Health Scan: Drivers: Beware of hookah smoking!

Now researchers at the Institute of Technology examine the connection between smoking a hookah (nargila) and driving.

By JUDY SIEGEL-ITZKOVICH
Teenagers drinking and smoking Hookah 521 (photo credit: Ariel Jerozolimski)
Teenagers drinking and smoking Hookah 521
(photo credit: Ariel Jerozolimski)
Road safety researchers have shown many times that drivers who smoke cigarette are much more likely to be involved in accidents than nonsmokers because their hands are occupied, and some even bend down to pick up lit butts from the floor. Now researchers at the transportation research institute of the Technion- Israel Institute of Technology in Haifa have conducted the first scientific research of its kind in the world to examine the connection between smoking a hookah (nargila) and driving.
The team, headed by Dr. Wafa Elias in cooperation with Ziv Hospital in Safed, found that smoking the water pipe increases involvement in traffic accidents by 40 percent – not because they’re doing it in the car but because of its effects on their brains and their risk-taking personality.
The research, which examined the effect of smoking a hookah on driving, continues other researches that pointed to damage such as the high amount of nicotine that the smoker inhales when using a hookah, because of the high amount of smoke inhaled in each suction. “There is a myth that hookah smoke, which passes through water, is filtered and therefore less dangerous,” said Elias, “but this is not true. On the contrary – the water cools the smoke and allows it to penetrate deeper into the lungs, thus increasing the damage caused while smoking.
One hour of smoking a hookah is equivalent to smoking 100 to 200 ordinary cigarettes.”
The study included 100 men and women aged 18 to 60 years, 70% of whom are hookah smokers; the remaining 30% were the control group.
All participants had similar characteristics, such as where they live, their driving experience and whether they are cigarette smokers. The research began with every participant smoking for half an hour one “head” of apple-flavored hookah tobacco. After smoking, the trial participants drove a simulator that simulated a 10-kilometer drive, during which the driver experienced 10 different driving-related events throughout which his reaction was measured, such as traffic lights, crossing cars, pedestrians crossing the road, dogs crossing the road and a dirt mound in the lane.
The hookah smoking group demonstrated a higher tendency to take risks when driving immediately after smoking a nargila. The involvement of this group in traffic accidents was 40% higher than that of the drivers in the control group. Even half an hour after smoking the hookah, simulator driving results showed two disturbing findings – these drivers had a 31% higher tendency to cross the road centerline (failure to keep from crossing the centerline) than the drivers in the control group. Another characteristic was a 33% increase in the total time during which the driver was not inside the driving lane and crossed the center- and sidelines of the lane. These two measures, crossing the center line and failure to remain inside the lane, indicate that driving stability is negatively affected after smoking a hookah. As a result, driving becomes less stable and more dangerous.
Smoking the hookah raised the heart rate of hookah smokers from 80 to 95 beats per minute, said Elias. “The increase in their heart rate resulted from hypoxia – a lack of oxygen and an increase in carbon monoxide levels in the blood – up to five times more than in a cigarette.
Hypoxia causes slurred speech, slow movements, dizziness, slight tremor, lack of self-control, a feeling of euphoria, decreased sight, decreased ability to identify colors, etc. High levels of carbon monoxide could result in brain damage and loss of consciousness.
“The heartbeat and carbon monoxide levels remained high even half an hour after smoking a hookah. These findings are highly significant, based on studies that show that carbon monoxide remains in the blood for four to six hours.
Drivers who smoke a hookah take more risks when driving. Smoking a hookah reduces caution and stability when driving,” she said. The study also examined, among others, the social tendencies of its participants. Most hookah smokers do not smoke cigarettes, as most of them mistakenly think it’s is an unhealthy habit.
Most of them also eschew alcohol.
Elias noted in her lecture that use of the hookah, which began in the Middle East, has increased in the Arab sector such that even women smoking a hookah is widely accepted.
Hookah smoking is currently a popular practice in many countries, yet research literature worldwide does not include any research that examines the impact of smoking on driving. “My Jewish students told me that use of the hookah has become common also among their friends, and a proof of this is the hookahs sold in almost every kiosk,” she said.
Drivers who smoked a hookah demonstrate a high level of risk-taking when driving and noncompliance with red traffic lights. The reason is that smoking a single hookah increases carbon monoxide in the blood by an amount equivalent to smoking 100 to 200 cigarettes.
Research institute head Prof. Shlomo Bekhor and National Road Safety Authority chairman Dr.
Shay Soffer, who organized the conference, stressed that the passive safety of vehicles was exhausted and most of the attention is now given to active safety. “Even in the more popular cars in the market today it is easy to find six airbags, a safety cage and systems such as ABS (anti-lock braking system) and ESP (electronic stability control),” said Soffer. “We are entering an era in which active systems are developed that warn the driver about lane departure and safety distance and provide traction control. For this reason, scientific researchers are an isle of excellence that helps us save lives. Traffic accidents are a global epidemic. Our war against them has had a significant impact. The number of Israeli fatalities from the beginning of the year until today is 100 fatalities lower than this number in the same period last year,” Soffer concluded.