It contains smoke from the tobacco as well as smoke from the heat source (e.g., charcoal) used in the hookah. Secondhand smoke from hookahs can be a health risk for people who don’t smoke.People who smoke hookah may be at risk for some of the same diseases as cigarette smokers.The amount of smoke inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500–600 ml inhaled when smoking a cigarette.In a single water pipe session, users are exposed to up to 9 times the carbon monoxide and 1.7 times the nicotine of a single cigarette. In a typical 1-hour hookah smoking session, users may inhale 100–200 times the amount of smoke they would inhale from a single cigarette.Because of the way a hookah is used, people who smoke hookah may absorb more of the toxic substances also found in cigarette smoke than people who smoke cigarettes do.This may put hookah users at additional risk. The heat sources used to burn hookah tobacco release other dangerous substances, like carbon monoxide.The tobacco in hookahs is exposed to high heat from burning charcoal, and the smoke is at least as toxic as cigarette smoke.Water pipe smoking delivers nicotine-the same highly addictive drug found in other tobacco products.Although many users think it is less harmful, studies have shown that hookah smoke contains many of the same harmful components found in cigarette smoke, such as nicotine, tar, and heavy metals.Hookah Smoking Compared With Cigarette Smoking Babies born to people who use hookah are also at increased risk for respiratory diseases.Babies born to people who smoked water pipes every day while pregnant weigh less at birth (at least 3½ ounces less) than babies born to those who do not smoke.Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart disease.Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder, and oral cancers.Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals.Limited information is currently available on the health risks of electronic tobacco products, including electronic hookahs.These products are battery powered and turn liquid containing nicotine, flavorings, and other chemicals into an aerosol, which is inhaled.New forms of electronic hookah products, including steam stones and hookah pens, have been introduced.These studies show past-year use ranging from 22% to 40%. Other small studies of young adults have found high prevalence of hookah use among college students in the United States.In 2018, the highest prevalence of use was observed in the Northeast, where 1 in 6 (15.0%) young adults aged 19-30 years had used a hookah to smoke tobacco during the previous year, and in very large cities, where almost 1 in 5 (19.3%) young adults in this age group reported past year use. Monitoring the Future also shows variations in hookah use by region and population density.Among 12 th graders, annual hookah use increased from nearly 1 in 6 students (17.1%) in 2010 to about 1 in 4 students (22.9%) in 2014, but since that time has decreased sharply to nearly 1 in 13 students (7.8%) in 2018.About 1 in every 8 (12.3%) young adults aged 19-30 years had used a hookah to smoke tobacco during the previous year.Nearly 1 in every 13 (7.8%) high school students in the United States had used a hookah to smoke tobacco during the previous year.
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