Indian Journal of Public Health

: 2014  |  Volume : 58  |  Issue : 3  |  Page : 204--205

The hookah experience: Stop them before it's too late!!!!

Vishal Khandelwal1, Ullal Anand Nayak2, Prathibha Anand Nayak3, Sushma Khandelwal4,  
1 Senior Lecturer, Department of Pediatric and Preventive Dentistry, IIDS, Indore, Madhya Pradesh, India
2 Professor and Head, Department of Pedodontics, Mahatma Gandhi Dental College, Jaipur, Rajasthan, India
3 Associate Professor, Department of Pedodontics, Mahatma Gandhi Dental College, Jaipur, Rajasthan, India
4 Lecturer, Department of Rasa Shastra, Shri Dhanwantri Ayurvedic Medical College and Research Centre, Mathura, Uttar Pradesh, India

Correspondence Address:
Dr. Vishal Khandelwal
Senior Lecturer, Department of Pediatric and Preventive Dentistry, IIDS, Indore - 453 112, Madhya Pradesh

How to cite this article:
Khandelwal V, Nayak UA, Nayak PA, Khandelwal S. The hookah experience: Stop them before it's too late!!!!.Indian J Public Health 2014;58:204-205

How to cite this URL:
Khandelwal V, Nayak UA, Nayak PA, Khandelwal S. The hookah experience: Stop them before it's too late!!!!. Indian J Public Health [serial online] 2014 [cited 2021 Apr 10 ];58:204-205
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Full Text


A growing body of frightening evidence suggests that children and the youth in India are experimenting with an alternate form of tobacco "the hookah or water pipe," which is available in a variety of flavors (apple, mint, cherry, chocolate, liquorice, etc.). In recent years, there has been a resurgence of the use of hookah around the world; most notably among young adults, especially professionals [1] and also in young people and women who, otherwise did not smoke cigarettes are beginning to use tobacco by smoking the hookah.

The hookah is used to smoke specially made tobacco by indirectly heating the tobacco, usually with burning embers or charcoal. The smoke is filtered through a bowl of water and then drawn through a rubber hose to a mouthpiece. The hookah is also known as, Narghile, Argileh, Shisha, Hubble-bubble, and Gaza. [1]

Similar to cigarettes, hookah is also related to various preventable diseases including coronary heart disease, adverse pulmonary effects and cancers of the lung, mouth, esophagus and bladder, reduced lung function, and decreased fertility. This is because hookah smoke contains carcinogens and heavy metals similar to cigarette smoke. [2]

Hookah smoking is typically practiced in groups, thus second-hand smoke from hookahs also poses a serious risk, as it contains smoke not only from the tobacco, but also from the heat source (e.g., charcoal) used in the hookah. [3] Sharing a hookah may increase the risk of transmission of tuberculosis, viruses such as herpes or hepatitis and other illnesses. The characteristic longer smoking sessions combined with increased smoke volume with the hookah make it potentially more dangerous than cigarette smoking. [4] A typical 1-h long hookah smoking session involves inhaling 100-200 times the volume of smoke inhaled from a single cigarette. [3] Due to the mode of smoking, including frequency of puffing, depth of inhalation, and length of the smoking session, hookah smokers could absorb higher concentrations of the toxins found in cigarette smoke. [1] However, many hookah users believe it to be safer and the increasing number of adolescents and young adults are unaware of the tobacco content of hookah and its harmful effects.

The Indian government prohibits the use of tobacco in public places and places of employment. However, unfortunately, the popularity of hookahs and the establishments that rent hookah pipes have increased greatly in the past decade in India, and are usually located in proximity to schools and colleges. There is also an increase in the number of "hookah lounges," which are commercial establishments where individuals can gather to socialize and smoke hookah. [5] The expansion of the hookah bar and café industry, especially in metropolitan cities and near universities and colleges illustrates the growth potential for hookah marketing and use. The target audience to these lounges is college students and young professionals in the age group of 18-30 years. An estimated 40-50 hookah lounges (liquide fumee) are being run in major Indian cities and the numbers continue to grow.

Cigarettes and gutkha have traditionally been the focus of media campaigns on the health hazards. The lack of such promotions on the dangers of hookah smoking may also be contributing to the increase in hookah use. Therefore, the antitobacco campaign community and tobacco research community should evaluate the social and personal health hazards and address the growing hookah epidemic through aggressive research and media messaging. Prevention methods like restricting the opening and running of hookah lounges are necessary to prevent this rising public health concern.


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3World Health Organization (Tobacco Free Initiative). website Advisory Note. Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators. 2005. Available from: [Last retrieved on 2005 Dec 15; Last accessed on 2013 Sep 12].
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