‘Hookah doesn’t spare smokers from inhaling cancer-causing compounds’

NEW YORK – People may think hookah is a safe alternative to cigarettes, but a new study shows hookah users are still exposed to cancer-causing compounds.

Laboratory tests have suggested risks from hookah, also known as water pipes. But the new study published in Cancer Epidemiology, Biomarkers and Prevention is the first to link real-life hookah use to exposure to nicotine and other harmful chemicals, researchers said.

“One of the main reasons for doing this study is water pipe smoking is becoming much more popular — especially among younger people and college students,” said Gideon St Helen, the study’s lead author from the University of California, San Francisco.

Water pipes consist of a long tube attached to a glass or plastic container that holds water. The tobacco, which is flavoured with fruits and sugar syrup, is burned using charcoal. The smoke passes through the water before being inhaled. 

Users often believe that the water filters out the toxins in the smoke, but Thomas Eissenberg, who was not involved with the new research, said that’s not the case.

“What the water does do is not filter the smoke, but cools the smoke so it’s very easy to inhale,” said Eissenberg, of Virginia Commonwealth University in Richmond, who has studied water pipe smoking.

Hookah is often used in a group and a session usually lasts about an hour, according to past research. 

For the new study, the researchers recruited 55 people from the San Francisco area who almost exclusively smoked hookah. They were asked to abstain from smoking any nicotine products during the week before going to a hookah bar for the study.

The participants provided three urine samples: one before smoking hookah, one immediately after and another the next morning.

After analysing participants’ urine samples, the researchers found that nicotine levels increased 73-fold following the hookah session.

They also found significant increases in other compounds that have been tied to increased risks of heart and respiratory diseases, and to lung and pancreatic cancer. 

“It’s always been a question by water pipe users — blogs and online reviewers — whether the results we get from the lab generalise to a real-life setting,” Eissenberg told Reuters Health. “This puts that to rest.”

It’s difficult to translate the findings into risks for a given hookah smoker, St Helen said. But he did say users are “increasing (their) risk of cancer and other tobacco-related diseases”.

“If you’re not smoking cigarettes because you’re worried about tobacco-caused diseases, you should also not be smoking water pipes,” Eissenberg said.