History of Hookah *
When asking what is hookah, it’s important to understand the origins and history of it. Hookah goes by several regional names, including hubble-bubble, goza, narghile and shisha. Originating in the Middle East hundreds of years ago, a hookah is a waterpipe designed for smoking tobacco. According to American for NonSmokers’ Rights, or ANR, hookah tobacco was traditionally sweet or flavored tobacco. Hookah smoking was also a social and cultural activity, often associated with Islam.
Hookah was originally developed in India. According to some historical narratives, and reported by the World Health Organization, it was developed by physician Hakin Abul Fath, seeking to provide a less harmful method of smoking tobacco. This was during the reign of Emperor Akbar from 1556 to 1605. The theory was that passing the smoke through water would reduce the harmful effects of smoking tobacco. While hookah varies slightly in pipe design and names throughout the Middle East region, the principles of how it works remain the same everywhere.
The Hookah Fad *
Today, hookah bars have popped up all over, particularly in areas with young adults, like college towns. While this appears to be a fad, hookah bars have long operated in Middle Eastern areas and neighborhoods. Hookah bars do not traditionally serve alcohol products –following Muslim rules forbidding it — but some have broken from that tradition and combine a hookah bar with a regular bar atmosphere, catering to college-aged clientele. One concern that opponents of hookah establishments have is that it could introduce young adults to smoking tobacco. This could lead to addiction to tobacco in someone who would not smoke cigarettes or use other forms of tobacco products. This is in part from the social atmosphere and also from the widespread belief that hookah is completely safe.
Another possible reason for the recent fad is an increase in laws regarding smoking in public. Many localities and states have banned smoking not only in restaurants, but also in bars and public spaces. Hookah bars give patrons a legal place to smoke tobacco products outside of their own home.
An additional appeal of hookah bars is their role as a social gathering spot. Much like a coffee shop, cafe or pub, these bars provide a setting for people to relax, talk, work and hang-out.
How Does Hookah Work? *
The use of a waterpipe is the core of hookah smoking. A waterpipe has several components: a waterbowl, a rubber hose, a body and a head. Each component serves a purpose for hookah tobacco use.
- The waterbowl varies in size and shape, but is always filled half-full with clean water. The water serves as a sort of filter for the smoke to pass through. In theory, this is what proponents say makes hookah smoking safer than other forms of tobacco use. Whether this is true has yet to be proven. The water does cool the smoke and provide a smoother vapor than smoking something like a regular pipe or cigarette.
- The rubber hose is attached to the bowl above the water level. It has a mouthpiece on the other end for inhaling. It can vary in length and design. Some waterpipes have multiple hoses attached for group use so each person can have their own, but share the tobacco. Some modern hookah pipes also have additional filters in the mouthpiece in an attempt to make them safer. The filters can be made from cotton or activated charcoal. Whether they do reduce the amount of potentially harmful components has not been proven.
- The head is where the tobacco goes. Moistened tobacco is placed in the head and a piece of charcoal or tinder is placed on top of the tobacco. The hookah tobacco is not directly lit, but burned by the charcoal or tinder. Sometimes the charcoal is separated from the tobacco by a thin, perforated sheet, like aluminum foil.
- Once the charcoal is lit, the smoker inhales through the hose. This pulls air through the charcoal and tobacco, helping it stay lit and pulling the resulting smoke into the waterbowl. The smoke then goes through the water in the bowl and bubbles up into the air-filled part of the chamber.
- As the user continues to inhale, the vapor goes through the tube and is inhaled into the lungs. Then it is exhaled, the same as any other smoked product. Traditionally, the hookah hose or the pipe would then be passed to another user.
- A hookah session usually lasts from 20 to 80 minutes, though each individual can use as little or as much as they desire. The hookah waterpipe is often passed around or used by a group as a social activity. The charcoal, or tinder, needs to frequently be re-lit as the pipe is used. Quick-lighting products are also available to aid in keeping the waterpipe lit.
- Accessories are also available for hookah, such as a firebox to keep hot charcoal at the ready and mesh designed to decrease the size of the bubbles. Some shops even sell portable hookah waterpipes.
A newer type of hookah called e-hookah or hookah pen is now on the market. Hookah pens work like an e-cigarette. Some hookah pens claim to contain no harmful components, like nicotine. Because regulations on these products is loose, the claims haven’t been tested.
Like other e-cigarettes, a cartridge of liquid — often flavored — is placed in the ‘pen’ and vaporized by a heating element. E-pens use a battery to activate the heating element that vaporizes the liquid. E-hookah, along with other vape pens, is unregulated and lacking in scientific research.
Concerns exist about the additives, chemicals and safety of the products. There is also concern about the amount of nicotine each cartridge contains, and therefore, how addictive e-hookah pens really are with regular use. The higher the amount of nicotine, the more addictive the products might be.
Proponents believe e-cigarettes a safer alternative because one isn’t inhaling smoke, but vapor. Without further research and regulation on ingredients, users of e-pens do take a risk, however, on quality and content of the ingredients, whether the vaporized liquid is safer or not.
Is Hookah Tobacco Safe *
While traditional and modern users claim that having the smoke pass through water to filter it decreases its harmful effects, hookah tobacco still contains nicotine. Like any other form of nicotine-containing tobacco, hookah smoking can be addictive, according to the Mayo Clinic. Another safety concern is how much smoke is inhaled in one hookah session. The WHO estimates that in one hookah session, a smoker might inhale as much as they would from 100 cigarettes. This, however, depends on if the hookah is shared as is tradition and how often one inhales from the pipe.
The other health concerns for hookah include:
- the risk of exposure to carcinogens, such as formaldehyde
- the charcoal or tinder used to burn the tobacco releases potential toxins, like heavy metals and tar
- exposure to second-hand smoke
- sharing the pipe potentially passes communicable diseases to the users
- e-hookah has no regulation on the ingredients used and information might be misleading
- the unknown amount of nicotine consumed in a hookah session
Can It be Used as an Alternative? *
One question many smokers might have is whether hookah is a safe alternative to cigarettes. There is also the question of hookah having potential as a possible aid in quitting smoking. One reason hookah use might be safer for smokers is the infrequent use. When used in a hookah bar or social setting, users don’t consume as much as the hookah is shared between multiple people. If a smoker only uses tobacco products at a hookah establishment, their exposure to the harmful aspects of tobacco will be limited, especially when compared to frequently smoking cigarettes. The traditional aspects of hookah help prevent it from happening anytime, anywhere.
Another factor is the availability of nicotine-free products, where one still has the sensation of smoking, but less of the addictive components. This can be a psychological help to those who seek the ritual aspects of smoking. This could also potentially be a useful tool for those attempting to cut back on tobacco use or even to quit smoking.
Using herbal smoking blends in hookah waterpipes that progressively contain less tobacco might help a smoker lessen their nicotine dependence. E-hookah formulas with little or no nicotine can serve the same purpose, giving the sensation of smoking with less of the addictive ingredients.
These options also allow users to be a part of the social aspects of smoking without becoming addicted to nicotine products.
Buying and Using Hookah *
Hookah tobacco, pipes and accessories can be purchased from local hookah bars, tobacco shops and Internet stores. Different flavors of hookah tobacco and different types of tobacco are available. When purchasing hookah products or e-hookah liquids, it’s important to buy from reputable suppliers to avoid additives you might not want in the products. Asking around or researching the companies used will help narrow down awn a large array of choices.