Hooked on Hookah? It’s Worse than Smokes, Says Iran

hookah pipe smoking woman
A 45 minute shisha session is the equivalent of puffing 100 cigarettes.

In a new study, Iranian researchers proved tobacco water pipes are as harmful as cigarettes, saying, “Our findings reveal profound effects of water pipe smoking on lung function, similar to the effects observed in deep inhalation cigarette smokers.” A student at Amman’s American Community School beat them to that conclusion by a solid six months.  The website he created as part of an 8th grade project presaged findings just published by Mashhad University scientists in the journal Respiralogy. The Iranian study, the first of its kind in the Middle East, also suggests that most females don’t cop to smoking shisha (or any other form of tobacco). Come on now, ladies, in the name of science, let’s be truthful.

Water pipes (also called hookah, shisha, nargila) are wrongly considered as a healthier way to enjoy tobacco. Old hippie legend suggests that forcing smoke through water filters out toxins.  Instead, studies show that tobacco’s contaminants have more sticking power when mixed with humidity.

The Israel Cancer Association (ICA) confirms that water pipe smoke contains tar, arsenic, chromium, lead, and nicotine. Pipes produce high levels of carbon monoxide which raises risk of throat and lung cancers and respiratory and cardiovascular diseases.

According to the Harvard Mental Health Letter, a 45 minute shisha session is the equivalent of puffing 100 cigarettes.

Unlike a quick cigarette drag, smoking a water pipe is a lengthy and languorous process.  Humidified smoke eases  throat dryness, encouraging longer shisha sessions. And it’s a social smoke: most light up with friends at special shisha lounges or smoke-friendly cafes.

Packages of nargila tobacco typically feature images of lush fruits.  Sweet smelling additives mislead users into thinking the habit is healthful.  A hard-hitting hookah pal says, “How could something that smells like sweet apples be bad for me?”  I’m guessing Snow White’s apple mishap doesn’t get much play in the Middle East.

The social aspect of shisha fuels the habit. Because pipes are frequently shared, users risk  herpes and mononucleosis.

A Dubai national survey, entitled Chronic Respiratory Symptoms in Adults, pegs 30% of Dubaians between 22 and 44 as regular shisha smokers. But these tobacco-heads have clouded thinking, they don’t see themselves as smokers.

Dr. Bassam Mahboub, of Dubai’s Rashid Hospital, coauthored the report in conjunction with a research team led by Dr Sulaiman Al Hammadi, of Al Ain’s UAE University.  Mahboub told Gulf News, “Most shisha smokers do not screen themselves as smokers, but anyone who smokes shisha three or more times a week is a smoker by definition.”

Back in Israel, an ICA survey says 22% of Israeli children have smoked water pipes, many introduced to shisha by their parents or other adults who see no problem with a bit of familial smoking.  (Am I a bad mother for not lighting up with the kids?)

The Knesset Finance Committee recently raised taxes on nargila tobacco to bring its costs up to cigarette prices.  Cost of a kilo of nargila tobacco was raised from $13 t0 $30. Prices will raise next year to $47, to $58 in 2014, and to $71 in 2015.

Pricing may deter most from taking up the habit, but once hooked on hookah, change is hard.  I suspect a recycling of a classic cigarette commercial running on 1960’s American TV,  “Shisha smokers would rather fight, than switch.”

Image of woman shisha user from Shutterstock

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4 thoughts on “Hooked on Hookah? It’s Worse than Smokes, Says Iran”

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  2. Emilio Nehme says:

    Not to forget the second hand smoke that people(old,young and children) could be exposed to when sitting in a Hooka smokers place environment. I saw examples of people who smokes Hooka and their children or babies are next. This is the worst. Hope there will be some control measures taken and the penalties would be applied.

  3. laurie says:


    So the Israeli Cancer Association, scientists at Mashhad University, the kid in the Jordan school and I all conspired to disparage the healthy habit of sheesha smoking?

    Yup, you’re spot on regarding the smoke – equivalent to 100 cigs. The method of delivery is what seems to make it “worse” than a cigarette, all the residual ills of pipe-sharing and humidified smoke and particulants.

    Peek at this link from the US Center for Disease Control:

    Happy to write about the upside of smoking water pipes – my research on that angle sadly comes up empty.

    Thanks for the comment!

  4. Jason says:

    As I see this is another one-sided, un-researched article about shisha smoking.
    To start off with- shisha tobacco contains 0% tar, FACT, and on average 0.05% nicotine, FACT!

    And when they say that its like smoking 100 cigarettes- yes maybe the quantity of smoke, not how harmful it is. In comparison thats like saying drinking a litre of water is like drinking a litre of vodka!
    Granted Im not saying that its not bad for you but it is no-where near as bad for you as cigarettes. A shisha smoker may smoke once a day if not a week. How many times does a cigarette smoker smoke?

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