Smoking hookah not safe alternative to cigarettes

Leslie Hanson
March 11, 2019

Hookah use is on the rise among teens and young adults in the US and the practice is commonly misperceived by youth as being both non-addictive and safer than smoking cigarettes, the American Heart Association (AHA) said in a scientific statement Friday.

There is growing evidence that hookah smoking affects heart rate and blood pressure, with chronic use linked to an increased risk of heart disease, the American Heart Association warned Friday.

Bhatnagar noted that hookah smoking is addictive and can lead to the use of other tobacco products such as cigarettes.

While several youths are aware of the risks associated with cigarette smoking and avoid it, there is a misperception among hookah users that this method of tobacco use is harmless.

The tobacco in hookah is flavoured with fruit, candy and alcohol flavours, making hookah the most popular flavoured tobacco product among the young audience.

The statement covers the design and operation of water pipes and how they're used by youths and adults; what is in hookah smoke that is or may be harmful; the cardiovascular risks; approaches to getting people to stop using hookahs; advice for healthcare professionals; and areas in need of further research.

This new statement, published online March 8, 2019, ahead of print in Circulation, aims to draw attention to the potential dangers of smoking from water pipes, particularly the short- and long-term effects on heart health, which are expected to be comparable to those seen with other forms of tobacco use. It has a water bowl containing tobacco, has a head with holes in the bottom, a body, a flexible hose with a mouthpiece, and burning charcoal that is placed on top of the tobacco bowl. Hookah tobacco is usually a combination of dried fruit, flavored tobacco and substances to keep the tobacco moist. Hookah users inhale huge smoke filled with large quantities of particulate matter at higher concentrations than cigarettes.

Hookah is also known as Narghile, Arghile, Shisha and Goza.

And smoking hookah increases the chances that a person will begin smoking cigarettes. Even short-term exposure to carbon monoxide in hookahs is toxic and can interfere with exercise capacity, according to the statement authors.

Hookah pipes deliver particulate matter with diameters ranging from 0.01 to 0.2 microns, with a median of 0.04 to 0.05 microns.

A single half-hour session of smoking tobacco in a hookah typically exposes the user to more carbon monoxide than a single cigarette.

Almost 5 percent of high school students and close to 14 percent of 18- to 24-year-olds in the United States use hookahs, recent surveys suggest.

And in the 2016 Monitoring the Future survey, 13% of 12th graders reported water pipe use over the previous year. Observational studies from Pakistan and India showed that "people who use hookah on a regular basis have higher levels of risk in terms of developing heart disease", Bhatnagar said. A study in the United Kingdom found that hookah use was more than twice as common as cigarette smoking. In the United States, recent surveys have estimated hookah usage that range from 4. In addition, those who use a hookah are more likely to start smoking cigarettes than those who have never smoked a hookah. Research is needed to effectively communicate the negative health impact of hookah smoking.

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