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Is Hookah Really a Safer Way to Smoke?

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Great news: Cigarette smoking rates are at an all-time low. Not-so-great news: Hookah—the ancient Indian method of inhaling tobacco via water pipe—may be on the rise, according to the Center of Disease Control and Prevention. Now, you know smoking is bad for you, but how bad is hookah specifically? Answer: Pretty bad.

Researchers from the University of Pittsburgh compared one hookah session—about 45 to 60 minutes or the length of time it takes to consume one bowl or head of tobacco—to cigarettes. Turns out, just one session was the equivalent of inhaling more than an entire pack of smokes. (Of course, multiple people usually split the bowl, but that's still a lot.) Worse, one hookah bowl had 125 times the smoke, 25 times the tar, 2.5 times the nicotine and 10 times the carbon monoxide of a cigarette. The study was published in Public Health Reports.

The problem isn't just what's in the hookah; it's also how it works, says Brian A. Primack, M.D., Ph.D., assistant vice chancellor for health and society at the University of Pittsburgh, and lead researcher of the study. "Because the tobacco is moistened, sweetened, and flavored, it can't be lit on fire and burn in a self-sustaining manner," he says. "So, a piece of charcoal is lit and put on top of the tobacco, and you also inhale the combustion products of the charcoal." Fun.

Hookah is a growing health issue as people are taking up the water pipe in record numbers. This type of smoking used to be seen as a sign of prestige and wealth but has only recently become popular in the west. It's especially trendy among younger people, with the CDC reporting that for the first time in history, hookah tobacco use is higher than cigarette use among young adults. One-third of college students say they've tried it and, according to University of Pittsburgh researchers, most of those individuals were not previous users of other forms of tobacco. 

"I think that people get the sense that it is healthier," says Primack. "But while the water in the base makes it cooler and easier to use, it doesn't remove the toxins." He points to overwhelmingly positive YouTube videos about hookah, and cites his previous research that 92 percent of hookah-related videos were rated as positive but only 24 percent of cigarette-related videos got the YouTube thumbs up.

Primack adds that another reason people may think it's healthier is because it tastes better. While it's illegal to have cherry-flavored cigarettes, for example, hookah tobacco comes in every flavor imaginable, including trendy ones that would specifically appeal to women.

Lastly, Primack points out that there's a fundamental difference in how we treat hookah tobacco useage. "Many indoor spaces do not allow cigarette smoking but do allow hookah smoking," he says. "This may give young people the mistaken impression that the government has decided that hookah smoking is okay."

But just because something is legal does not mean it's good for you. This is one trend you'll definitely want to skip.

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