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

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What is a hookah?

A hookah is a water pipe used to smoke specially-made tobacco. The 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 actually 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 frequency of puffing, the depth of inhalation, and how long the hookah session lasts.

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 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.

Quick Guide25 Effects of Smoking on Your Looks and Life

25 Effects of Smoking on Your Looks and Life

Smoking Quiz: How to Quit Smoking

Which of these are not signs of cigarette addiction?

  1. Smoking even when you're sick in bed
  2. Smoking more than three cigarettes a day
  3. Smoking within 30 minutes after you wake up in the morning
  4. Having difficulty snuffing out that first cigarette of the day

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 advise on smoking cessation.

REFERENCES:

Centers for Disease Control and Prevention (CDC). "Dangers of Hookah Smoking." Updated: Nov 09, 2015.
<https://www.cdc.gov/features/hookahsmoking>

Centers for Disease Control and Prevention (CDC). "Hookahs." Updated: Dec 01, 2016.
<https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/>

Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion. "Hookahs. Updated: Dec 01, 2016.
<https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/>

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

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Reviewed on 5/24/2017
References
REFERENCES:

Centers for Disease Control and Prevention (CDC). "Dangers of Hookah Smoking." Updated: Nov 09, 2015.
<https://www.cdc.gov/features/hookahsmoking>

Centers for Disease Control and Prevention (CDC). "Hookahs." Updated: Dec 01, 2016.
<https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/>

Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion. "Hookahs. Updated: Dec 01, 2016.
<https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/>

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

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