Why Hookah Smoking Is a Health Risk, Even for Just One Night

Smoking a hookah water pipe, even for a single night, can increase cancer causing agents and spike the nicotine levels in your urine according to a new study published in the journal Cancer Epidemiology, Biomarkers & Prevention.


While prior studies have shown an association between hookah smoking and increased potential health risks, this study looked at the impacts of just a single, normal night of hookah use.

Researchers at the University of California, San Francisco designed the study noting that the general perception is that hookah smoking—which consists of inhaling tobacco via a water pipe—is relatively safe. They note in the background  of their report that it’s growing trend both globally and in the US, especially among young people, despite the fact that “clinical experimental studies [on hookah use] indicate significant exposures to tobacco smoke carcinogens.”

For the recent study, they looked at urine samples from  55 people both before and after smoking water pipes in a hookah bar. All 55 participants had prior experience smoking hookah. Urine samples were analyzed for nicotine, cotinine, the tobacco-specific nitrosamine, and other known cancer-causing chemicals.

Each participant smoked an average of 0.6 bowls of tobacco and spent 74 minutes using the hookah pipe. After smoking the hookah, every participants’ urine had an 73-fold increase in nicotine and  the levels of cotinine (a metabolite of nicotine) had quadroupled. The levels of various breakdown products of chemicals known to increase cancer also spiked in the urine. These included  NNAL -- which  doubled -- and the breakdown products of volatile organic compounds -- which increased 14 to 91 percent.

The researchers' conclusion states, “Water pipe smoking in a hookah bar is associated with significant nicotine intake and carcinogen exposure.”

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