secondhand smoke)?

People who smoke hookahs and cigarette smokers are at risk for some of the same diseases and health problems, including:

If you feel you may be addicted to smoking hookahs or cigarettes, contact your doctor or other health care professional for advice on smoking cessation.

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Medically Reviewed on 5/25/2022
The RWU Health and Wellness Educators. "Hookah vs. Cigarettes Facts, Misconceptions and Risks." <http://rwu.edu/sites/default/files/hookahbrochure.pdf>.

United States. Centers for Disease Control and Prevention (CDC). "Dangers of Hookah Smoking." Nov. 9, 2015. <https://www.cdc.gov/features/hookahsmoking>.

United States. Centers for Disease Control and Prevention (CDC). "Hookahs." Dec. 1, 2016. <https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/>.

United States. Centers for Disease Control and Prevention (CDC). Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion. "Hookahs. Dec. 1, 2016. <https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/>.