Study Finds Hookah Tobacco Less Toxic Than Cigarette Tobacco

1997 was the last big year for cigarettes in the United States. While adults were largely casting them aside, more than a third of high school seniors considered themselves smokers. The following year the top five tobacco producers in the U.S. signed the Master Settlement Agreement, resulting in tighter restrictions on marketing of tobacco products and a concession that smoking cigarettes was in fact causing health problems. Since then, cigarette use among teens has been on the decline.

Smoking hookah, the Middle Eastern water pipe, however, is slowly, but steadily on the rise. Last year the Monitoring the Future study reported more high school seniors were smoking hookah than cigarettes.

"Young people are very interested in it," says Ryan Saadawi, the lead graduate student on an American Chemical Society study examining the effects of hookah smoking. "Cherry apple and bubble gum are more enticing than Marlboro Red."

Hookah tobacco is a mix of fruit-flavorings, sugar, and tobacco. To smoke it, you place a wad of the sticky sugar laced tobacco into a ceramic bowl and cover it with a aluminum foil. On top of the aluminum foil you place a hookah coal. The burning embers heat the tobacco mix (known as shisha), producing smoke that bubbles down through a container of water and into a long hose-like tube with a mouthpiece for inhaling. The candy-sweet flavors hook kids in and popular myths that smoking hookah isn't as bad for you as smoking cigarettes only add to the appeal.

According to smoker's lore, as the smoke passes through the water bowl it's filtered of toxins and cooled, preventing it from burning your lungs. The CDC and American Lung Association have argued for a number of years that hookah is as bad, if not worse, than cigarettes. While some recent studies have been done, including one on hookah smoking and respiratory effects, there isn't a lot of research related to hookah smoking out there.

Today, the American Chemical Society is releasing its initial analysis of hookah tobacco—a step towards further understanding the habit.

Dr. Joseph Caruso, a professor of chemistry at the University of Cincinnati, led the study. His team tested 12 different varieties of shisha manufactured in the U.S. and the Middle East. After breaking the tobacco down to a liquid state and analyzing it for metal type and concentration, the results showed that hookah tobacco had fewer metals and organic toxicants than cigarette tobacco.

But, hold on to your party favors, this isn't a victory for hookah yet.

Most (if not all) of the toxicants and metals in tobacco products are absorbed from the soil tobacco grows in. In fact, researchers found that shisha from the Middle East tended to have a higher volume of metal contaminants as a result—cadmium, aluminum, iron, lead, and arsenic to name a few. Still, allowing for environmental factors, most all tobacco is created equal. What differentiates cigarettes from shisha is the amount of tobacco in each. Cigarettes contain more tobacco than shisha, which is heavily diluted with additives like molasses and fruit flavoring.

Though there's less tobacco in the mix, it doesn't mean smoking hookah is less harmful than cigarettes overall. To determine that, more studies will have to be done. Saadawi muses that hookah's noxiousness may not be a matter of tobacco at all: "There's levels of concern in the charcoal and we're still looking into the levels of toxicity in the smoke."

Concerns with charcoal, range from its metal content to the amount of carbon monoxide it emits. In addition to carbon monoxide, burning coal also results in an cancer causing air pollutant known as polycyclic aromatic hydrocarbons. The way Hookah is smoked—in social cafes where several groups of people sit and smoke continuously for an hour or two—may also be a factor in determining how dangerous smoking hookah really is. "If you have a lot of people smoking in a closed space, the charcoal could be a problem," says Saadawi.

While Dr. Caruso and his team still have several more tests to conduct concerning hookah smoke and coals, Saadawi says he hopes to have some more answers soon. He plans to release a second study, testing the effects of hookah smoke, in January 2014.