Hooked on Hookah


  • A hookah is a water pipe that is believed to have originated in 16th century India and is also referred to as shisha, borry, goza, narghile, arhile, shui yan dai, or hubble-bubble.
  • More than 300 hookah bars, lounges, cafes, etc. are operating in the United States, with at least 64 in California.
  • Hookah is an efficient nicotine delivery system.
  • Some people can become addicted to nicotine after smoking tobacco just a few times.


  • Hookah smoke produces nearly 100 times more tar, 4 times more nicotine, 11 times more carbon monoxide, 2 ½ times more phenanthrene (co-carcinogen), 4 times more fluranthracene (cocarcinogen), and 5 times more chrysene (tumor initiator) than cigarette smoke, for each gram of the respective tobaccos.
  • Hookah smoke of various fruity flavors, tastes, and aromas may be even more harmful than disease-causing cigarette tobacco smoke.
  • Hookah smokers are exposed to three times greater amounts of carbon monoxide, an odorless gas, than are cigarette smokers.
  • Because the duration of a single puff of hookah smoke is double that of a cigarette, and the suction pressure for inhalation of hookah smoke is four times that for a cigarette, the hookah smoke reaches deeper into lung tissue.
  • Fifteen minutes of hookah smoking is about the same as chain smoking five cigarettes.
  • Hookah smoke can cause infertility in women and impotence in men, and low birth weight and birth defects in babies born to smoking mothers.
  • Hookah smokers have a high risk of lip, tongue, mouth, larynx and esophagus cancers.
  • When people smoke from hookahs, they often share mouthpieces. Sharing mouthpieces adds the risk of getting colds, viruses like herpes, oral bacteria infections and tuberculosis.
  • Under California state law, smoking tobacco – in any form, flavored or unflavored, in a water pipe or in a cigarette or cigar – is prohibited in indoor workplaces. The sale of tobacco in any form to minors under age 18 is illegal.

Sources: RESPECT (Resources and Education Supporting People Everywhere Controlling Tobacco); Mardi Richmond, Tobacco Pipes and Hookahs Journeyworks Publishing Santa Cruz, CA, 2003; Asotra, Kamlesh, Ph.D. Hooked on Hookah? What You Don’t Know Can Kill You. Burning Issues Tobacco’s Hottest Topics. Tobacco-Related Disease Research Program Newsletter. Volumn 7, Number 3 August 2005