VCU logoWe all know of smoking in general to be dangerous for our health. However it now appears that waterpipe smokers may not be well informed of the health consequences. A study led by a Virginia Commonwealth University investigator suggests that people who smoke tobacco through a waterpipe could be exposed to identical toxicants as puffing cigarettes. This includes carbon monoxide and nicotine that could result in nicotine addiction and heart disease.

The authors of this novel study are of the opinion that physicians and public health officials should offer enough counseling and information to waterpipe smokers. In the U.S., the popularity of smoking tobacco with a waterpipe also known as hookah or shisha has appeared to surge in popularity over the past eight to 10 years. This trend has particularly found to have increased among adults between 18 to 24 years of age.

Some waterpipe smokers may believe their method of smoking to be a little better than smoking cigarettes. They appear to be convinced that their smoking technique delivers less tar and nicotine as compared to regular smokers. They also believe that it may have fewer adverse health effects.

“The results are important because they provide concrete, scientific evidence that contradicts the oft-repeated myth that waterpipe tobacco smoking does not involve users inhaling the same harmful chemicals that cigarette smokers do,” mentioned principal investigator Thomas Eissenberg, Ph.D., professor in the VCU Department of Psychology.

“We hope that these results will be used by physicians and public health officials to inform waterpipe tobacco smokers that they risk tobacco-induced nicotine addiction and cardiovascular disease,” he further remarked.

Eissenberg suggests that no single study in the past has under controlled, laboratory conditions compared the human toxicant exposure related with waterpipe and cigarette smoking. Together with Alan Shihadeh, Sc.D., associate professor at the American University of Beirut in Lebanon, Eissenberg pitted the toxicant exposure linked with waterpipe smoking and cigarette smoking against each other. This was conducted between 2008 and 2009 among 31 participants between the ages of 18 and 50.

Two 45-minute sessions were needed to be completed by each participant. One session included smoking tobacco through a waterpipe while the other one involved smoking a single cigarette. An assessment of the nicotine and carbon monoxide levels in the participants’ blood was then taken. The experts also measured heart rate, puff number and puff volume.

Interestingly on an average the study experts discovered that the carbon monoxide levels to which participants were exposed when they were smoking a waterpipe were higher than when they were smoking a cigarette.
Being specific, the peak waterpipe quantity of carbon monoxide found fastened to red blood cells or the COHb level was observed to be nearly three times that of cigarette. Peak nicotine levels however were no different, though exposure to nicotine was noted in both methods of tobacco smoke. In addition to this an examination of the number and volume of each puff apparently revealed that as compared to cigarette smoking, smoking waterpipe tobacco included the inhalation of about 48 times more smoke.

Shihadeh had earlier conducted studies that seemed to show the presence of compounds that cause cancer and other diseases in waterpipe tobacco smoke. The investigating team was hence concerned about the large amount of smoke inhaled when using a waterpipe

Eissenberg, and Shihadeh, plan to continue their laboratory studies of waterpipe tobacco smoking to analyze other dangerous chemicals that could be inhaled when individuals and groups engage in this behavior. Large-scale studies of the health effects of tobacco use in the future, they hope will assay waterpipe smokers separately. This, they think should help in ascertaining the extent to which waterpipe tobacco smoking can be associated with tobacco-caused disease.

This new study has been published in the December issue of the American Journal of Preventive Medicine.