Hookah vs Cigarette – A Comparative Study

What Is Hookah?

Here we explore the effects of hookah smoking vs cigarettes. Hookahs came back in vogue after cigarettes were banned for their adverse effects on health. However, how healthy are hookahs is what we explore here, and see the health risks that both habits include.

Hookah smoking

What Is the Difference Between Pipe Tobacco and Cigarette Tobacco?

Growing Popularity of Hookah Smoking Among Young Adults

Health studies in recent years show that tobacco use has declined among youngsters. However, they are open to experimenting with alternative tobacco-based products such as hookah. The age group that tries hookah is the largest in the age group between 18 and 19. By the age of 21, there is about 10% of the young adult population that gets started with hookah usage. Among them, however, only about 1% try it regularly.

Is Smoking Hookah Bad for You? Misconceptions about Hookah’s Safety Compared to Cigarettes

Hookahs are thought to be safer than smoke due to the use of water pipes. The water cools and is thought to filter out the smoke. Hence many think that smoking using hookah is safer than using cigarettes. Many even explore novel aspects such as can you smoke weed with a hookah. It is thought that the water filters out the dangerous smoke before it is inhaled. However, when one smokes hookah for a single session it delivers tar 25 times and smokes 125 times more than a single cigarette.

The Hookah: A Deceptive Perception

About Hookah Smoking and Its Cultural Origins

Hookah smoking is a tradition that has been passed on from ancient India, Persia, Turkey, and Egypt. It was prevalent in the Middle Eastern countries mostly. The practice of smoking hookah is all about flavored tobacco being inhaled through a water pipe. It was seen as a way to entertain and relax, among friends or family. The first hookah can be traced back to the 16th century. It started in India when glass manufacturing had just begun, through the British East India Company.

Components of a Hookah: Smoke Chamber, Water Bowl, Pipe, and Hose

At the time when hookah was first introduced, it was used among noblemen, usually in high society. The hookah comprised a mechanism to purify smoke that rose from tobacco leaves, over water kept in a glass base. The hookahs included wooden shafts with the smoke coming through another secondary shaft. Hookahs usually incorporate flavored tobacco. The smoke comes through a water pipe. A hose inbuilt inside the pipe enables users to take a puff.

What is in hookah? The following are the components of a hookah:

Hookah Bowl or Head

This is made of ceramic or clay and sits on top of the hookah. This part holds the shisha tobacco.

Charcoal Tray or Plate

This is a metal disc that sits on the hookah stem. It catches the excess ash from charcoals on the bowl.

Hookah Shaft or Stem

This is a metal section that connects all other components of the hookah. It is also known as the down stem.

Hose Adapter

This is a conical piece that is open, cylindrical. This attaches to the hookah hose.

Purge Valve

It is also called the check valve. There is a threaded cap that has a ball bearing inside. It screws on or off the hookah.

Hookah Hose

This is the part that users inhale through.

Hookah Base

This refers to the bottom part of the setup. It holds water which filters out the smoke.

Flavoring of Hookah Tobacco and the Heating Process Using Charcoal

Hookah is also known as shisha. It usually contains tobacco that is flavored with fruit pulp or honey. Nowadays there is tobacco-free shisha as well. It can also contain molasses. Traditionally it used to be combined with charcoal. This helped to heat the tobacco and produce the smoke.

Dangers Lurking in the Smoke

Is smoking a pipe bad for you? Even though tobacco smoke passes through water, hookah smoke has high toxic levels. Both tobacco, as well as smoke, has toxic agents that can cause oral, bladder, or lung cancer. Tobacco juices can irritate the linings of the mouth. This increases the chances of oral cancer.

Comparison of Harmful Chemicals in Hookah vs Cigarette Smoke

Hookah Cigarette
It contains 36 times more tar, 15 times more carbon monoxide, and 70% more nicotine. Less harmful ingredients as in a hookah.
Hookah smokers inhale more toxins and carcinogenic chemicals. Lesser toxins as in hookah smoke.
An hour of hookah smoking is equivalent to smoking 40 cigarettes or how many puffs in a pack of 20 cigarettes. Cigarette smokers will smoke lesser cigarettes in an hour.

Increased Exposure to Different Toxins

Though the hookah smoke passes through water the toxic agents remain high here. The tobacco as well as the smoke includes several toxic factors such as tar, carbon monoxide, and other carcinogens in hookah smoke. These can cause oral, bladder, or lung cancer. The tobacco juices irritate the mouth. This, in turn, increases the chances of oral cancer.

Duration of Sessions and Their Impact

Usually, a hookah session lasts between one to two hours. This also lengthens the impact of the intake of smoke. During this time users inhale about 100 to 200 times the smoke that emanates from a cigarette. Users get exposed to 9 times the carbon monoxide as well as 1.7 times the nicotine level as compared to smoking a single cigarette.

Health Risks Associated with Hookah Smoking

Health risks associated with hookah smoking are numerous, such as heart disease, cancer, lung disease, and others. Details of these are enumerated in several health authority articles. The main ones are listed below.

Nicotine: A Common Thread

How much nicotine is in a hookah? This is one of the major risks. Due to high nicotine exposure, people get stomach, oral, esophagus, lung, and bladder cancers.

Nicotine’s Role as a Habit-Forming Chemical

When it comes to addiction, the strength of the buzz that hookah smoking creates depends on nicotine content. This will vary as per the length of the hookah smoking sessions. However many feel that the addictive aspect of hookah smoke is lessened compared to cigarettes.

Parallel Addiction

Many wonder about the addiction potential that exists between smoking hookah and cigarettes. Addiction potential might vary between cigarette smoking and hookah, but harmful effects are higher in the latter. Most of the harmful ingredients found in the smoke of cigarettes are found in hookah smoke as well. This relates to heavy metals, tar and how much nicotine is in a hookah.

Secondhand Smoke and Beyond

As with cigarette smoking, hookah smoke also has harmful effects on the health of the smoker as well as others around them.

Negative Effects of Second-Hand Hookah Smoke on Bystanders

Negative effects of hookah smoke on others include risks of stroke, lung cancer, and coronary heart disease.

Risks of Using or Sharing Unclean Hookah Pipes

Those who share hookah pipes with others face heightened health risks. These include the risk of developing herpes lesions as well as hepatitis.

Hookah Smoking during Pregnancy

It is known to link to adverse effects such as low birth weight in babies. This is yet another health risk, especially for pregnant or expectant mothers. Exposure to hookah smoke can increase not only the risk of low weight at birth of the babies. But it also increases the risk of premature births.

Long-Term Consequences: Hookahs vs Cigarettes

Similar Health Risks of Hookah and Cigarette Smoking

Health risks, especially in the long term, are similar for cigarette as well as hookah smoke. That is, users increase risks of oral cancer, bladder, and lung cancer. They are also at risk of having coronary heart disease.

Absence of Toxin Filtration in Hookah Water Cooling Process

Contrary to popular belief, the process of passing the hookah smoke over water does not act as an effective filter. Hence, toxins remain in the hookah smoke and are inhaled by the user as well as others around them.

Potential for Hookah Smoking to Lead to Cigarette Use

Studies do not show that hookah smoking will necessarily lead to cigarette usage. However, the same adverse health effects come from hookah smoke as is evident in cigarette smoking.


Key findings between hookah smoke and cigarette smoke indicate that the same level of toxins and health risks remain in both. Since hookah smoking sessions last longer the effect of such inhalation is higher than smoking single cigarettes at a time. Also, the popular myth that hookah smoke that passes through water is filtered, is unfounded. Hence, hookah smokers should be aware of such effects before they opt for such habits. There are also increased risks from sharing the hookah pipe with others. Others around such users get exposed to the adverse effects of hookah smoke.
Сheck out our previous article comparing Cigar vs Cigarette.