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Getting together to “smoke a hubb” has become hugely fashionable among young people. The hubb / hubbly bubbly / water pipe / hookah is widely viewed as a mellow, convivial activity with some of the cool cache of recreational drug use but none of the risk.

Time to burst that bubble, says the Cancer Association of South Africa (CANSA):

Hubbly bubblies: Frequently Asked Questions

Q: What is a hubbly bubbly?

A: A hubbly bubbly (also called a hubb / hookah / water pipe) is an instrument for smoking tobacco, which is often flavoured. It consists of a base container, usually made of glass, attached to one or many smoking tubes. The tobacco smoke is cooled by passing it through water in the the hookah's base,

Q: Isn’t hookah smoke better than cigarette smoke because it passes through water?

A:  No, the water doesn’t clean the smoke. Hookah and cigarette smoke both contain poisons, including nicotine, tar, carbon monoxide, arsenic and lead, among many others. Arsenic is used as a rat poison, and carbon monoxide is a deadly gas also found in motor car exhaust. Lead is a neurotoxin (i.e. even in small amounts, it can damage the nervous system.)

Q: Do you get less nicotine from a hookah than a cigarette?

A: The water does absorb some of the nicotine, but hookah smokers can nonetheless be exposed to sufficient amounts to cause addiction. A hookah smoker takes about 100 puffs in a single (approximately 45 minute-long) session, while a cigarette smoker takes about 10 puffs per cigarette. In other words, you can take in as much nicotine by smoking one hookah pipe as you can by smoking 10 cigarettes. Nicotine is the addictive agent in tobacco, but it’s not too directly damaging to your health. It’s the “tar” in tobacco smoke that causes cancer. The smoke produced in a typical hookah smoking session can contain about 36 times more tar, and about 8 times more carbon monoxide, than the smoke from a single cigarette.

Q: Are hookahs addictive?

A: The hookah can be as addictive as cigarette, because, as explained above, users are exposed to addictive quantities of the drug nicotine. Some hookah smokers show the signs of addiction i.e. they crave a smoke, they struggle to quit the habit, experience withdrawal symptoms when they stop, etc.

Q: Why are hookahs so appealing to young people?

A: The sweet flavour and pleasant smell makes it easier to inhale the smoke without coughing. Also, smoking hookahs is a social, satisfyingly ritualistic activity for many, further encouraged by the prevailing myth that it's harmless and doesn't involve “proper drugs”.

Q: What are the long-term health effects of hookah smoking?

A: Scientists are just starting to investigate all the negative impacts associated with the hookah, but, given its similarity to cigarette smoke, it is likely that many tobacco-related diseases will be linked to hookah use. This includes damage your lungs, making it painful or difficult to breathe. It can cause cancer of the mouth, lungs and bladder, or a heart attack. Sharing a hookah also means you can get germs from other people: the bacteria that cause TB, and the virus that causes herpes, can be passed on to you by sharing a hookah.

Q: Even if I don’t do it myself, is it bad to be in a room where people are smoking a hookah?

A: Yes; breathing the air in a room where people are smoking a hookah exposes non-smokers to many deadly chemicals. Children whose parents smoke hookahs are more likely to have lung infections than children whose parents do not smoke hookahs.

Q: If a pregnant woman smokes a hookah can she harm her baby?

A: Yes. The carbon monoxide and other poisons will pass from the mother’s blood to the unborn baby, and can stunt its growth.

Q: Is there a safe level of smoking a hookah?

A: There is no level of tobacco use, however low and in any form, that can be considered safe. And the more you use, the greater the risks.

- Olivia Rose-Innes, EnviroHealth Editor, Health24, June 2011

References:
CANSA (2010). Frequently Asked Questions: Hubbly Bubbly
CANSA (20008). Fact Sheet: Hookahs are deadly

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