It seems as if the waterpipe has captivated the nation. Although a popular cultural practice in the Middle East, hookah has recently gained a large social following in the United States, especially among members of the youth generation.
Hookah, also known as a narghile or shisha, is a waterpipe that consists of a base filled with water, a bowl that heats the tobacco, a pipe that connects the bowl to the base and a hose or mouthpiece through which the smoke is drawn, according to the American Lung Association.
In Charlottesville, the Twisted Branch Tea Bazaar, a local tea house and restaurant located on the Downtown Mall, is one of the most popular places to smoke hookah. Fourth-year Engineering student and Twisted Branch Tea Bazaar worker Daniel Overstreet described how a hookah is prepared:
“When we get a hookah order, we change the water in the base, assemble the body, blow out the hose to make sure nothing is in it, pack the bowl with whatever flavor the customer wants, heat the coal, cover the [bowl] with foil, poke holes in the foil to provide ventilation for the coal and cover the whole thing,” Overstreet said. “I only work at night, but I know that during the day someone thoroughly cleans all the hookahs and preps them so that at night when we are busier, getting hookahs ready is easier and more efficient.”
Overstreet, however, said he does not smoke, noting he dislikes all tobacco products. He said, however, if he were to smoke, he would choose hookah and not cigarettes.
“I have the least aversion to hookah for several reasons — it’s flavored, which makes it taste better,” Overstreet said. “The smoke’s interaction with the water makes it smoother and it is a strongly social activity, as opposed to smoking cigarettes, which can start socially but then easily becomes a personal addiction.”
Although the social aspect of smoking hookah is recognized, many of the common misconceptions about hookah tend to be overlooked, including the belief that water filtration reduces toxic chemicals in the smoke and that it is not as harmful as smoking cigarettes. According to a recent study by the ALA, “The level of nicotine increased up to 250 percent and the cotinine level increased up to 120 percent after just one session of smoking, lasting 40 to 45 minutes. Waterpipe use may increase exposure to carcinogens because smokers use a water pipe over a much longer period of time, often 40 to 45 minutes, rather than the 5 to 10 minutes it takes to smoke a cigarette.”
Because of the longer, more sustained period of inhalation and exposure, a waterpipe smoker could possibly inhale as much smoke as consuming 100 or more cigarettes during a single hookah session, the study stated.
It has also been suggested that the social aspect of waterpipe smoking increases the risk of contracting other infectious diseases such as tuberculosis and viruses, such as hepatitis and herpes, through the sharing of the mouthpiece.
“Another potential problem is that commonly used heat sources that are applied to burn the tobacco, such as wood cinders or charcoal, are likely to increase the health risks from waterpipe use because when burned on their own these heat sources release high levels of potentially dangerous chemicals, including carbon monoxide and metals,” the ALA study stated.
Susan Bruce, director of the University’s Center of Alcohol and Substance Education said one session of hookah results in more tar, nicotine and carbon monoxide then smoking one cigarette.
“Because the smoke is cooled before [going] into the lungs, people can inhale more deeply and hold it in their lungs longer which increases the absorbance of the chemicals in the smoke,” she said. “Hookah smokers absorb 8.4 times the carbon monoxide for a single hookah session than cigarette smokers do by smoking a cigarette.”
Bruce also cited a Center of Alcohol and Substance Education survey used to assess University students’ levels of smoking that found that almost four out of five University students do not smoke tobacco and do not fall under the category of “situational smokers” — a category under which most hookah smokers would fall.
“Fortunately, we’ve noticed a positive trend among students,” Bruce said, adding that there has been a drop in tobacco use among students during the past decade. “Ten years ago in 1998, 37.8% percent of students had used tobacco, while today that number is only 18.7 percent.”
She noted that secondhand hookah smoke is dangerous as well.
“Just sitting in a hookah bar is the equivalent to smoking 15 to 20 cigarettes,” she said. “Hookah smoke has very high levels of heavy metals such as arsenic, lead and cadmium — none of which are even slightly filtered through the water when a person inhales secondhand smoke.”
Bruce said Student Health provides many resources for students who want to quit smoking, including “Quit Kits” that help smokers overcome nicotine addiction through nicotine replacement therapy and brochures that help smokers identify their smoking habits and triggers to better tackle overcoming them.
Even though it has been found that hookah can have negative effects on your health, smoking hookah undoubtedly is a popular cultural and social activity among young people in the U.S.
“I think the reason that hookah has become so popular has to do with the novelty of it,” Overstreet said. “It’s different.”
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