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TRDRP-funded Researchers Show Alarming Health Effects of Hookah

A team of researchers, including TRDRP grantees Mary Rezk-Hanna and Ronald Victor, recently published that, for adults aged 18 to 34, smoking hookah can be just as damaging to the cardiovascular system as smoking combustible tobacco.  Hookah waterpipes utilize burning charcoal briquettes to heat and combust the flavored tobacco, then smoke is drawn through a long hose and into the smokers’ airways, lungs and, ultimately, into blood circulation.  As hookah becomes increasingly popular, it is critical to understand its health effects so that evidence-based policy and regulatory decisions can be made.

The research team recruited young, healthy hookah smokers that do not smoke combustible cigarettes for the study.  After abstaining from hookah, cigarettes, and alcohol for half a day and avoiding exercise for a whole day, research subjects relaxed in a quiet room for 15 minutes then smoked hookah in a controlled smoking chamber for 30 minutes.  The research team measured heart rate, blood pressure, respiration, vascular stiffness, and blood nicotine levels of subjects before, and immediately after smoking.  As a control, the same measurements were taken on a sub-set of research subjects who were present in the same setting for the same period of time without smoking hookah.

As expected, based on previous studies, hookah smoking caused increases in heart rate, respiratory rate, blood pressure and blood nicotine levels.  The team’s novel finding was that hookah smoking subjects experienced a greater vascular stiffening in large arteries compared to non-smoking controls.  Vascular stiffness is an early sign of hypertension and, left unchecked, can put too much stress on the heart and lead to heart attack or heart failure.  Moreover, the increases in vascular stiffness observed in this study are equivalent to those reported after smoking combustible cigarettes.

While hookah has previously been marketed and is perceived by users as a safer alternative to combustible cigarettes, the results of this study demonstrate that, to the contrary, the acute cardiovascular effects are comparable to those observed from combustible cigarettes. Dr. Rezk-Hanna and Dr. Ronald’s results offer evidence of the harm caused by hookah to inform policy and regulatory decision makers.


Read the full text article at the American Journal of Cardiology (subscription required)

hookah pipe surrounded by a cloud of smoke