One hookah tobacco smoking session delivers 25 times the tar of a single cigarette

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Public Release: 11-Jan-2016
One hookah tobacco smoking session delivers 25 times the tar of a single cigarette
University of Pittsburgh Schools of the Health Sciences

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.

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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.

"It's not a perfect comparison because people smoke cigarettes and hookahs in very different ways," said Dr. Primack. "We had to conduct the analysis this way--comparing a single hookah session to a single cigarette--because that's the way the underlying studies tend to report findings. So, the estimates we found cannot tell us exactly what is 'worse.' But what they do suggest is that hookah smokers are exposed to a lot more toxicants than they probably realize. After we have more fine-grained data about usage frequencies and patterns, we will be able to combine those data with these findings and get a better sense of relative overall toxicant load."

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