As cigarette smoking rates fall, more people are smoking tobacco from hookahs—communal pipes that enable users to draw tobacco smoke through water. A new meta-analysis led by the University of Pittsburgh School of Medicine shows that hookah smokers are inhaling a large load of toxicants.
The findings, published online and scheduled for the January/February print issue of the journal Public Health Reports, represent a meta-analysis, or a mathematical summary of previously published data. The research team reviewed 542 scientific articles potentially relevant to cigarette and hookah smoking and ultimately narrowed them down to 17 studies that included sufficient data to extract reliable estimates on toxicants inhaled when smoking cigarettes or hookahs.
They discovered that, compared with a single cigarette, one hookah session delivers approximately 125 times the smoke, 25 times the tar, 2.5 times the nicotine and 10 times the carbon monoxide.
“Our results show that hookah tobacco smoking poses real health concerns and that it should be monitored more closely than it is currently,” said lead author Brian A. Primack, M.D., Ph.D., assistant vice chancellor for health and society in Pitt’s Schools of the Health Sciences. “For example, hookah smoking was not included in the 2015 Youth Risk Behavior Surveillance Survey System questionnaire, which assesses cigarette smoking, chewing tobacco, electronic cigarettes and many other forms of substance abuse.”
Dr. Primack and his co-authors note that comparing a hookah smoking session to smoking a single cigarette is a complex comparison to make because of the differences in smoking patterns. A frequent cigarette smoker may smoke 20 cigarettes per day, while a frequent hookah smoker may only participate in a few hookah sessions each day.
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