On any given Saturday night, large crowds of people may be lined up outside of Gypsy Café and Habibi Café on Broxton Avenue for hookah, a form of tobacco smoking which is becoming a growing trend in the United States, particularly among college-aged people.
Hookah, also known as shisha or narghile, is a water pipe device which can be used to smoke any substance but is usually used to smoke flavored tobacco. When the substance is heated, it gives off vapor, which is drawn into a water-filled chamber where it becomes gas that bubbles up through a tube and can be inhaled from a mouthpiece.
“It seems to be taking off worldwide,” said Thomas Eissenberg, associate professor of psychology at the Institute for Drug and Alcohol Studies at Virginia Commonwealth University. “It’s striking how it’s getting more and more common.”
Yet this popular form of smoking may have health effects as serious as those of cigarette smoking, according to new studies. The main controversy surrounding hookah use has been whether it is more or less harmful to a person’s health than cigarette smoking.
“I’m not oblivious to the fact that it’s going to be harmful,” said Ayda Haghighatgoo, a third-year political science student and regular hookah smoker. “I hear both sides of the story of whether hookah is more harmful or cigarettes. For myself, I’m torn.”
Hookah users breathe in the same nicotine, tar and carcinogens from the tobacco smoke that cigarette smokers inhale and also take in carbon monoxide and other toxins from the charcoal that is used to constantly heat the tobacco in the water pipe, Eissenberg said.
In a single session of hookah smoking, which typically lasts about 45 minutes, users may inhale 100 times the volume of smoke inhaled from a single cigarette, he added.
Though research into the risks of hookah use is in its early phases, scientists hypothesize that diseases such as lung cancer, other cancers, cardiovascular disease and nicotine dependency that are associated with cigarette smoking are also linked to hookah use.
In a recent study, Christopher Loffredo, associate professor and director of the cancer genetics and epidemiology department at Georgetown University, and his colleagues compared the cheek cells of hookah and cigarette smokers to those of nonsmokers.
Loffredo found that the cells of hookah and cigarette smokers exhibited greater amounts of genetic damage than the cells of nonsmokers.
“There is a certain very low background rate (of genetic damage) in the cells of nonsmokers,” Loffredo said.
“But smoking elevates this by four or five times. We couldn’t tell the difference between the cells of hookah smokers and those of cigarette smokers ““ they behaved the same.”
Researchers say that the misconceptions that hookah is not very dangerous to a person’s health may account for its popularity.
Some may believe that hookah is less harmful because the flavors of the tobacco make it more appealing and seemingly less harsh than cigarettes, Loffredo said.
Many of the myths surrounding the safety of hookah lies in the use of water in the device, which some believe filters out the harmful substances in the smoke.
“The feeling is that it’s mellow,” said Steven J. Gallegos, tobacco prevention and control coordinator of the American Lung Association of California.
“But the water is nothing more than a conduit between the tobacco and the mouth ““ you’re still getting the same poisons from the tobacco and smoke,” he said.
Scientists are primarily concerned that the social appeal and misconceptions of hookah smoking will lead to a greater number of people becoming addicted to nicotine and that hookah users may eventually become cigarette smokers.
“Once their body becomes interested in nicotine, the brain likes to have that reward pathway fired,” Loffredo said.
In addition to the inherent risks of smoking tobacco, researchers say that second-hand smoke and the spread of infectious diseases such as tuberculosis and herpes make hookah use a growing public health concern.
“Whether people are in hookah bars as smokers or as guests who are not smoking, they are being exposed to the same things as cigarettes expose them to,” Loffredo said.
So far, there has been one documented case of an infectious disease spread through the use of hookah, Eissenberg said.
Scientists and most hookah smokers agree that more research needs to be conducted. For now, researchers suggest that people who are interested in trying hookah for the first time become aware of the potential risks.
“Know the dangers before you go in, and ask questions of the hookah owner,” Gallegos said.