Smoking through a hookah is not harmless, according to a new study. In addition to the usual tobacco carcinogens, dangerous levels of benzene are inhaled from the lump of smoldering charcoal that ignites the moist tobacco mixture.
Benzene is known to cause leukemia and is a suspected cause of other cancers. Every American has low levels from car exhaust and other pollutants, but no level is considered safe.
Smoking a mix of tobacco, fermented fruit, molasses and other flavorings through a water pipe has been common in the Middle East for centuries. The habit has spread to the West in recent years under various names, including hookah, shisha and argileh.
For the study, scientists from San Diego State University measured levels of S-phenylmercapturic acid, a breakdown product of benzene, in the urine of more than 100 hookah smokers and their nonsmoking companions on the mornings after they had all been to hookah lounges.
The daily smokers had almost six times as much benzene byproduct in their urine as typical nonsmoking Americans do. After long evenings of smoking, some had 10 times as much.
Their companions, who inhaled secondhand smoke, had levels only about half those of the smokers, but still higher than average nonsmoking Americans.
“There are more than 300 flavors, like apple, vanilla, mint,” said the lead author, Nada O. F. Kassem, associate director of the university’s behavioral epidemiology center. “They make it smell nice so people think it’s not harmful, but it’s carcinogenic.”