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Hookah Packs 25 Times the Tar of a Single Cigarette

And that's not even the half of it.

There’s really no grey area when it comes to the negative impact cigarettes have on our health. We know they’re terrible. But hookah? That’s been a bit of a question mark. 

New research from the American Thoracic Society found evidence of lung function abnormalities in cells lining the airways of light-use hookah smokers. These are men and women who smoke no more than three bowls per week for fewer than five years averaging the age of 24. Compared to nonsmokers, hookah users coughed more frequently and produced more mucus and had a greater circulation of small particles (shed by endothelial cells) in the lungs, which indicates ongoing damage to the capillaries.

This comes after researchers from the University of Pittsburgh School of Medicine sought to see how dangerous hookah smoke is for men and women since the Centers for Disease Control and Prevention recently reported that, for the first time in history, past 30-day use of hookah tobacco was higher than past 30-day use of cigarettes among U.S. high school students. What's more, about a third of U.S. college students have smoked tobacco from a hookah when most of those individuals never previously used forms of tobacco.

In the meta-analysis (a mathematical summary of previously published data) of over 540 articles boiled down to 17 relevant studies, researchers found hookah smokers are, in fact, inhaling a huge amount of toxicants.

When 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, the researchers discovered. But they note that comparing a hookah smoking session to smoking a single cigarette is tricky because the patterns are so different. For example, a frequent cigarette smoker may smoke 20 cigarettes per day, while a hookah smoker may only participate in a few hookah sessions each week.

"It's not a perfect comparison because people smoke cigarettes and hookahs in very different ways,” says lead study author Brian A. Primack, M.D., Ph.D. "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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