Hookah smokers are inhaling toxic chemicals that may harm the heart

Smoking tobacco in waterpipes, more commonly known as hookahs, results in inhaling toxic chemicals, often at levels exceeding cigarette smoke, that may harm the heart and blood vessels, according to a new scientific statement published in the American Heart Association’s journal Circulation.

Waterpipes go by many names – hookah, narghile, argileh, shisha and goza – and usually consist of a head or bowl that holds tobacco, a body, water base and hose that ends with a mouthpiece. Burning charcoal is placed on top of the tobacco-filled bowl. Hookah tobacco is usually a combination of dried fruit, flavored tobacco and substances to keep the tobacco moist.

During a hookah smoking session that typically last for 30 or more minutes, users inhale many liters of smoke filled with large quantities of particulate matter at higher concentrations than cigarettes.

Although direct comparisons between hookahs and cigarettes have some limitations, a single session of hookah use typically results in greater exposure to carbon monoxide than a single cigarette. Even short-term exposure to carbon monoxide in hookahs is toxic and can interfere with exercise capacity, according to the statement authors.

In addition to carbon monoxide, hookah smoke contains other potentially harmful chemicals that can affect the cardiovascular system, including nicotine, air pollutants, particulate matter, volatile organic chemicals, polycyclic aromatic hydrocarbons, acrolein, lead, cadmium and arsenic. Most of these toxins are higher in hookah than cigarette smoke.

Research article: Water Pipe (Hookah) Smoking and Cardiovascular Disease Risk: A Scientific Statement From the American Heart Association

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