With Supreme Court's recent verdict to permit sale and use of hookah and tobacco-containing products in licensed premises, it's obvious that hookah bars in India would flourish in the coming years, providing bigger platforms for youth, crazy about hookahs, to continue smoking legally. It's clear that as hookah bars are on the rise, increasing awareness about health hazards of smoking hookahs need to be given more attention. Allowing hookahs in specialised premises doesn't take away the fact that smoking hookahs can be as dangerous as smoking cigarettes.
According to the Centers for Disease Control and prevention (CDC), a one hour long hookah session comprises 200 puffs compared to 30 puffs in a cigarette. Naturally, the volume of smoke inhaled in a hookah session is much higher than the volume of smoke inhaled with a cigarette. A single session of waterpipe hookah produces smoke equivalent to that of 50 cigarettes. So, all health risks associated with cigarette smoking will evidently boost with hookah smoking. Here's why hookah smoking is not a better alternative to cigarettes.
Increases the risk of cancer: Based on the assumption that water filters the smoke and reduces exposure to toxic substances, many people perceive hookahs as less harmful compared to cigarette smoke that can cause cancer. However, hookahs too can cause cancer.
Hookah uses charcoal to heat tobacco, giving rise to fumes containing high levels of carbon monoxide, Carcinogenic Polyaromatic Hydrocarbons (PAH), and other cancer-causing toxic substances. Studies have found that hookah smokers have higher levels of the protein Carcinoembryonic Antigen (CEA) in their blood, which is linked to tumour formation [3]. Hookah smoke can increase the risk of cancer of the mouth, lungs, stomach and esophagus, with carcinoma of the pancreas and lungs at the forefront [1].
Reduces oxygen level in the blood: One of the major smoke toxicants present in hookah smoke is Carbon Monoxide (CO). CO lowers the blood s ability to carry oxygen throughout the body, giving rise to a host of health issues ranging from anemia to stroke.
Increases risk of lung problems: From common throat irritation, chest congestion to cough and wheezing, those who smoke hookahs heavily are at a greater risk of suffering from all kinds of respiratory and lung problems due to high levels of carbon monoxide inhaled. Hookah smoke contains a high level of fine particulate matter that settles in the lungs, increasing the risk of cardio-respiratory hazards. Studies have also linked hookah smoking to higher risk of diseases like tuberculosis and chronic bronchitis [2].
Can cause heart diseases: Toxic substances from hookah smoke can settle down in the arteries and block them to cause heart diseases. Heavy smoking of hookah is also linked to an increased level of triglycerides, which is a major risk factor for development of coronary heart disease. It can also cause variations in heart rate, giving rise to arrythmia [1].
Increases risk of spread of infections: The hookah waterpipes used in hookah bars are reused by consumers. Naturally, if the instrument is not cleaned properly, it can serve as a medium for easy, rapid spread of infections.
Increases health risks in infants: Smoking hookah is no longer a trend followed by men, women too, are fond of it. The dangers of hookah smoking in women are much greater, with the risk extending to the next generation. There is evidence suggesting that women smoking hookahs daily carry a risk of delivering low birth-weight babies compared to non-smokers. Further, infants born to such women have a greater risk of suffering from respiratory problems [2].
Increases health hazards in passive smokers: Hookah parlours are always filled with smoke so dense that after a point it becomes difficult to see the person sitting across. This increases hazards due to indoor pollution, affecting the health of non-smokers. With the volume of smoke passive smokers are exposed to in a hookah bar, they're subject to similar or even greater risks as smokers.
Image source: Getty images
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References:
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Aslam HM, Saleem S, German S, Qureshi WA. Harmful effects of shisha: literature review. International Archives of Medicine 2014;7:16. doi:10.1186/1755-7682-7-16.
Chaouachi K. Hookah (Shisha, Narghile) Smoking and Environmental Tobacco Smoke (ETS). A Critical Review of the Relevant Literature and the Public Health Consequences. International Journal of Environmental Research and Public Health 2009;6(2):798-843. doi:10.3390/ijerph6020798.
Cobb C, Ward KD, Maziak W, Shihadeh AL, Eissenberg T. Waterpipe Tobacco Smoking: An Emerging Health Crisis in the United States. American journal of health behavior 2010;34(3):275-285.
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