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Hookah Smoking
Hookah (aka shisha, argileh, nargile, hubble-bubble, water pipe, hooka, goza, meassel, sheesha) is an Arabic water-pipe in which fruit-scented tobacco is burnt using coal, passed through an ornate water vessel and inhaled through a hose.
Click here to read GASP's presentation given at the 2009 American Public Health Association conference outlining concerns with hookah smoking.
Health Consequences
The smoking of hookahs presents particular public health hazards including secondhand smoke exposure and transmission of infectious disease. The US Centers for Disease Control fact sheet on waterpipe smoking emphasizes that it is as dangerous as cigarette smoking. "Hookah smokers are at risk for the same kinds of diseases as are caused by cigarette smoking, including oral cancer, lung cancer, stomach cancer, cancer of the esophagus, reduced lung function, and decreased fertility.
The May 10, 2010 issue of Pediatrics (the official journal of the American
Academy of Pediatrics) published a
study on hookah smoking rates of young adults (ages 18-24) in Canada.
Out of 871 young adults surveyed in 2007-2008, 23% had smoked a hookah
in the previous year, which is almost three times higher than the 8% reported
in a 2006 survey. Another finding was that younger age, male gender, speaking
English, not living with parents, and higher household income, independently
increased the odds of water-pipe use. Click
here to read an MSNBC news article about the study, which attributed
the
rise in hookah smoking to numerous factors:
- Low cost
- Easy access
- Appeal of the social interaction that accompanies use
- Commercialization by the media
- Availability of sweetened, flavored, and aromatic tobacco or maassel, which can mask the taste of tobacco
- Misperceptions of low risk to health
- Misbelief that the water filters the toxins from the smoke
- Lack of public health warnings about the dangers of water-pipe use
- Misperception
that water-pipe smoking is less addictive than cigarette smoking
Around the globe, the health consequences and alure to teens of addictive waterpipe tobacco is known. Denmark, a country with a high incidence of hookah smoking, is investigating a ban. A 2009 study by the National Cancer Society and Maastricht University found young people who use water pipes are three times as likely to smoke regular cigarettes.
The World Health Organization Advisory Note issued in 2005 cites:
"Waterpipe smoke contains numerous toxicants known to cause lung cancer, heart disease and other diseases, adverse effects on pregnancy. Same secondhand smoke disease risks caused by cigarette smoking. In one waterpipe smoking session, waterpipe smoker may inhale up to
equivalent of 100 cigarettes."
An August 2009 study by the UK Department of Health and Tobacco Control Collaborating Centre found that one session of smoking shisha resulted in carbon monoxide levels at least four to five times higher than the amount produced by one cigarette. High levels of carbon monoxide can lead to brain damage and unconsciousness. Shisha smokers had 40-70 ppm of CO in their breath, affecting 8-12% of their blood. Click here to read a news article about the study. A case study published in the International Journal of Emergency Medicine documents a 19 year old healthy man sufferering from carbon monoxide poisoning from hookah smoking.
New Jersey Regulations
- Additional
cigar bar related regulations to the SFAA were published by the NJ DHSS
and filed in the NJ Register at 39 N.J.R. 4395(b) in April 2007. The
register first lists the public comments, followed by the NJ Department
of Health responses. To read these rules related to waterpipe smoking
that were adopted as regulations, click
here and go to page 74 of the Westlaw Document. At the end are the
rules that were adopted.
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Hookah establishments are considered the same as cigar bars and are regulated as exceptions under the 2006 New Jersey Smoke-Free Air Act (SFAA). If the cigar bar did not exist before December 31, 2004, it will not qualify under the Cigar Bar or Tobacco Retail Establishment (TRE) exemption requirements.
updated June 1, 2010
This information is created by the Tobacco Control Policy and Legal Resource Center of New Jersey GASP, which provides expert information, guidance, and technical assistance about policy, legislation, and litigation, especially regarding smokefree air. Major funding for this service is provided by the New Jersey Department of Health and Senior Services (NJ DHSS).The information presented on this website is not intended as, nor to be construed, or used, as legal advice, and should not be used to replace the advice of your legal counsel.