A hookah, also known as a water pipe or narghile, is a device used to heat and inhale flavored tobacco called shisha. The apparatus involves a bowl, a body, a water basin, and a hose with a mouthpiece. Unlike cigarettes, where tobacco is burned directly, hookah involves indirectly heating a moist mixture. The resulting smoke is cooled by passing through water before it is inhaled. Understanding the materials used is key to understanding its effects.
The Raw Ingredients of Shisha
The tobacco mixture used in a hookah is called mu’assel, which is an Arabic word meaning “honeyed.” This product consists of four main components. The base is tobacco leaf, often washed to reduce its natural nicotine content.
Binding agents, typically molasses or honey, provide the syrupy texture and sweetness. Glycerin is added as a humectant, retaining moisture. When heated, the glycerin vaporizes easily, creating the thick, visible clouds characteristic of hookah smoke. The final component is a blend of natural or artificial flavoring agents, such as mint, apple, or various fruit flavors.
The Role of Charcoal and Water in Hookah Use
The process relies on burning charcoal to generate the heat necessary to vaporize the shisha mixture. This charcoal, which can be quick-lighting briquettes or natural coconut coals, is placed on top of the bowl, separated by foil or a screen. The charcoal itself is a source of highly toxic substances, primarily carbon monoxide (CO), produced by incomplete combustion. These toxic compounds are drawn into the smoke stream and inhaled.
The smoke then travels down a tube and bubbles through the water in the base. Many users mistakenly believe this water acts as a filter, removing harmful toxins. However, the water’s primary function is merely to cool and humidify the smoke, making inhalation easier. Scientific data confirms the water does not filter out a significant amount of toxic chemicals or nicotine.
Toxic Chemical Output in Hookah Smoke
When the shisha mixture is heated, a complex blend of harmful chemicals is released and inhaled. Carbon monoxide (CO) is a primary concern, generated in extremely high concentrations by the heat source. Due to the long duration of a typical session, users are exposed to CO levels eight times higher than normal, potentially leading to CO poisoning.
Hookah smoke also contains substantial levels of tar and ultrafine particulate matter. Though the smoke is cooled, these particles penetrate deep into the lungs, causing cellular damage. A single hookah session can expose a user to 36 times the amount of tar and 8.4 times the amount of carbon monoxide compared to a single cigarette. Furthermore, the smoke contains numerous known carcinogens, such as polycyclic aromatic hydrocarbons (PAHs) and benzene, along with heavy metals like lead and cadmium. Nicotine is also present, often resulting in a higher total dose absorbed over the course of a long session.
Specific Health Consequences
The inhalation of toxic chemicals over time leads to a range of detrimental health outcomes. Respiratory illnesses are a direct consequence of the particulate matter and tar, which can lead to reduced lung function, chronic bronchitis, and Chronic Obstructive Pulmonary Disease (COPD). The high concentration of carbon monoxide puts immediate stress on the cardiovascular system by reducing the blood’s oxygen-carrying capacity.
Exposure to nicotine and CO causes an increase in heart rate and blood pressure, which significantly contributes to cardiovascular risks, including heart disease and an elevated risk of stroke. The presence of numerous carcinogens in the smoke increases the likelihood of developing various cancers, including oral, lung, bladder, stomach, and esophageal cancers. A unique risk involves the transmission of infectious diseases. Sharing the same hose and mouthpiece among multiple users can easily spread pathogens like the herpes virus, influenza, and tuberculosis.