Hookah smoking is a widespread social activity, but users often report dizziness or lightheadedness, sometimes referred to as “hookah sickness.” This sensation arises from several physiological responses within the body due to the components and process of hookah use.
Nicotine’s Role
Nicotine, present in the tobacco used in hookah, significantly influences the body’s central nervous system. When inhaled, nicotine rapidly enters the bloodstream, leading to an increase in both heart rate and blood pressure. This stimulant effect can also cause blood vessels to constrict, potentially reducing the flow of blood and, consequently, oxygen to the brain.
Hookah sessions often last for extended periods, allowing for deeper and more prolonged inhalation, which can result in a higher absorption of nicotine into the bloodstream. For individuals not regularly exposed to nicotine, or those consuming it in higher doses, these cardiovascular changes can manifest as lightheadedness or dizziness.
Carbon Monoxide Exposure
A significant factor contributing to dizziness from hookah use is exposure to carbon monoxide (CO), a gas produced by the burning charcoal that heats the shisha. Carbon monoxide is particularly concerning because it is colorless and odorless, making it difficult to detect. When inhaled, CO binds to hemoglobin in red blood cells much more readily than oxygen, forming carboxyhemoglobin (COHb).
This binding reduces the blood’s capacity to transport oxygen throughout the body, including to the brain. This oxygen deprivation directly leads to symptoms such as dizziness, headaches, nausea, and fatigue.
Other Contributing Factors
Several additional physiological factors can contribute to dizziness during or after hookah use. The act of taking deep, prolonged inhales, often followed by breath-holding, can temporarily disrupt the body’s oxygen and carbon dioxide balance, leading to a temporary reduction in oxygen levels or hyperventilation. This imbalance can induce lightheadedness.
Dehydration also plays a role, as the dry, warm smoke and the extended duration of hookah sessions can lead to fluid loss. When the body becomes dehydrated, blood volume decreases, which can lower blood pressure and reduce oxygen delivery to the brain, contributing to feelings of faintness. Smoking on an empty stomach can further intensify dizziness, as fluctuating blood sugar levels can make an individual more susceptible.
Smoking in poorly ventilated areas concentrates harmful gases, increasing the risk and severity of symptoms. Individual sensitivity and pre-existing health conditions can also significantly influence a person’s susceptibility to dizziness from hookah.
Addressing Dizziness
If dizziness occurs during hookah use, stop smoking immediately and move to an area with fresh air. Sitting or lying down can help stabilize blood flow and reduce the sensation of lightheadedness. Drinking water is recommended to combat dehydration, a common contributor to dizziness. If low blood sugar is suspected, consuming a light snack can help alleviate symptoms.
Seek medical attention if dizziness is severe, persistent, or accompanied by other concerning symptoms such as chest pain, severe headache, confusion, or fainting. To reduce the risk of future dizziness, ensuring proper ventilation during sessions, staying well-hydrated, eating before smoking, and taking regular breaks can be beneficial. Pacing oneself and avoiding excessive or rapid inhalation can also help mitigate adverse effects.