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Smoking Shisha vs. Cigarettes, or Getting Hooked on Hookah

Hookah Smokers Beware

© Roberta Kyle 2012, all rights reserved

According to a new study, one in three American college students has tried smoking shisha or hookah(the two terms are interchangeable) and hookah lounges are sprouting as quickly as dandelions on a suburban lawn in college towns and big cities across the country.

Hookah is hot and its popularity is growing,particularly among the 18-24 demographic. According to an even newer study,published online by the Psychology of Addictive Behaviors,, one in four non smoking female college freshman will try hookah for the first time at school this year.

The problem is that, no matter how you slice it, tobacco is toxic and nicotine is highly addictive. It looks like hookah is well on the way to becoming the gateway to cigarette smoking/nicotine addiction for college age and college bound young people-- something that few neophyte hookah smokers know about or give any thought to. Though the research is just beginning, it is very clear that unlike what many hookah smokers thing, hookah is definitely NOT a safe alternative to cigarette smoking/

Diagram of a hookah or water pipe

Diagram of a hookah or water pipe

What Is Hookah?

Hookah (aka Shisha) refers to both the water pipe itself and to the activity of smoking flavored tobacco through it. It is a social experience which tends to take place in a hookah bar or lounge where customers can talk watch TV,read or play chess while they smoke. People do occasionally throw hookah parties in their own homes, but mostly, they indulge at a hookah bar or lounge in a session that lasts from 30 to 60 minutes.

Special, flavored tobacco, is heated over charcoal and then water cooled while being inhaled by the user through a water pipe. The hookah itself sits in the center of the table and smokers pass the mouthpiece to one another, which is part of the social aspect of the experience.

There is a whole etiquette which has evolved in hookah lounges around shisha/hookah as a social experience. Hookah originated centuries ago in Persia or India, and has become an integral part of the culture of the region. In Western Europe and North America, it is a relatively recent phenomenon but has been wholeheartedly embraced by a younger generation for whom cigarettes are no longer cool. This generation is creating its own etiquette. Hookah is not immoral or illegal and there is no problem with it if one is of age and making an informed choice. I need to stress that particularly for North Americans with Middle Eastern roots, hookah lounges are a cultural rite of passage and an extension of a time honored cultural tradition. That said, there are dangers to which young people and their parents should pay attention and there are serious health consequences to be mindful of..

A Generational Divide

Kids as young as fifteen and sixteen are trying hookah, convinced that perfumed tobacco filtered through water is less dangerous than tobacco inhaled directly into the lungs via cigarettes.In America, hookah lounges are doing a land office business with the high school and college crowd while flying just under the legal radar. You can't buy a pack of cigarettes if you are sixteen, but you probably won't get carded in a hookah bar as long as somebody over 18 actually places the order and pays the bill. Someone will happily pass the pipe to you.

Ask any fourteen year old about hookah and they know all about it, even if they haven't tried it. Ask any forty year old and you will get a puzzled look. In America shisha is the preserve of the young. This is a new hip thing-- not your parents pack of Camels. It is also international and cross cultural just like the Millennial Generation itself. Mom and Dad may have invaded My Space and Facebook, but they are unlikely to show up at the hookah lounge.

The problem is that nicotine, no matter how delivered, is highly addictive and has a powerful effect on the human brain. It has also been shown that the younger one is when one starts smoking, the the more permanent changes take place in the brain and the harder it is to stop later on down the road. It is also true that after a few sessions in a hookah bar, a teenages may start craving nicotine and start bumming cigarettes, only to become hooked on them as well. In other words, for young people, hookah can be a gateway to cigarettes and a lifetime of consequences from nicotine addiction.

What You Should Know

I just have to say it again: Smoking tobacco through a water pipe is just as bad or worse for your health than puffing away on a cigarette. Do not think that just because the tobacco is burned in a bowl and filtered through water that it is safe. Do not suppose, either, that the nicotine in that tobacco has been in any way diluted or made less addictive by being flavored, burned over charcoal and passed through water before entering your body. Some pretty impressive authorities say that it isn't so.

While scientific studies are really only beginning to be done, it is looking like smoking hookah may, in some cases, be even worse for you than smoking cigarettes. There is little question that nicotine is powerfully addicting and that one can get hooked on it through hookah, cigarettes, cigars or even the gum and lozenges that are meant to help you stop smoking. Here are a few of the things some of the experts have to say.

According to the Mayo Clinic

  • Hookah smokers are exposed to even more carbon monoxide than cigarette smokers
  • Hookah smoke contains the same high levels of toxic compounds, tar, heavy metals and carcinogens as cigarette smoke.
  • Hookah smokers may actually inhale more tobacco smoke than cigarette smokers do because of the large volume of smoke they inhale in one smoking session, which can last as long as 60 minutes.

According to a study published in August 2012 in the journal Respirology smoking hookah and cigarettes are equally damaging in terms of breathing and lung function.

  • a comparison of deep inhalation cigarette smokers and hookah smokers showed similar effects on lung function and respiratory symptoms (chest tightness, coughing, and wheezing).

The CDC(Centers for Disease Control) fact sheet has a section on hookah which compares hookah to cigarettes. It states:

  • A typical 1-hour-long hookah smoking session involves inhaling 100–200 times the volume of smoke inhaled from a single cigarette.
  • Due to the mode of smoking—including frequency of puffing, depth of inhalation, and length of the smoking session—hookah smokers may absorb higher concentrations of the toxins found in cigarette smoke
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The CDC goes on to state that hookah smokers are at risk for the same cancers and respiratory diseases as cigarette smokers and ends by concluding that Hookah smoking is NOT a safe alternative to smoking cigarettes.

The Bottom Line

Listen up if you are someone who frequents hookah lounges or is thinking of doing so. Pay attention also if you are the parent of a young teen. Hookah, Shisha, whatever you call it, is a nicotine delivery system that has all the risks associated with smoking cigarettes and then some.

There is lots of information around about this. I've included a section of some of the more informative links to hookah articles online and a simple search will turn up many more. If you are college bound or have a child who is, check out as much information as you can. Going to a hookah lounge may seem like a fun and slightly exotic social thing to do, and it may be just that, but if you get into the habit, you could be making a decision that will cast a very long shadow.

Author's Message

If you enjoyed this article, I hope you will want to check out my other hubs on quitting smoking. If you are a smoker or ex smoker, or just a person with an opinion or a story of your own on this topic, please feel free to share in the comments section at the end of this article.

My aim is not to preach or pass judgement. I feel strongly that smoking is a choice, not a moral issue. But for those who are smoking because they have to, not because they want to, or who are just starting to experiment with tobacco, I offer the facts and a warning, as well as my own personal experience for whatever all that is worth.

I was a heavy smoker for more than 30 years . It took me many tries and many years to quit, but I finally and have been smoke free for over a decade. I am not a doctor or scientist. I'm just someone who smoked fifty or sixty cigarettes a day for more than 30 years and who doesn't have to do that anymore. I've learned a lot about nicotine addiction and the process of quitting and I just want to pass it on to anyone who might find it useful.

Online Articles and Resources


Marwan Asmar from Amman, Jordan on June 20, 2016:

Nice hub. In Jordan nearly everyone is hooked on a hookah and inhale like its nobody's business. We too have cafes with hookahs and everyone is at it. The smoke can be at times intoxicating but no one seems to care despite the health warnings

Roberta Kyle (author) from Central New Jersey on January 15, 2013:

Ohmygosh-- I just noticed two comments that I overlooked and have not responded to-- so sorry and I'm responding now.

KellyMediaBest-- the tobacco may not be filled with additives but it is full of the same carcinogens as cigarette smoke More importantly, all tobacco is full of nicotine, which is the addictive substance in all tobacco and a killer for sure. You are sadly mis-informed.

Hi Sherri-- I too had no idea until recently how popular hookah was with the younger crowd-- sort of not your grandfather's Marlboro syndrome-- but they need to know it is just as dangerous if not more so. I think that hookah lounges get through the same loophole that cigar lounges do but you raise an interesting point and thanks for the link

Roberta Kyle (author) from Central New Jersey on December 23, 2012:

Thanks wrenfrost56 and I'm glad you found the hub interesting.

Right you are Vinaya-- if anything shisha is more harmful because of how deeply it is inhaled. Filtering the tobacco through water and flavoring it with spices does nothing to take away the addictive and carcinogenic quality of tobacco smoke.

Vinaya Ghimire from Nepal on December 22, 2012:

Many people think tobacco used in shisha is not as harmful as in cigarette. However, this is wrong interpretation. Thanks for your comprehensive article.

wrenfrost56 from U.K. on October 30, 2012:

Shocking but as ever packed full of information and well wriiten. Thank-you for drawing my attention to this issue. :)

Sherri from Southeastern Pennsylvania on October 25, 2012:

Being one of those persons over 40, I hadn't given shisha much thought even though I knew about it, although only from Paraglider's hub. Until now, with your hub, I didn't realize how popular it's become among younger folks in this country.

I'm left with a curiosity about the legality of shisha here in the US. You can't smoke a cigarette in a restaurant or bar, in most establishments in the US these days, so how are shisha lounges legal or regulated? Are they a matter of private clubs, or maybe special licensing. In wondering about these things, I found a Wiki entry that lists smoking bans by state in the US.

Hookah bars may be exempt, as cigar bars may be, in some states. I had no idea the whole thing was so complicated!

Super hub, as always, Robie. This one's even more special, because it points to important addiction and cultural issues that haven't begun to be dealt with. Up and all that jazz.

KellyMediaBest from Tampa, Florida on October 24, 2012:

Cool post. Its true that the water in a hookah pipe does not filter the tobacco, but tobacco used in shisha is completely different than what's packing into a cigarette. The shisha tobacco is not filled with all of the rat poison and formaldehyde that is in cigarettes. The dangers that come with smoking hookah are bad because of the amount of smoke taken in, and the duration of the "sessions". Because it is a social act, people sit around for an hour or so, and take in large amounts of smoke at a time. For the most part, the actual tobacco is just candied with flavor, not mixed with the 100 or so other chemicals that cigarette tobacco is laced with.

Roberta Kyle (author) from Central New Jersey on October 23, 2012:

Hi KJForce and thanks for commenting. I dunno--nobody was saying back in the day that a bong rendered the hash harmless or that marijuana smoked using a bong wouldn't get you high-- in fact some said it made you higher-- but you are right, smoke in the lungs is smoke in the lungs period and human nature doesn't change.

suzettenaples-- good to see you too. Yup, this whole hookah thing is totally a youth fad. People over forty just draw a blank while every teen you talk to knows about it and many have tried it. They not only love " owning" hookah, they want to believe that it is much different from smoking cigarettes-- a very dangerous assumption IMHO

Suzette Walker from Taos, NM on October 22, 2012:

Very interesting and informative article. I had not heard about this prior to reading this hub. Why o why do young people keep looking for addictive things? Smoking is smoking - I can't believe young, intelligent people can't see this as harmful. Thank you for bringing this to our attention!

kjforce from Florida on October 22, 2012:

robie2..Looking back, what is the difference ? in the 70's the " bong " ( h20 pipe) was popular , hash/mj was smoked....smoke in the lungs is smoke in the is not normal..and the toxins from some of these fads are more dangerous, as we already have issues in the tissues !

So basically we have swapped one bad thing for another bad thing..but this will never change with human society....great hub subject, thanks for the awareness...very helpful !!!

Roberta Kyle (author) from Central New Jersey on October 21, 2012:

I had no idea myself that it was such a trend -- when I started reading up on it and questioning some younger people, I was amazed to find that they had many misconceptions about hookah-- thinking that it was safer than cigarettes. It's not, as I found out when I dug around a little further. Somebody needs to spread the word because it is soooooo easy to get hooked on nicotine and sooooo hard to get unhooked. Thanks for stopping by and commenting-- always good to see you Billybuc

Bill Holland from Olympia, WA on October 21, 2012:

I am so out of it, Roberta! I didn't have a clue what this was...I had heard the term but didn't know what it meant. Thanks for the clarification and it is great information for sure.

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