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Hookah smokers inhale more smoke than cigarette users
June 3, 2018, 11:45 am

Smoking tobacco from a hookah (water-pipe) accounted for over half of the tobacco smoke volume consumed by young adult hookah and cigarette smokers, shows a new study by the University of Pittsburgh.

The study, funded by the National Cancer Institute in the US, found that toxicants exposures — such as tar, carbon monoxide and nicotine — were lower, yet substantial, for those young adults who smoked tobacco just using a hookah, compared to those who smoked both hookah and cigarettes.

Since most hookah smokers are not daily users, while many cigarette users smoke multiple times a day, it might appear that the vast majority of public health and policy-related interventions should be directed at cigarette smoking. But the new research shows that hookah smoking contributes significantly to the burden of tobacco smoke-related toxicants inhaled by young people. As such, it is imperative that public health and policy efforts should explicitly address hookah smoking in addition to cigarette smoking.

Whereas smoking one cigarette involves about 10 to 12 puffs, each containing a volume of 50 milliliters of smoke, one 45- to 60-minute hookah session can involve 100 inhalations of about 500 milliliters each. This results in large smoke loads for hookah smokers, even if their use is less frequent. Hookah smoking accounted for 54.9 percent of the smoke, 20.9 percent of tar, 10.3 percent of carbon monoxide and 2.4 percent of nicotine consumed by participants in the previous 30 days of the study conducted by the university.

Smoking tobacco from a hookah attracts young users because it is flavored and sweetened, done in a social setting and is often less irritating compared to cigarette smoking. Besides being a direct source of toxicants itself, hookah smoking has been linked to transition to cigarette smoking. All of this, combined with the new findings around the volume of hookah smoke consumed, should guide future efforts to prevent young adults from becoming hookah smokers.

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