Given the well-known health risks, Josh, a 22-year-old University of California-San Diego student would never consider puffing away on a cigarette. But that doesn’t mean he doesn’t indulge in tobacco smoking. Like a growing number of young people around the country, Josh gets his buzz from a water pipe, commonly called a hookah.
A hookah, sometimes called a shisha, is a tall water pipe used to smoke flavored tobacco through a hose and mouthpiece. It's a method that’s been used for centuries in the Middle East.
In the last decade, water pipes have gained global acceptance and its use among teens and young adults is on the rise in the United States, Canada, Southeast Asia and Europe, even as cigarette smoking is decreasing among this age group, numerous studies show.
The American Lung Association (ALA) is one of many health organizations that considers the popularity of hookah use a “growing public threat,” especially among urban youth and college students with easy access to hookah bars, cafes and restaurants.
Researchers and public health advocates believe hookah use is skyrocketing for a number of reasons. For starters, the recent proliferation of water pipe establishments creates an acceptable social environment for groups to smoke together.
Water pipe tobacco is also less expensive than cigarettes because it is largely unregulated. Local laws governing hookah use vary dramatically, so in some places it’s widely available to teens too young to purchase other tobacco products. And hookah tobacco may contain fruity flavorings and deliver a “smoother” smoke that appeals to teens and young adults.
But perhaps the most important reason water pipes have gained in popularity is that many young people wrongly believe that it is less harmful to their health than cigarette smoking, says Peyton Jacob III, Ph.D., a University of California, San Francisco (UCSF) research chemist at San Francisco General Hospital and Trauma Center.
Jacob, along with renowned UCSF tobacco researcher Dr. Neal Benowitz and other colleagues, recently published data showing hookah users are getting very high exposure to some pretty dangerous toxic substances.
“We found that water-pipe smoking is not a safe alternative to cigarette smoking, nor is it likely to be an effective harm reduction strategy,” Jacobs said in a press release.
Compared to non-smokers, daily hookah smokers are likely at increased risk for lung, bladder, stomach and oral cancers, Benowitz added.
The new study, published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, found hookah smoking resulted in a different pattern of toxic chemicals in users’ blood and urine that may result in a cancer risk profile that is different — but just a dangerous — from that of cigarette smoking.
Previous studies have linked hookah smoking to cancers, heart disease, infectious diseases and other serious illnesses.
Like their counterparts who smoke cigarettes, women who have regularly used water pipes during pregnancy have low birth weight babies who are also at greater risk of respiratory illnesses than babies born to nonusers, according to the U.S. Centers for Disease Control and Prevention.
The UCSF study is the first to report that water pipe and cigarette smoking differs in their toxicant exposure patterns, with water pipe smokers getting higher exposures to carbon monoxide and benzene but lower levels of nicotine.
In the small, randomized study of 13 healthy volunteers, eight men and five women, UCSF researchers detected twice the amount of metabolic benzene, a volatile organic compound known to cause leukemia in humans, and 250 percent more carbon dioxide in water pipe smokers.
However, study participants had half the amount of total nicotine — the addictive agent in tobacco products — in their blood during a 24-hour period compared with cigarette smokers.
Jacob said that while nicotine levels were measured at substantially lower levels, “it’s still enough to sustain addiction.”
The researchers acknowledge sharing water pipes in social settings compared to a controlled study environment may result in less toxic agent exposure, so they’re conducting more research to test this assumption.
Previous studies found exposure to secondhand smoke in social settings, such as a hookah bars, can pose serious risk to nonsmokers because it contains smoke from the tobacco and the charcoal used to heat the water pipe.
Lynette Summerill is an award-winning writer and Scuba enthusiast who lives in San Diego with her husband and two beach loving dogs. In addition to writing about cancer-related issues for EmpowHER, her work has been seen in publications internationally.
Sources:
Hookah Smoking: A growing threat to public health. American Lung Association. Policy statement.
Online: http://www.lung.org/stop-smoking/tobacco-control-advocacy/reports-resources/cessation-economic-benefits/reports/hookah-policy-brief.pdf
Hookah. CDC Fact Sheet. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs
Hookah Gaining Popularity Among College Students. Tracy Pederson, Psyche Central. 13 Oct. 2012.
http://psychcentral.com/news/2012/10/13/hookah-gaining-popularity-among-college-students/46042.html
Reducing Hookah Use: A Public Health Challenge for the 21st Century. White Paper, The Bacchus Network/Tobacco Free U.
http://www.tobaccofreeu.org/pdf/HookahWhitePaper.pdf
Bidi and Hookah Use Among Canadian Youth: Findings from the 2010 Canadian Youth Smoking Survey. Czoli CD, Leatherdale ST, Rynard V. Prev Chronic Dis 2013;10:120290. DOI:
http://dx.doi.org/10.5888/pcd10.120290
“Comparison of Nicotine and Carcinogen Exposure with Water Pipe and Cigarette Smoking.” Peyton Jacob III, Ahmad H. Abu Raddaha, Delia Dempsey, Christopher Havel, Margaret Peng, Lisa Yu, and Neal L. Benowitz.
Cancer Epidemiol Biomarkers PrevPublished OnlineFirst March 5, 2013; doi:10.1158/1055-9965.EPI-12-1422 April 15, 2013
http://cebp.aacrjournals.org/content/early/2013/04/09/1055-9965.EPI-12-1422.abstract
“Water-pipe Smoking May Not Be a Safe Alternative to Cigarette Smoking.” Jeremy Moore. American Association for Cancer Research. April 19, 2013.
http://www.aacr.org/home/public--media/aacr-in-the-news.aspx?d=3105
Reviewed May 24, 2013
by Michele Blacksberg RN
Edited by Jody Smith