Is Hookah Good For You?

It’s gaining popularity, but it may not be as healthy an alternative as you think.

Is Hookah Good For You?

It’s pretty sneaky. In the same way Phillip Morris marketed cigarettes, equating smoking their brand with the rugged Wild West individualism of the Marlboro Man, (the cigs became the world’s best-selling), it looks like the popularity of the Star Wars franchise has—maybe through the law of unintended consequences—helped make hookah smoking the new cool for youngsters and young adults.

At the time of the first Star Wars film in 1977, hookah smoking was limited to some enduring hippies and a few Middle Eastern aficionados. But then along came Jabba the Hutt with his always-by-his-side hookah and the spark was lit.

In 2005 when Hasbro put out a Star Wars action figure for the bounty hunter Dannik, the pipe-smoking alien in the ’97 film, they added a hookah on his belt. Obi-Wan Kenobi, the old Jedi Master himself, also sat around a hookah with friends to discuss all things Jedi. By the beginning of 2008, hookahs had made appearances in over 20 different Star Wars movies, short stories, novels, comic books and video games. Over the course of the 10 Star Wars movies, hookahs have played an ever-increasing role. Little wonder that from 2008 to 2014 the number of high school kids who had ever smoked a hookah went from almost 9 percent to 13 percent; middle-schoolers jumped from under 3 percent to 5 percent; and estimates of hookah use among college students range from 9.5 percent to 20.4 percent.

Today, hookah (narghile, shisha, water-pipe) smoking is a global tobacco epidemic causing worldwide degradation of lung function. Consider these facts:

  • Even though cigarette use is declining, partially due to smoke-free workplace laws, consumer awareness and higher taxes, hookah bars that rent water pipes and sell flavored tobacco mixtures are gaining in popularity and remain largely unregulated.  
  • Many hookah users believe the practice is less harmful than cigarettes, yet according to the American Lung Association, a single daily water-pipe use is the same as smoking 10 cigarettes. Hookah smoking sessions lasting 45 to 60 minutes are equal to smoking between 40 and 400 cigarettes.
  • A new study in the journal Tobacco Control points out that while smoking one cigarette involves around 10 puffs—each delivering about 50 milliliters of smoke—one 45- to 60-minute hookah session may add up to 100 inhalations, and each one delivers about 500 milliliters of smoke.
  • Besides triggering body-wide inflammation, hookah use is associated with the spread of infections such as herpes and HPV from several smokers using a single mouthpiece.

The American Lung Association believes—as do we—that hookah smoking is a growing public health threat and efforts should be made to restrict its use, especially among teens and young adults: “Hookah smoking…may lead to a resurgence in tobacco use among vulnerable populations. Both the American Lung Association and the World Health Organization recommend that laws or regulations prohibiting cigarette or other tobacco use in public places apply to hookah smoking.”

Medically reviewed in July 2019.

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