Water pipes – hookahs or nargilas – are thought by users and even many physicians to be “less dangerous” than cigarettes to the respiratory system.

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 products.

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.

This misleads users into thinking it is “less harmful.”

According to an ICA survey, almost 22 percent of Israeli youths have tried water pipes.

As 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 280.

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.”

Meanwhile, the 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.

Three groups of smokers, including 57 water-pipe smokers, 30 deep-inhalation cigarette smokers and 51 normal-inhalation cigarette smokers were identified and studied.

Forty-four nonsmokers were studied as a control group.

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 were found.

A quarter to a third of water-pipe smokers suffered from wheezing, while almost 37% had chest tightness and 21% had a cough.

“Our study is the first report regarding the importance of the method of cigarette smoke inhalation with respect to effects on the respiratory system,” Boskabady concluded.

“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.

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