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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

A Parent's Life A Parent's Life

Parents -- What You Need To Know About Hookahs

July 16, 2014

By Claire McCarthy M.D.

Boston Children's Hospital

Parents, do you know what a hookah is? If not, you should. Then take the time to talk to your teens about the health risks associated with it. 

What Is Hookah?

A hookah is a water pipe that people use to smoke a specially made tobacco. Often the tobacco is  flavored. A hookah is also called narghile, argileh, shisha, hubble-bubble or goza.   

A hookah uses coal to burn the tobacco. This creates either smoke or a vapor that is inhaled through a tube. People usually smoke a hookah as a group, passing the mouthpiece from one person to another. There are also some newer, electronic hookahs that are battery-operated, similar to e-cigarettes. 

Why You Should Be Concerned

Hookah smoking is on the rise among youth. According to a 2014 study in the journal Pediatrics, 18% of high school seniors have smoked a hookah. 

Hookahs have been around for centuries. Smoking hookahs began in ancient Persia and Asia, where it was considered a very aristocratic and elegant thing to do. Perhaps because of this reputation — and because it's an ancient practice — many people think that it isn't as dangerous as smoking cigarettes. But it is just as dangerous, if not more so. 

The smoke you inhale from a hookah contains the smoke from both the coal and the tobacco, which are full of toxins and carcinogens. The smoke also has nicotine, the chemical that makes people addicted to tobacco. 

Smoking a hookah can lead to all the same health risks as smoking a cigarette, such as cancers of the mouth, esophagus, stomach, lung, bladder and other parts of the body. It can lead to lung disease, cardiovascular disease, infertility, and low birth weight in the babies of women who smoke hookah. Also, because the mouthpiece is often passed from person to person, there is the risk of passing infection. 

Because hookahs are smoked as a group, the smoking session may last a while. This can lead to more exposure to the toxins. Also, an hour of hookah smoking exposes someone to as much as 200 times the smoke as smoking a cigarette.

Education Is Key

The most important thing we all can do is educate ourselves and others about the health risks of smoking hookahs. That's why parents need to talk to their children, teachers need to talk to their students and coaches need to talk to their athletes. Anyone who interacts with young people should find out what they know about hookahs, and whether they are smoking them.

If youth think that smoking a hookah is just something fun to do with their friends, they could end up putting their health and life in danger. They need to know about the health risks. And that smoking a hookah is a very bad idea.

Youth will always take risks and try things that aren't healthy for them. It's our job as caring adults to do everything we can to reduce the risks, and keep them as healthy and safe as we can. Talking about hookahs is another way to do that.

For more information on hookahs and their health risks, check out the fact sheet on hookahs from the Centers for Disease Control and Prevention.

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Claire McCarthy, M.D., a senior medical editor for Harvard Health Publications, is an assistant professor in pediatrics at Harvard Medical School. She is an attending physician and Medical Communications Editor at Children's Hospital Boston.

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