Hookah smoking

• Smoking
• Smoking and Cigarette Market in Russia

Is hookah harmful?

Hookah smoke is very dense and the content of carcinogenic substances in it is as high as in cigarette smoke. Even if you don't smoke and just walk past a hookah bar, in 3 minutes you can get an impressive dose of carcinogenic substances and be no different from smokers, having the same risks. Moreover, in an hour of smoking a hookah, a person inhales the amount of smoke exceeding 200 times the smoke from one cigarette!

In addition, when smoking hookah, cold smoke enters the body, which does not have time to turn on the protective mechanisms in the respiratory tract - the production of antibodies and immune factors. Thus, harmful substances penetrate the body instantly.

Smoke from cigarettes is hot, the protective mechanism works faster^[1]

2025: Multiple Factors Negatively Affecting Health

In June 2025, Evgeny Khaitovich, a therapist at the Digital Clinic of the Insurance House of VSK, a clinical pharmacologist told what the harm of a hookah is.

The hookah is arranged in such a way that when smoking, smoke passes through the water, but this does not mean its purification. Water does not trap most toxic substances: nicotine, benzapyrene, heavy metals, carbon monoxide - all of which penetrate the smoker's respiratory tract. Moreover, flavored mixtures often contain additional chemical additives that increase health harms.

Hookah smoking is associated with an increased risk of respiratory diseases - from chronic bronchitis to irreversible obstructive pulmonary disease.

With regular consumption, the likelihood of infections increases due to the general mouthpiece and a warm, moist environment - ideal for bacteria and viruses. At the same time, the fact that a person can inhale 100-200 times more smoke in one hookah session than when smoking a cigarette is often ignored.

Oncological risks have also been proven. Cancers of the lungs, mouth, esophagus and bladder are diseases whose connection with hookah smoking is described in a number of scientific papers. The danger increases with the frequency and duration of use.

The cardiovascular system responds to hookah with increased heart rate, increased blood pressure and vascular spasms. In people with already existing cardiovascular diseases and risks, this can provoke exacerbation or complications.

Nicotine addiction develops in the same way as when smoking regular cigarettes. Often it is reinforced by a social factor - the habit of "resting with a hookah" becomes a routine, especially among young people. Behavioral dependence is formed, often accompanied by a decrease in motivation for failure.

Finally, passive smoking in a hookah bar or at home is dangerous for everyone who is nearby: harmful compounds remain in the air, especially when using coals.

2024: Hookah increases the risk of dying from cancer by 3 times. Tested for 39 thousand people

Smoking hookah increases the risk of death from certain types of malignancies by three times. This is evidenced by the results of a study by Vietnamese scientists, published on July 11, 2024.

The work was attended by specialists from Zui Tang University, the Institute of Preventive Medicine and Public Health and Hanoi Medical University. Data from 39,401 people were examined, of which 52.3% were women. To perform the assessment, people were divided into four groups: cigarette smokers, hookah smokers, cigarette and hookah smokers, as well as those who never smoked.

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Фото: Unsplash

During the observation period from 2007 to 2019, 554 deaths from cancer were recorded among the entire group. It has been established that people who smoke exclusively hookah have a 2.66 times higher risk of death from malignancies compared to those who have never smoked. In particular, the risk of death from liver cancer increases by 3.92 times, from lung cancer - by 3.49 times, from nasopharyngeal cancer - by 2.79 times, from stomach cancer - by 4.11 times.

Charcoal used to heat tobacco can raise health risks by producing high levels of carbon monoxide, metals and carcinogenic chemicals. Even after the hookah smoke has passed through the water, it contains high levels of these toxic substances, "the US Centers for Disease Control and Prevention (CDC) said.

The study also showed that smoking hookah 11 to 15 times a day increases the risk of death from cancer by 3.42 times. Starting smoking between the ages of 26 and 30 increases the risk of death by four times, as does smoking experience between 9 and 20 years. Overall, people who have ever smoked (both hookah and cigarettes) have a 1.87 times higher risk of dying from cancer compared to never smoked.^[2]

2019: Vaping and hookah smoking threatens tuberculosis

Smoking vape and hookah threatens serious infectious diseases, including tuberculosis and "popcorn lung disease." Oleg Kutushev, head of the Moscow Center for the Prevention and Treatment of Tobacco Addiction, warned about this in May 2019.

- There is no technical regulation of liquids in vapes and hookahs, which means that there is no confidence in the composition of the purchased products. Hookahs are not sanitized - the risk of developing tuberculosis and infectious diseases increases, - explained the narcologist in an interview with the Moscow agency.

Tobacco smoke contains seven thousand toxic substances, about 50 carcinogens and mutagens, heavy metals and even radioactive substances, Kutushev noted. According to him, these facts are undeniable, there are no safe breaths and exhalations of tobacco smoke.

Soaring using tobacco heating devices threatens the development of "popcorn lung disease," which affects the alveoli. At the same time, eight out of ten people after a year and a half smoking vapes switch to ordinary cigarettes.

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