Hookah Smoking Metes Out Toxic Substances

A new study shows that the tobacco and fruit mixture smoked in public hookah bars contains more carbon monoxide (CO) and benzene than does smoking half a pack of cigarettes daily.

Researchers at San Francisco General Hospital Medical Center (CA, USA; sfghed.ucsf.edu/) and the University of California, San Francisco (UCSF; USA) conducted a crossover study to assess daily nicotine and carcinogen exposure with water pipe and cigarette smoking in 13 people who were experienced in using both products. The participants smoked only a hookah for four days and then, after a week with no restrictions, only cigarettes. The volunteers averaged three water pipe sessions or 11 cigarettes per day, and underwent daily blood, urine, and breathing tests.

The results showed that water pipe use was associated with a significantly lower intake of nicotine, greater exposure to carbon monoxide (CO), and a different pattern of carcinogen exposure compared with cigarette smoking, which included a greater exposure to benzene and high molecular weight polycyclic aromatic hydrocarbon (PAH), but less exposure to tobacco-specific nitrosamines, 1,3-butadiene, acrolein, acrylonitrile, propylene oxide, ethylene oxide, and low molecular weight PAHs. The study was published in the May 2013 issue of Cancer Epidemiology, Biomarkers & Prevention.

“A different pattern of carcinogen exposure might result in a different cancer risk profile between cigarette and water pipe smoking. Of particular concern is the risk of leukemia related to high levels of benzene exposure with water pipe use,” concluded lead author research chemist Peyton Jacob III, PhD.

Hookah smoking has been practiced for hundreds of years in India, the Middle East, and North Africa, but it is newer in parts of Europe and North America. The substances heated in a hookah vary; for the study, the researchers used pastes chosen by the participants that were 5%–10% tobacco combined with honey, molasses, and bits of fruit. This paste goes in the bowl of the pipe, which is covered with a perforated piece of aluminum foil and topped with a burning piece of charcoal; the smoker then inhales through the pipe, which filters the smoke through water placed in the base bottle.

Related Links:
San Francisco General Hospital Medical Center
University of California, San Francisco