Understanding the Risks of Hookah Smoking

Understanding the Risks of Hookah Smoking

Over the next three hotline blog posts, I will be writing on the overall health and oral implications of hookah smoking, e-cigarette smoking and marijuana so that our patients can consider the impacts theses habits have when planing their family dental care in Portland.

While cigarette smoking isn’t nearly as popular with teens in the United States as it was a decade ago, that doesn’t mean teens don’t smoke. A new study finds that a more exotic form of tobacco use, hookah smoking, is on the rise among U.S. teens.  In fact, 18 percent of high-school seniors surveyed said they had smoked a hookah in the past year.

Hookah smoking is performed with a multi-stemmed, often times glass based water pipe that consists of one or more long flexible stems connected to a base with containers for water and tobacco. Smoke is drawn from the sem and cooled through the water before being inhaled by the user. The pipe is designed to vaporize or smoke a flavored tobacco called shisha.

People often believe that smoking from a hookah removes the nicotine and other toxins from the tobacco. This is not true. The nicotine in hookah tobacco is addictive, and like cigarette smokers, people who smoke hookah are at risk for a variety of health problems.  Oral health complications, which have more of a bearing for patients scheduling family dental care in Portland, include oral cancer and gum disease.

Hookah Smoke and Oral Cancer

At our SW Portland dentist office, we know that many patients consider smoking from a hookah or pipe a safer option compared to cigarettes and cigars. Unfortunately, the purification process of cooling tobacco smoke through water only effects the taste, and does nothing to remove the harmful toxins and nicotine that makes smoking such a potent health risk.

In fact, smoking from a hookah can actually be even more dangerous than using cigarettes. By making the smoke less harsh to breath in, smoking from a hookah makes it easier to smoke more than you would normally. Smoking a hookah for 60 minutes is actually equal to smoking 40 to 400 cigarettes, according to Roger Williams University’s Health and Wellness Educators.

Here’s the actual truth about hookah smoking:

  • The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals. Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.
  • Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder, and oral cancers.
  • Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.
  • Like regular smokers, hookah smokers are at an increased risk of developing periodontal disease.

Other Health Effects of Hookah Smoke

Obviously, if you’re smoking 40 cigarettes – the equivalent of two packs – in an hour, you’re going to have a substantially higher risk for developing a range of chronic health problems.

  • Hookah tobacco and smoke contain several toxicities that can cause atherosclerosis and heart disease.
  • Viral and Bacterial Infections may be passed to other smokers by sharing a hookah.
  • Hookah smokers are at a risk for lung, stomach, esophageal cancer.  Also seen is a reduction in lung function and decreased fertility.

The Facts: Hookah Smoking Compared With Cigarette Smoking

Now that we’ve helped to dispel some of the common misconceptions about hookah smoking, let’s take a look at some of the facts related to the habit:

  • One hour of hookah use exposes smokers to 100-200 times the volume of smoke in a typical cigarette.
  • A bowl of hookah tobacco contains the amount of nicotine in approximately 100 cigarettes.
  • Compared to traditional cigarette smoke, hookah smoke has about 6 times more carbon monoxide and 46 times more tar.
  • Hookah smoke contains many of the same harmful chemicals in traditional cigarette smoke: carbon monoxide, tar, arsenic, chromium, cobalt, cadmium, nickel and lead.
  • The amount of smoke inhaled during a typical hookah session is about 90,000 ml, compared with 500–600 ml inhaled when smoking a cigarette.


Websites for Patient Education:





*Information collected from the Centers of Disease Control

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