Used for centuries, hookah originated in ancient Persia and India. It is typically practiced in groups, with a tube passed from person to person. It is known by many different names, including narghile, argileh, shisha, hubble-bubble, and goza. But don’t be confused by the exotic names: hookah smoking is not safe. It carries many of the same health dangers as smoking cigarettes.

• Hookah smoking is most common among university students 
• In 2010, nearly one in five 12th grade students had used a hookah in the past year 
• Youth and the community should recognize hookah use as a dangerous practice and not a safe alternative to cigarette smoking.    

• Hookah smoke is as toxic as smoke from cigarettes and contains addictive nicotine 
• Hookah smokers may absorb higher concentrations of the same toxins found in cigarette smoke 
• Using a hookah is equivalent to, and can be worse than, smoking cigarettes  
  • An hour-long hookah session includes 200 puffs, while an average cigarette is 20 puffs 
  • The volume of smoke inhaled during a typical hookah session is 150 times the smoke inhaled  by a person smoking a cigarette  
  • Even after passing through water, hookah smoke contains high levels of carbon monoxide, heavy metals, and cancer causing chemicals

• Hookah smoking has the same negative health effects as cigarette smoking, including:  
  • Cancer (oral, lung, stomach, and esophageal) 
  • Reduced lung function 
  • Decreased fertility 
  • Women giving birth to babies with low-birth weight 
  • Secondhand smoke is hazardous to non-smokers  

      Additionally, hookah smoking may transmit infectious diseases (such as herpes, tuberculosis, influenza and hepatitis) when sharing hookah mouthpieces  

“Smoking a hookah should be considered a ‘gateway drug’ – hookahs are a gateway to cancer, chemotherapy, and radiation treatments. There is NO safe level of hookah use.” 

-- Stephen A. Haering, MD, MPH, FACPM, Former Health Director 

“Selling sweet-flavored tobacco to naïve high school and college kids in a cool dispenser (a hookah) is really just selling kids candy-flavored poison in attractive packaging. I find those selling hookah products just as morally reprehensible as those selling hard drugs to our kids. Both are dealers in death and disease.” 

-- Bob Custard, REHS, Former Environmental Health Manager

• Centers for Disease Control and Prevention (CDC) Hookah website 
• American Lung Association’s Hookah Smoking fact sheet.