Water pipes – hookahs or nargilas – are thought by users and even many
physicians to be “less dangerous” than cigarettes to the respiratory
They think that forcing the smoke to go through water before it
reaches the lungs filters out the toxins.
But Iranian researchers at
Mashhad University of Medical Science – who have just published a study on the
matter in the journal Respirology – have found that nargilas are just as harmful
to lung function and the respiratory system as conventional tobacco
Asked to comment, the Israel Cancer Association noted that most
nargila tobacco is imported (or smuggled in) from Arab countries, where the
tobacco crops are watered with sewage water. There is also no supervision of
tobacco production by the authorities there.
The ICA added that smoke
from nargilas contain tar – benzoapyrene is a polycyclic aromatic hydrocarbon
found in coal tar that causes mutations and is highly carcinogenic – arsenic,
chromium and lead, as well as the addictive nicotine. The byproducts are
mutagenic and highly carcinogenic.
Smoking a water pipe is a drawn-out
process, unlike smoking a cigarette.
Nargila tobacco packets are usually
designed with pictures of fruits, and a sweet odor is added to mislead users
into thinking they are somehow “healthful and innocent,” the ICA added. Besides
lung cancer and other ills, nargila users are at risk of throat cancer, herpes
of the lips and infectious mononucleosis (“kissing disease”) because the water
pipes are passed around.
Many Israeli children who use them were
introduced to their use by their parents or other adults who share the water
pipe with them. The moisture created by the water eases the feeling of dryness
caused in the throat by the smoking compared to cigarettes.
misleads users into thinking it is “less harmful.”
According to an ICA
survey, almost 22 percent of Israeli youths have tried water pipes.
the tobacco is cheaper than cigarettes, the Knesset Finance Committee recently
raised taxes on nargila tobacco to gradually make their cost equal. The price of
a kilo of nargila tobacco has been raised from NIS 50 to NIS 115; this will go
up in early 2013 to NIS 185, to NIS 230 in 2014 and the following year to NIS
The ICA is fighting the use of water pipes, which by law (which is
not well enforced and is regularly violated) cannot be sold to minors, with
information campaigns such as “Nargilas are Cigarettes.”
Iranian research, headed by Dr. Mohammad Hossein Boskabady, was intended
to compare lung function and respiratory symptoms among water pipe smokers,
deep- or normal- inhalation cigarette smokers and nonsmokers.
groups of smokers, including 57 water-pipe smokers, 30 deep-inhalation cigarette
smokers and 51 normal-inhalation cigarette smokers were identified and
Forty-four nonsmokers were studied as a control
Results showed an increased prevalence and severity of respiratory
symptoms among water-pipe smokers and cigarette smokers. Similar effects of
water-pipe smoking and deep-inhalation cigarette smoking on respiratory status
A quarter to a third of water-pipe smokers suffered from
wheezing, while almost 37% had chest tightness and 21% had a cough.
study is the first report regarding the importance of the method of cigarette
smoke inhalation with respect to effects on the respiratory system,” Boskabady
“Our findings reveal that there were profound effects of water
pipe smoking on lung function values, which were similar to the effects observed
in deep inhalation cigarette smokers,” the Iranians said.