The traditional water pipe, known as a hookah, shisha, or narghile, is used to smoke flavored tobacco that is heated by charcoal. The smoke passes through a water basin before being inhaled. The short answer to whether hookah provides a psychoactive effect, commonly described as a “buzz,” is yes, it typically does. This sensation is a complex physiological response resulting from the combined effects of nicotine on the central nervous system and the introduction of other gases into the bloodstream. Understanding the nature of the hookah buzz requires separating the stimulating effects of nicotine from the potentially disorienting effects of the smoke’s byproducts.
Nicotine Content and Delivery
The primary chemical responsible for the psychoactive effects of hookah is nicotine, the addictive substance naturally present in tobacco. Hookah tobacco, often called mu’assel or shisha, is a moist, flavored mixture that is exposed to heat from burning charcoal. While the nicotine concentration by weight in shisha may appear low compared to a cigarette, the method of consumption leads to significant exposure.
A single hookah session commonly lasts between 45 and 60 minutes, dramatically extending the duration of smoke inhalation. Users take many deep, prolonged puffs, leading to a massive total volume of smoke inhaled—up to 100 to 200 times the volume of a single cigarette. This prolonged exposure means that a single hookah session can deliver approximately 1.7 to 2.5 times the amount of nicotine absorbed from one cigarette, providing the chemical foundation for the sought-after “buzz.”
The Mechanism of the Nicotine Buzz
The sensation associated with the buzz is directly linked to how absorbed nicotine interacts with the brain. Nicotine is rapidly distributed through the bloodstream and crosses the blood-brain barrier, where it acts as an agonist, mimicking the natural neurotransmitter acetylcholine. Nicotine binds to and activates receptors located on nerve cells.
This binding interaction triggers a cascade of neurochemical releases, particularly within the brain’s reward pathway. The most significant effect is the increased release of dopamine in the nucleus accumbens, a region associated with pleasure and reward. The surge of dopamine produces the feelings of mild euphoria and temporary relaxation that users describe as the buzz.
Nicotine also promotes the release of adrenaline, which causes physiological changes like an increase in heart rate and blood pressure. This adds a stimulating component to the overall experience. This dual effect of simultaneous relaxation and mild alertness defines the sought-after feeling of the nicotine buzz.
Carbon Monoxide and Other Contributors to Dizziness
While nicotine causes the stimulating and euphoric effects, a secondary factor often contributes to the overall lightheadedness and dizziness experienced during a session. The charcoal used to heat the tobacco is a major source of carbon monoxide (CO), an odorless and colorless gas. A single hookah session can expose a user to up to 10 times more carbon monoxide than a single cigarette.
This high level of CO is concerning because carbon monoxide binds to hemoglobin in the red blood cells much more readily than oxygen, forming carboxyhemoglobin. When carboxyhemoglobin levels rise, the blood’s capacity to transport oxygen to the body’s tissues, including the brain, is reduced. This state of oxygen deprivation, or hypoxia, generates symptoms like headache, nausea, vertigo, and lightheadedness, which many users mistake for a stronger nicotine buzz.
The deep and prolonged inhalation technique characteristic of hookah smoking can also contribute to a mild form of hyperventilation. Increased inhalation can briefly alter the balance of oxygen and carbon dioxide in the blood, further contributing to feelings of dizziness or faintness. Therefore, the overall “buzz” from hookah smoking is a mixture of central nervous system stimulation from nicotine and the disorienting effects of carbon monoxide exposure.