Hookah

For other uses of "Hookah", see Hookah (disambiguation).

An Egyptian hookah (shisha)
An Indian man smoking hookah, Rajasthan, India

A hookah (Arabic: أرجيلة [arghileh]; Persian: قلیان [qalyān]; Hindustani: हुक़्क़ा (Devanagari) حقّہ (Nastaleeq)[hukkā], ḥuqqah, Hukić—also known as a Pneumatic Water Pipe, narghile, arghileh, qalyān, or by other names) is a single or multi-stemmed instrument for vaporizing and smoking flavored tobacco, called shisha, whose vapor or smoke is passed through a water basin—often glass-based—before inhalation.[1][2][3]

Health risks of smoking hookah include exposure to toxic chemicals that are not filtered out by the water[4] and risk of infectious disease when hookahs are shared.[5][6] The waterpipe was either invented by an Irfan Shaikh of the Mughal Empire or originates from the time of the Safavid dynasty of Persia,[7][8][9][10] from where it eventually spread to the east into India during that time.[7][11][12][13] The hookah or Argyleh also soon reached Egypt and the Levant during the Ottoman dynasty from neighbouring Safavid dynasty, where it became very popular and where the mechanism was later perfected.

The word hookah is a derivative of "huqqa", an Arabic term.[14] Outside its native region, hookah smoking has gained popularity in Australia, Europe, North America,[15] South America, Southeast Asia, Tanzania, and South Africa, largely due to immigrants from the Levant, where it is especially popular, especially among younger people.

Names and etymology

A small hookah/argileh

Argilah or Argileh (Arabic: أرجيلة‎,[16] sometimes pronounced Argilee) is the name most commonly used in Lebanon, Syria, Palestine, Jordan, Israel, Azerbaijan, Uzbekistan and Iraq. Nargile derives from the Persian word nārghile, meaning coconut, which in turn comes from the Sanskrit word nārikela (नारिकेल), suggesting that early hookahs were hewn from coconut shells.[17][18]

In Croatia, Serbia, Bosnia and Herzegovina, the Republic of Macedonia, Turkey and Bulgaria, na[r]gile (на[р]гиле; from Persian nargile) is used to refer to the pipe. Šiša (шиша) refers to the tobacco that is smoked in it. The pipes there often have one or two mouth pieces. The flavored tobacco, created by marinating cuts of tobacco in a multitude of flavored molasses, is placed above the water and covered by pierced foil with hot coals placed on top, and the smoke is drawn through cold water to cool and filter it. In Albania, the hookah is called "lula" or "lulava".

"Narguile"[19] is the common word in Spain used to refer to the pipe, although "cachimba"[20] is also used, along with "shisha" by Moroccan immigrants in Spain.

Shisha or sheesha (شيشة), from the Persian word shīshe (شیشه), meaning glass, is the common term for the hookah in Egypt, Sudan and countries of the Arab Peninsula (including Kuwait, Bahrain, Qatar, Oman, UAE, Yemen and Saudi Arabia), and in Algeria, Morocco, Greece, Tunisia and Somalia. In Yemen, the term mada'a (مداعة) is also used.

In Persia, hookah is called "Qalyān" (قلیان). Persian qalyan is included in the earliest European compendium on tobacco, the tobacolgia written by Johan Neander and published in Dutch in 1622. It seems that over time water pipes acquired a Persian connotation as in eighteenth-century Egypt the most fashionable pipes were called Karim Khan after the Persian ruler of the day.[21] This is also the name used in Ukraine, Russia and Belarus.

In Uzbekistan and Afghanistan, a hookah is called chillim.[22]

In Pakistan the name most similar to the English hookah is used: huqqa (حقّہ), In Sindhi its called Huqqo (حُقو).[23]

In Maldives, hookah is called "Guduguda".[24]

In Philippines, hookah is called "Hitboo" and normally used in smoking flavored marijuana.[25] The hookah pipe is also known as the "Marra pipe" in the UK, especially in the North East, where it is used for recreational purposes.

The widespread use of the Indian word "hookah" in the English language is a result of the British Raj, the British dominion of India (1858–1947), when large numbers of expatriate Britons first sampled the water pipe. William Hickey, shortly after arriving in Kolkata, India, in 1775, wrote in his Memoirs:

The most highly-dressed and splendid hookah was prepared for me. I tried it, but did not like it. As after several trials I still found it disagreeable, I with much gravity requested to know whether it was indispensably necessary that I should become a smoker, which was answered with equal gravity, "Undoubtedly it is, for you might as well be out of the world as out of the fashion. Here everybody uses a hookah, and it is impossible to get on without ...[I] have frequently heard men declare they would much rather be deprived of their dinner than their hookah."[26]

History

Smoking The Hookah

According to Cyril Elgood (PP.41, 110) in India the physician Irfan Shaikh, at the court of the Mughal emperor Akbar I (1542 - 1605 AD) invented the idea.[27][28][29][30] However, a quatrain of Ahlī Shirazi (d. 1535), a Persian poet, refers to the use of the ḡalyān (Falsafī, II, p. 277; Semsār, 1963, p. 15), thus dating its use at least as early as the time of the Shah Ṭahmāsp I. It seems, therefore, that Abu’l-Fath Gilani should be credited with the introduction of the ḡalyān, already in use in Persia, into India.[27] There is, however, no evidence of the existence of the water pipe until the 1560s. Moreover, tobacco is believed to have reached Persia around 1600, so that suggests another substance was probably smoked in Ahlī Shirazi's quatrain, perhaps through some other method.[31]

Following the European introduction of tobacco to Persia and India, Hakim Abu’l-Fath Gilani, who came from Gilan, a province in the north of Persia, migrated to Hamarastan.[32] He later became a physician in the Mughal court and raised health concerns after smoking tobacco became popular among Indian noblemen.[33] He subsequently envisaged a system which allowed smoke to be passed through water in order to be 'purified'.[28] Gilani introduced the ḡalyān after Asad Beg, the ambassador of Bijapur, encouraged Akbar I to take up smoking.[28] Following popularity among noblemen, this new device for smoking soon became a status symbol for the Indian aristocracy and gentry.[28][30]

Modern development

Instead of copper, brass and low quality alloys manufacturers increasingly use stainless steel and aluminium. Silicone rubber compounds are used for hookah hoses instead of leather and wire. New materials make modern hookahs more durable, eliminate odors while smoking and allow washing without risks of corrosion or bacterial decay. New technologies and modern design trends are changing the appearance of hookahs.[34]

Despite obvious benefits of modern hookahs, because of high production cost and lack of modern equipment in traditional hookah manufacturing regions, most of the hookahs are still produced with older technologies.

Culture

Middle East

A café in Istanbul, 1905

In the Arab world and the Middle East, people smoke waterpipes as part of their culture and traditions. Local names of waterpipe in the Middle East are, argila, čelam/čelīm, ḡalyān or ghalyan, ḥoqqa, nafas, nargile, and shisha. [27]

Social smoking is done with a single or double hose hookah, and sometimes even triple or quadruple hose hookahs are used at parties or small get-togethers. When the smoker is finished, s/he either places the hose back on the table, signifying that it is available, or hands it from one user to the next, folded back on itself so that the mouthpiece is not pointing at the recipient.

Most cafés in the Middle East offer shishas.[35] Cafés are widespread and are amongst the chief social gathering places in the Arab world (akin to public houses in Britain).[36]

Persia

Naser al-Din Shah Qajar smoking qalyan
Persian woman with hookah (qalyan), 1900, Iran

The exact date of the first use of ḡalyān in Persia is not known. However, the earliest known literary evidence of the hookah, anywhere, comes in a quatrain by Ahlī Shirazi (d. 1535), a Persian poet, referring to the use of the ḡalyān (Falsafī, II, p. 277; Semsār, 1963, p. 15), thus dating its use at least as early as the time of the Shah Ṭahmāsp I. This suggests, the hookah was already in use in ancient Persia, and it made its way into India soon afterward.[27]

Although the Safavid Shah ʿAbbās I strongly condemned tobacco use, towards the end of his reign smoking ḡalyān and čopoq (q.v.) had become common on every level of the society, women included. In schools, both teachers and students had ḡalyāns while lessons continued (Falsafī, II, pp. 278–80). Shah Safi of Persia (r. 1629-42) declared a complete ban on tobacco, but the income received from its use persuaded him to soon revoke the ban.[37] The use of ḡalyāns became so widespread that a group of poor people became professional tinkers of crystal water pipes. During the time of Abbas II of Persia (r. 1642-1666), use of the water pipe had become a national addiction (Chardin, tr., II, p. 899). The shah (king) had his own private ḡalyān servants. Evidently the position of water pipe tender (ḡalyāndār) dates from this time. Also at this time, reservoirs were made of glass, pottery, or a type of gourd. Because of the unsatisfactory quality of indigenous glass, glass reservoirs were sometimes imported from Venice (Chardin, tr., II, p. 892). In the time of Suleiman I of Persia (r. 1694-1722), ḡalyāns became more elaborately embellished as their use increased. The wealthy owned gold and silver pipes. The masses spent more on ḡalyāns than they did on the necessities of life (Tavernier apud Semsār, 1963, p. 16).

An emissary of Sultan Husayn (r.1722-32) to the court of Louis XV of France, on his way to the royal audience at Versailles, had in his retinue an officer holding his ḡalyān, which he used while his carriage was in motion (Herbette, tr. p. 7; Kasrawī, pp. 211–12; Semsār, 1963, pp. 18–19). We have no record indicating the use of ḡalyān at the court of Nader Shah, although its use seems to have continued uninterrupted. There are portraits of Karim Khan of the Zand dynasty of Iran and Fat′h-Ali Shah Qajar which depict them smoking the ḡalyān.[38] Iranians had a special tobacco called Khansar (خانسار, presumably name of the origin city, Khvansar). The charcoals would be put on the Khansar without foil. Khansar has less smoke than the normal tobacco.

Saudi Arabia

Saudi Arabia is in the process of implementing general smoking bans in public places. This includes shishas.[39][40] Additionally, the city of Riyadh has banned shisha cafes within city limits.

Syria

Bedouin smoking a hookah, locally called nargileh, in a coffeehouse in Deir ez-Zor, on the Euphrates, 1920s.

Although perceived to be an important cultural feature of Syria (see Smoking in Syria), narghile had declined in popularity during most of the twentieth century and was used mostly by older men. Similar to other Middle Eastern countries, its use increased dramatically during the 1990s, particularly among youth and young adults.[41][42] As of 2004, prior to the Syrian Civil War, 17% of 18- to 29-year-olds, 10% of 30- to 45-year-olds, and 6% of 46- to 65-year-olds reported using narghile, and use was higher in men than women.[42] More recent data is not available.

Turkey

Nargile became part of Turkish culture from the 17th century. Back then, it became prominent in society and was used as a status symbol. Nargile was such an important Turkish custom that it even sparked a diplomatic crisis between France and the Ottoman Empire.[43] Western Turkey is noted for its traditional pottery production where potters make earthenware objects, including nargile bowls.[44]

South Asia

India

Mughal emperor, Jahangir's jade hookah, National Museum, New Delhi.
The intricate work on a Malabar Hookah
Gaddi village men with hookah, on mountain path near Dharamsala, India

The concept of hookah is thought to have originated In India,[45] once the province of the wealthy, it was tremendously popular especially during Mughal rule. The hookah has since become less popular; however, it is once again garnering the attention of the masses, and cafés and restaurants that offer it as a consumable are popular. The use of hookahs from ancient times in India was not only a custom, but a matter of prestige. Rich and landed classes would smoke hookahs.

Tobacco is smoked in hookahs in many villages as per traditional customs. Smoking tobacco-molasses is now becoming popular amongst the youth in India. There are several chain clubs, bars and coffee shops in India offering a wider variety of mu‘assels, including non-tobacco versions. Hookah was recently banned in Bangalore. However, it can be bought or rented for personal usage or organized parties.[46]

Koyilandy, a small fishing town on the west coast of India, once made and exported hookahs extensively. These are known as Malabar Hookhas or Koyilandy Hookahs. Today these intricate hookahs are difficult to find outside Koyilandy and are becoming difficult even to find in Koyilandy itself.

As hookah makes resurgence in India, there have been numerous raids and bans recently on hookah smoking, especially in Gujarat.[47]

Pakistan

Although it has been traditionally prevalent in rural areas for generations,[48] smoking hookahs has become very popular in the cosmopolitan cities of Pakistan. One can see many cafés in Pakistan offering hookah smoking to its guests. Even lots of households have hookahs for smoking or decoration purposes.

In Punjab, Pakhtunkhwa, and in northern Balochistan, the topmost part on which coals are placed is called chillum.

In big cities like Karachi and Lahore, cafes and restaurants offered Hookah and charged per hour. In 2013, it was banned by the Pakistan Supreme court. The cafe owners started offering shisha to minors which was the major reason for the ban.[49]

Bangladesh

The hookah has been a traditional smoking instrument in Bangladesh, particularly among the old Bengali zamindar gentry.[50] However, flavored shisha was introduced in the early 2000s. Hookah lounges spread quite quickly between 2008–2011 and became popular among young people as well as middle-aged people as a relaxation method. There have been allegations of a government crack-down on hookah bars to prevent illicit drug usage.[51]

Nepal

A hookah at a restaurant in Nepal

Hookahs (हुक़्क़ा), especially wooden ones, are popular in Nepal. Use of hookahs is considered to symbolize elite family throughout history. These days hookahs are also getting popular among younger people and tourists. The main tourists places like Kathmandu, Pokhara and Dharan are famous for Hookah Bars. You can smoke hookahs at the rate of 175 Rs Minimum [52]

Southeast Asia

In Southeast Asia, the hookah, where it is predominantly called shisha, was particularly used within the Arab and Indian communities.

Hookah was virtually unknown in Southeast Asia before the latter 20th century, yet the popularity among contemporary younger people is now vastly growing. Southeast Asia's most cosmopolitan cities, Makati, Bangkok, Singapore, Phnom Penh, Siem Reap, Hanoi and Ho Chi Minh City, now have various bars and clubs that offer hookahs to patrons.

Although hookah use has been common for hundreds of years and enjoyed by people of all ages, it has just begun to become a youth-oriented pastime in Asia in recent times. Hookahs are most popular with college students, and young adults, who may be underage and thus unable to purchase cigarettes.[53]

South Africa

In South Africa, hookah, colloquially known as a hubbly bubbly or an okka pipe, is popular amongst the Cape Malay and Indian populations, wherein it is smoked as a social pastime.[54] However, hookah is seeing increasing popularity with white South Africans, especially the youth. Bars that additionally provide hookahs are becoming more prominent, although smoking is normally done at home or in public spaces such as beaches and picnic sites.

In South Africa, the terminology of the various hookah components also differ from other countries. The clay "head/bowl" is known as a "clay pot". The hoses are called "pipes" and the air release valve is known as a "clutch".

The windscreen (which is considered optional and not used by most people) is known as an "As-jas", which directly translates from Afrikaans to English as an "ash-jacket". Also, making/preparing the "clay pot" is commonly referred to as "racking the hubbly".

Some scientists point to the marijuana pipe as an African origin of hookah.[55]

United States and Canada

See also: Hookah lounge
A hookah and a variety of tobacco products are on display in a Harvard Square store window in Cambridge, Massachusetts, United States.

During the 1960s and 1970s, hookahs were a popular tool for the consumption of various derivations of tobacco, among other things.[56] At parties or small gatherings the hookah hose was passed around with users partaking as they saw fit. Typically, though, open flames were used instead of burning coals.

Today, hookahs are readily available for sale at smoke shops and some gas stations across the United States, along with a variety of tobacco brands and accessories. In addition to private hookah smoking, hookah lounges or bars have opened in cities across the country.

Recently, certain cities, counties, and states have implemented indoor smoking bans. In some jurisdictions, hookah businesses can be exempted from the policies through special permits. Some permits, however, have requirements such as the business earning a certain minimum percentage of their revenue from alcohol or tobacco.

In cities with indoor smoking bans, hookah bars have been forced to close or switch to tobacco-free mixtures. In many cities though, hookah lounges have been growing in popularity.[57] From the year 2000 to 2004, over 200 new hookah cafés opened for business, most of them targeted at young adults[58] and located near college campuses or cities with large Middle-Eastern communities. This activity continues to gain popularity within the post-secondary student demographic.[59] Hookah use among high school students rose from 4.1% to 9.4% from 2011 to 2014 while cigarette smoking decreased from 15.8% to 9.2% during this same time period, according to the US CDC.[60] According to a 2011 study, 40.3 percent of college and university students surveyed had smoked tobacco from a hookah.[61] As of 8 July 2013, at least 1,178 college or university campuses in the U.S. have adopted 100% smokefree campus policies that eliminate smoking in indoor and outdoor areas across the entire campus, including residences.[62]

Structure and operation

How to Hookah-video

Components

Excluding grommets, a hookah consists of a number of components, four of which are essential for its operation.

Bowl

Also known as the head of the hookah, the bowl is a container, usually made out of clay, marble, or glass that holds the coal and tobacco during the smoking session. The bowl is loaded with tobacco then covered by a screen or perforated aluminum foil. Lit coals are then placed on top, which allows the tobacco to heat to the proper temperature.

Vortex Bowls

There is also a variation of the head which employs a fruit rather than the traditional clay bowl. The fruit is hollowed out and perforated in order to achieve the same shape and system a clay bowl has, then it is loaded and used in the same manner.

Bowls have evolved in recent years to incorporate new designs that keep juices in the tobacco from running down the stem. The Tangiers Phunnel Bowl and Sahara Smoke Vortex Bowl are two examples of such bowls.

Windscreen

A Hookah Cover windscreen is a cover which sits over the bowl area, with some form of air holes. This prevents wind from increasing the burn rate and temperature of the coal, and prevents ash and burning embers from being blown onto the surrounding environment. This may also offer some limited protection from fire as it may prevent the coal from being ejected if the hookah is bumped.

Hose

Today, the hose (one or more) is a slender flexible tube that allows the smoke to be drawn for a distance, cooling down before inhalation. The end is typically fitted with a metal, wooden, or plastic mouthpiece of different shapes, size, color or material type. According to J.S. Gamble in A Manual of Indian Timbers in 1902 (Page 668), the bark of the white Himalayan birch Betula utilis ssp. jacquemontii was used to make early hookah tubes.

Purge valve

Many hookahs are equipped with a purge valve connected to the airspace in the water jar to purge stale smoke which has been sitting unused in the jar for too long. This one-way valve is typically a simple ball bearing sitting over a port which seals the port by gravity alone and will open if positive pressure is created by blowing into the hose. The bearing is held captive with a screw-on cover. The cover should be opened and the bearing and seat cleaned of residue and corrosion regularly to ensure proper sealing.

Water base

Woodworkers from Damascus, Syria creating wood components for hookah production (19th century)

The body of the hookah sits on top of the water base, or sometimes referred to as vase. The downstem hangs down below the level of the water in the jar. Smoke passes through the body and out the downstem where it bubbles through the water. This cools and humidifies the smoke. Liquids such as fruit juice may be added to the water or used in substitution. Pieces of fruit, mint leaves, and crushed ice may be added.

Plate

A plate or ashtray sits just below the bowl to catch ashes falling off the coals.

Grommets

Grommets in a hookah are usually placed between the bowl and the body, between the body's gasket and the water jar, and between the body and the hose. The grommets, although not essential (the use of paper or tape has become common), will help to seal the joints between the parts, therefore decreasing the amount of air coming in and maximizing the smoke breathed in.

Diffuser

A piece attached to the bottom of the stem, usually made of plastic and in a grid pattern, to make a smoother smoke and a subdued noise. By breaking the naturally larger bubbles coming up the water from the pipe into smaller bubbles, it lowers the amount of suction or "pull" needed to continue bringing smoke to the chamber. This also cools the smoke down more efficiently. It is used as a luxury item used for a better smoking experience and is not a required component.

Consumable items

Mu‘assel
A package of Al Fakher watermelon flavored hookah tobacco.

Tobacco or Mu‘assel (Arabic: معسل which means "honeyed"), also sometimes called Shisha in places where it does not refer to the Hookah itself, is a syrupy tobacco mix with molasses and vegetable glycerol as moisturizer and specific flavors added to it. Typical flavors of mu‘assel include apple, grape, guava, lemon, mint, as well as many other fruit based mixes. Non-tobacco-based mu'assel is also available in certain areas where tobacco smoking is not allowed.

Charcoal

Charcoal is the source of energy to produce heat that will be transferred to the tobacco inside the bowl. Since the glycerol is used to moisturize the tobacco, then to produce smoke, the charcoal should be able to generate heat above the boiling point of glycerol that is 290 °C. Therefore, charcoal for hookah smoking must be hard, high density, easy to ignite, and burn longer with persistent heat.[63]

Operation

Hookah cross-section view

The jar at the bottom of the hookah is filled with water sufficient to submerge a few centimeters of the body tube, which is sealed tightly to it. Deeper water will only increase the inhalation force needed to use it. Tobacco or tobacco-free molasses are placed inside the bowl at the top of the hookah. Often the bowl is covered with perforated tin foil or a metal screen and coal placed on top. The foil or screen separates the coal and the tobacco, which minimizes inhalation of coal ash with the smoke and reduces the temperature the tobacco is exposed to, in order to prevent burning the tobacco directly.

When one inhales through the hose, air is pulled through the charcoal and into the bowl holding the tobacco. The hot air, heated by the charcoal vaporizes the tobacco without burning it.[64] The vapor is passed down through the body tube that extends into the water in the jar. It bubbles up through the water, losing heat, and fills the top part of the jar, to which the hose is attached. When a smoker inhales from the hose, smoke passes into the lungs, and the change in pressure in the jar pulls more air through the charcoal, continuing the process.

If the hookah has been lit and smoked but has not been inhaled for an extended period, the smoke inside the water jar may be regarded as "stale" and undesirable. Stale smoke may be exhausted through the purge valve, if present. This one-way valve is opened by the positive pressure created from gently blowing into the hose. It will not function on a multiple-hose hookah unless all other hoses are plugged. Sometimes one-way valves are put in the hose sockets to avoid the need to manually plug hoses.

Health effects

Exposure to pathogens that cause infectious diseases

When people share a hookah, there is a risk of spreading infections diseases such as oral herpes, tuberculosis, hepatitis, influenza, and h. pylori.[65] Using disposable mouthpieces may reduce this risk but does not eliminate it.[66]

Exposure to toxic chemicals

Hookah smoke contains multiple toxic chemicals.[67] Water does not filter out many of these chemicals.[67] Hookah smoke contains toxic chemicals that come from the burning of the charcoal, tobacco, and flavorings. Hookah smokers inhale many chemicals that can cause cancer, heart disease, lung disease, and other health problems.[68] These chemicals include tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons (PAHs; e.g., benzo[a]pyrene and anthracene), volatile aldehydes (e.g. formaldehyde, acetaldehyde, acrolein), benzene, nitric oxide, heavy metals (arsenic, chromium, lead), and carbon monoxide (CO).[68] Hookah smoking increases the amount of carbon monoxide (CO) in a person's body to eight times their normal level.[69] Compared to smoking one cigarette, a single hookah session exposes users to more carbon dioxide and PAHs, similar levels of nicotine, and lower levels of tobacco-specific nitrosamines.[4][68] Because of inhaling these chemicals, hookah smokers are at increased risk of many of the same health problems as cigarette smokers.[6][67]

Short-term health effects

Carbon monoxide (CO) in hookah smoke binds to hemoglobin in the blood to form carboxyhemoglobin, which reduces the amount of oxygen that can be transported to organs including the brain. There are several case reports in the medical literature of hookah smokers needing treatment in hospital emergency rooms for symptoms of CO poisoning including headache, nausea, lethargy, and fainting.[70][71][72][73] This is sometimes called “hookah sickness.”[74] Hookah smoking can damage the cardiovascular system in several ways.[4][6] Its use elevates heart rate and blood pressure.[75] It also impairs baroreflex control (which helps to control blood pressure)[76] and cardiac autonomic functioning (which has many purposes, including control of heart rate)[4][77][78] Hookah use also acutely harms vascular functioning,[75] increases inflammation,[79] and harms lung function and reduces the ability to exercise.[80]

Long-term health effects

Current evidence indicates hookah may cause numerous health problems.[4][6][67] Hookah smoking appears to increase the risk of several cancers (lung, esophageal, and gastric), pulmonary diseases (impaired pulmonary function, chronic bronchitis, and emphysema), coronary artery disease, periodontal disease, obstetrical and perinatal problems (low birth weight and pulmonary problems at birth), larynx and voice changes, and osteoporosis. Many of the studies to date have methodological limitations, such as not measuring hookah use in a standardized way.[6] Larger, high quality studies are needed to learn more about the long-term health effects of hookah use and of exposure to hookah smoke.[6]

Effects of secondhand exposure to hookah smoke

Second-hand smoke from hookahs contains significant amounts of carbon dioxide, aldehydes, PAHs, ultrafine particles, and respirable particulate matter (particles small enough to enter the lungs).[4] Study have found that concentrations of particulate matter in the air of hookah bars were in the unhealthy to hazardous range according to Environmental Protection Agency standards.[81] The air in hookah bars also contains significant amounts of toxic chemicals including: aromatic hydrocarbons, carbon monoxide, nicotine, and trace metals. The concentrations in the air of all these toxic substances are greater than for cigarettes (for the same number of smokers per hour).[82] During a typical one-hour hookah session, a user expels into the air 2-10 times the amount of cancer-causing chemicals and other harmful chemicals compared to a cigarette smoker.[82] No studies have examined the long-term health effects of exposure to secondhand hookah smoke, but short term effects may include experience respiratory symptoms such as wheezing, nasal congestion, and chronic cough.[83][84] Hookah bar employees, who often are exposed to toxic air for extended amounts of time, may be at especially high risk of health problems from secondhand smoke.

Addiction to and dependence on hookah

Hookah smokers inhale nicotine which is an addictive chemical. A typical hookah smoking session delivers 1.7 times the nicotine dose of one cigarette[85] and the nicotine absorption rate in daily waterpipe users is equivalent to smoking 10 cigarettes per day.[86] Many hookah smokers, especially frequent users, have urges to smoke and show other withdrawal symptoms after not smoking for some time, and it can be difficult to quit.[87][88][89][90] These signs and symptoms of addiction and dependence are very similar to the signs of cigarette addiction. People who become addicted to hookah may be more likely to smoke alone.[91] Hookah smokers who are addicted may find it easier to quit if they have help from a quit-smoking counseling program.[88][92][93]

See also

References

  1. ↑ The cyclopaedia of India and of Jordan and eastern and southern Asia, Volume 2. Bernard Quaritch. 1885. Retrieved 2007-08-01. HOOKAH. Hindi. The Indian pipe and apparatus for smoking.
  2. ↑ "Hookah". Encyclopædia Britannica. Retrieved 2008-04-08.
  3. ↑ "WHO Study Group on Tobacco Product Regulation (TobReg) an advisory note Waterpipe tobacco smoking: dangerous health effects include risk to public safety if used by multiple users, research needs and recommended actions by regulators, 2005" (PDF). Who.int. Retrieved 2013-09-03.
  4. 1 2 3 4 5 6 WHO Study Group on Tobacco Product Regulation (2015). Advisory note: waterpipe tobacco smoking: health effects, research needs and recommended actions by regulator (PDF) (2nd. ed.). Geneva: World Health Organization.
  5. ↑ Akl, EA; Gaddam, S; Gunukula, SK; Honeine, R; Jaoude, PA; Irani, J (June 2010). "The effects of waterpipe tobacco smoking on health outcomes: a systematic review.". International Journal of Epidemiology 39 (3): 834–57. doi:10.1093/ije/dyq002. PMID 20207606.
  6. 1 2 3 4 5 6 El-Zaatari, ZM; Chami, HA; Zaatari, GS (March 2015). "Health effects associated with waterpipe smoking.". Tobacco Control. 24 Suppl 1: i31–i43. doi:10.1136/tobaccocontrol-2014-051908. PMID 25661414.
  7. 1 2 Sandra Alters, Wendy Schiff (28 Jan 2011). Essential Concepts for Healthy Living Update. Jones & Bartlett Learning.
  8. ↑ Nichola Fletcher (1 Aug 2005). Charlemagne's tablecloth: a piquant history of feasting. Macmillan. p. 10.
  9. ↑ Cassell (1902). "Cassell's magazine". Cassell.
  10. ↑ Harmsworth Brothers (1899). "The Harmsworth monthly pictorial magazine". Harmsworth Brothers: 372.
  11. ↑ The Wealth of India. Council of Scientific & Industrial Research. Retrieved 2007-08-01. The smoking of hookah and hubble-bubble started in India during the reign of the great Moghul emperor, Akbar
  12. ↑ Prakash C. Gupta (1992). Control of tobacco-related cancers and other diseases: proceedings of an international symposium, January 15–19, 1990, TIFR, Bombay. Prakash C. Gupta. p. 33.
  13. ↑ Devichand, Mukul (2007-06-25). "UK | Magazine | Pipe dream". BBC News. Retrieved 2013-09-03.
  14. ↑ Rousselet, Louis (2005) [1875]. "XXVII — The Ruins of Futtehpore". India and Its Native Princes: Travels in Central India and in the Presidencies of Bombay and Bengal (Reprint — Asian Educational Services 2005 ed.). London: Chapman and Hall. p. 290. ISBN 81-206-1887-4.
  15. ↑ Brockman, LN; Pumper, MA; Christakis, DA; Moreno, MA (December 2012). "Hookah's new popularity among US college students: a pilot study of the characteristics of hookah smokers and their Facebook displays". BMJ Open. 2 12 (6): e001709. doi:10.1136/bmjopen-2012-001709. PMID 23242241.
  16. ↑ http://forvo.com/word/%D8%A3%D8%B1%D8%AC%D9%8A%D9%84%D8%A9/ Forvo - Pronunciation in Arabic
  17. ↑ "Nargile". mymerhaba. Retrieved 2013-09-03.
  18. ↑ "Smoke like an Egyptian—Sri Lanka". Lankanewspapers.com. Retrieved 2010-08-22.
  19. ↑ "Diccionario de la lengua española - Vigésima segunda edición" (in Spanish). Buscon.rae.es. Retrieved 2010-08-22.
  20. ↑ "Diccionario de la lengua española - Vigésima segunda edición" (in Spanish). Buscon.rae.es. Retrieved 2010-08-22.
  21. ↑ Rudolph P. Matthee (2005). The pursuit of pleasure: drugs and stimulants in Persian history, 1500-1900. Princeton University Press. p. 124.
  22. ↑ Robert Connell Clarke (1998). Hashish!. Red Eye Press. p. 140.
  23. ↑ "Online Etymology Dictionary.". Dictionary.com. Retrieved 30 June 2011.
  24. ↑ Melvin Ember, Carol R. Ember (2001). Countries and Their Cultures: Laos to Rwanda. Macmillan Reference USA. p. 1377.
  25. ↑ John Adrian Rosit (1969). Adrian Rosit's Guide to THC. Rex Bookstore. p. 33.
  26. ↑ Memoirs of William Hickey (Volume II ed.). London: Hurst & Blackett. 1918. p. 136.
  27. 1 2 3 Razpush, Shahnaz (15 December 2000). "ḠALYĀN". Encyclopedia Iranica. pp. 261–265. Retrieved 19 December 2012.
  28. 1 2 3 4 Sivaramakrishnan, V. M. (2001). Tobacco and Areca Nut. Hyderabad: Orient Blackswan. pp. 4–5. ISBN 81-250-2013-6.
  29. ↑ Blechynden, Kathleen (1905). Calcutta, Past and Present. Los Angeles: University of California. p. 215.
  30. 1 2 Rousselet, Louis (1875). India and Its Native Princes: Travels in Central India and in the Presidencies of Bombay and Bengal. London: Chapman and Hall. p. 290.
  31. ↑ "TOBACCO – Encyclopaedia Iranica". Iranicaonline.org. 2009-07-20. Retrieved 2013-09-03.
  32. ↑ "History of Shisha". ShishAware. Retrieved 21 June 2013.
  33. ↑ "An Oriental Delight". Medium. Retrieved 21 June 2013.
  34. ↑ "RestoratorChef Magazine #4 2013". Medium. Retrieved 22 February 2015.
  35. ↑ Shane Christensen (25 Jan 2011). Frommer's Dubai. John Wiley & Sons. p. 141.
  36. ↑ Fritz Allhoff (23 Feb 2011). Coffee - Philosophy for Everyone: Grounds for Debate. John Wiley & Sons. p. 10.
  37. ↑ Rudolph P. Matthee (2005). The pursuit of pleasure: drugs and stimulants in Iranian history, 1500-1900. Princeton University Press. p. 139.
  38. ↑ "Encyclopædia Iranica | Articles". Iranica.com. Retrieved 2010-08-22.
  39. ↑ "Saudi Arabia bans smoking in public places". The National (Abu Dhabi). 31 July 2012. Retrieved 31 October 2014.
  40. ↑ "Saudi Arabia Bans Smoking In Most Public Places". The Huffington Post. Retrieved 31 October 2014.
  41. ↑ Rastram, S; Ward, KD; Eissenberg, T; Maziak, W (2004). "Estimating the beginning of the waterpipe epidemic in Syria". BMC Public Health 4 (32). doi:10.1186/1471-2458-4-32. PMID 15294023.
  42. 1 2 Ward, KD; Hammal, F; Vander Weg, MW; Maziak, W; Eissenberg, T (2006). "The tobacco epidemic in Syria". Tobacco Control 15 (Supplement 1): i24–9. doi:10.1136/tc.2005.014860. PMC 2563543. PMID 16723671. Retrieved 13 June 2015.
  43. ↑ Kinzer, Stephen (1997-06-10). "Inhale the Pleasure of an Unhurried Ottoman Past - New York Times". Nytimes.com. Retrieved 2013-09-03.
  44. ↑ Crane, Howard (1988). "Traditional Pottery Making in the Sardis Region of Western Turkey". Muqarnas 5: 12.
  45. ↑ "Everything You Wanted to Know About Shisha Pipes". www.theshishashop.com. Retrieved 9 June 2015.
  46. ↑ "Business at hookah-less cafes go up in smoke". The Times Of India. 7 June 2011.
  47. ↑ "Hookah". Indian Express. Retrieved 2008-06-08.
  48. ↑ "Full text | Hookah smoking and cancer: carcinoembryonic antigen (CEA) levels in exclusive/ever hookah smokers". Harm Reduction Journal. Retrieved 2010-08-22.
  49. ↑ "Sheesha ban smoked". The Pakistan Today. 8 July 2013. Retrieved 7 March 2015.
  50. ↑ Kaneta Choudhury; S.M.A. Hanifi; Abbas Bhuiya; Shehrin Shaila Mahmood (December 2007). "Sociodemographic Characteristics of Tobacco Consumers in a Rural Area of Bangladesh". Journal of Health, Population and Nutrition. v.25(4): 456–464. PMC 2754020. PMID 18402189.
  51. ↑ Ahmed Shatil Alam. "Killer in disguise". The New Age. Retrieved 7 March 2015.
  52. ↑ Nepal, ECS. "Smoke on The Water: Hubby-bubbly .Hookah". ECS Nepal. Retrieved 28 February 2011.
  53. ↑ "Use of Cigarettes and Other Tobacco Products Among Students Aged 13-15 Years - Worldwide, 1999-2005". Cdc.gov. Retrieved 2010-08-22.
  54. ↑ Independent Online. "Hubble-bubble as cafes go up in smoke". Iol.co.za. Retrieved 2010-08-22.
  55. ↑ "The Mysterious Origins of the Hookah (Narghile)" The Sacred Narghile
  56. ↑ Jillian Krotki (29 October 2008). "Hookah lounge brings ’60s pastime back to the present". Seminnole Chronicle.com. Retrieved 2013-09-03.
  57. ↑ Harben, Victoria (2 May 2006). "Beyond the Smoke, There is a Solidarity Among Cultures". Cgnews.org. Retrieved 2013-09-03.
  58. ↑ Lyon, Lindsay "The Hazard in Hookah Smoke". (28 January 2008)
  59. ↑ Quenqua, Douglas (30 May 2011). "Putting a Crimp in the Hookah". The New York Times. Retrieved 2013-09-03.
  60. ↑ Arrazola, RA; et al. (17 April 2015). "Tobacco use among middle and high school students--United States, 2011-2014". Mortality and Morbidity Weekly Report 64 (14): 381–385.
  61. ↑ "Hookah Use Widespread Among College Students; Study Reveals Mistaken Perception of Safety in Potential Gateway Drug". Sciencedaily.com. 6 April 2011. Retrieved 2013-09-03.
  62. ↑ "Colleges and Universities". no-smoke.org.
  63. ↑ "Hookah Charcoal Characteristics". Supremecarbon.com. Retrieved 2013-09-03.
  64. ↑ Mridula, Morgan (2009). Hamid-Balma, Sarah, ed. "Vaporizers: Safe Alternatives to Smoking?" (PDF). Visions Journal: British Columbia's Mental Health and Addictions Journal (Vancouver, BC Canada) 5 (4): 29. ISSN 1490-2494.
  65. ↑ "Hookah Smoking — A Growing Threat to Public Health" (PDF). American Lung Association. Retrieved 13 June 2015.
  66. ↑ http://www.simcoemuskokahealth.org/Topics/Tobacco/TobaccoUsePrevention/HookahsAndWaterpipes.aspx. Missing or empty |title= (help)
  67. 1 2 3 4 Akl, EA; Gaddam, S; Gunukula, SK; Honeine, R; Jaoude, PA; Irani, J (2010). "The effects of waterpipe tobacco smoking on health outcomes: a systematic review". International Journal of Epidemiology 39 (3): 834–587. doi:10.1093/ije/dyq002. PMID 20207606.
  68. 1 2 3 Shihadeh, A; Schubert, J; Klaiany, J; El Sabban, M; Luch, A; Saliba, NA (2015). "Toxicant content, physical properties and biological activity of waterpipe tobacco smoke and its tobacco-free alternatives". Tobacco Control 24 (Supplement 1): i22–i30. doi:10.1136/tobaccocontrol-2014-051907. PMID 25666550.
  69. ↑ Martinasek, MP; Ward, KD; Calvanese, AV (2014). "Change in carbon monoxide exposure among waterpipe bar patrons". Nicotine & Tobacco Research 16 (7): 1014–9. doi:10.1093/ntr/ntu041. PMID 24642592.
  70. ↑ Cavus, UY; Rehber, ZH; Ozeke, O; Ilkay, E (2010). "Carbon monoxide poisoning associated with narghile use". Emergency Medicine Journal 27 (5): 406. doi:10.1136/emj.2009.077214. PMID 20442182.
  71. ↑ La Fauci, G; Weiser, G; Steiner, IP; Shavit, I (2012). "Carbon monoxide poisoning in narghile (water pipe) tobacco smokers". Canadian Journal of Emergency Medicine 14 (1): 57–59. PMID 22417961.
  72. ↑ Lim, BL; Lim, GH; Seow, E (2009). "Case of carbon monoxide poisoning after smoking shisha". International Journal of Emergency Medicine 2: 121–122. doi:10.1007/s12245-009-0097-8.
  73. ↑ Türkmen, S; Eryigit, U; Sahin, A; Yeniocak, S; Turedi, S (2011). "Carbon monoxide poisoning associated with water pipe smoking". Clinical Toxicology (Philadelphia) 49 (7): 697–698. doi:10.3109/15563650.2011.598160. PMID 21819288.
  74. ↑ Pearl, Mike. "Is hookah sickness just carbon monoxide poisoning". Retrieved 13 June 2015.
  75. 1 2 Alomari, MA; Khabour, OF; Alzoubi, KH; Shqair, DM; Eissenberg, T (2014). "Central and peripheral cardiovascular changes immediately after waterpipe smoking". Inhal Toxicol 26 (10): 579–587. doi:10.3109/08958378.2014.936572. PMID 25144473.
  76. ↑ Al-Kubati, M; Al-Kubati, AS; al'Absi, M; Fiser, B. (2006). "The short-term effect of water-pipe smoking on the baroreflex control of heart rate in normotensives". Autonomic Neuroscience. 126-127: 146–9. doi:10.1016/j.autneu.2006.03.007. PMID 16716761.
  77. ↑ Cobb, CO; Sahmarani, K; Eissenberg, T; Shihadeh, A (2012). "Acute toxicant exposure and cardiac autonomic dysfunction from smoking a single narghile waterpipe with tobacco and with a "healthy" tobacco-free alternative". Toxicology Letters 215 (1): 70–75. doi:10.1016/j.toxlet.2012.09.026. PMID 23059956.
  78. ↑ St Helen, G; Benowitz, NL; Dains, KM; Havel, C; Peng, M; Jacob, P (2014). "Nicotine and carcinogen exposure after water pipe smoking in hookah bars". Cancer Epidemiol Biomarkers Prev 23 (6): 1055066. doi:10.1158/1055-9965.EPI-13-0939. PMID 24836469.
  79. ↑ Hakim, F; Hellou, E; Goldbart, A; Katz, R; Bentur, Y; Bentur, L (April 2011). "The acute effects of water-pipe smoking on the cardiorespiratory system". Chest 139 (4): 775–81. doi:10.1378/chest.10-1833. PMID 21030492.
  80. ↑ Hawari, FI; Obeidat, NA; Ayub, H; Ghonimat, I; Eissenberg, T; Dawahrah, S; Beano, H (August 2013). "The acute effects of waterpipe smoking on lung function and exercise capacity in a pilot study of healthy participants". Inhalation toxicology 25 (9): 492–7. doi:10.3109/08958378.2013.806613. PMID 23905967.
  81. ↑ Kumar, SR; Davies, S; Weitzman, M; Sherman, S (March 2015). "A review of air quality, biological indicators and health effects of second-hand waterpipe smoke exposure.". Tobacco control. 24 Suppl 1: i54–i59. doi:10.1136/tobaccocontrol-2014-052038. PMID 25480544.
  82. 1 2 Daher, N; Saleh, R; Jaroudi, E; Sheheitli, H; Badr, T; Sepetdjian, E; Al Rashidi, M; Saliba, N; Shihadeh, A (1 January 2010). "Comparison of carcinogen, carbon monoxide, and ultrafine particle emissions from narghile waterpipe and cigarette smoking: Sidestream smoke measurements and assessment of second-hand smoke emission factors.". Atmospheric Environment 44 (1): 8–14. doi:10.1016/j.atmosenv.2009.10.004. PMID 20161525.
  83. ↑ Tamim, H; Musharrafieh, U; El Roueiheb, Z; Yunis, K; Almawi, WY (2003). "Exposure of children to environmental tobacco smoke (ETS) and its association with respiratory ailments.". The Journal of asthma : official journal of the Association for the Care of Asthma 40 (5): 571–6. doi:10.1081/jas-120019029. PMID 14529107.
  84. ↑ Zeidan, RK; Rachidi, S; Awada, S; El Hajje, A; El Bawab, W; Salamé, J; Bejjany, R; Salameh, P (August 2014). "Carbon monoxide and respiratory symptoms in young adult passive smokers: a pilot study comparing waterpipe to cigarette.". International journal of occupational medicine and environmental health 27 (4): 571–82. doi:10.2478/s13382-014-0246-z. PMID 25012596.
  85. ↑ Eissenberg, T; Shihadeh, A (December 2009). "Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure.". American journal of preventive medicine 37 (6): 518–23. doi:10.1016/j.amepre.2009.07.014. PMID 19944918.
  86. ↑ Neergaard, J; Singh, P; Job, J; Montgomery, S (October 2007). "Waterpipe smoking and nicotine exposure: a review of the current evidence.". Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 9 (10): 987–94. doi:10.1080/14622200701591591. PMID 17943617.
  87. ↑ Aboaziza, E; Eissenberg, T (March 2015). "Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence?". Tobacco control. 24 Suppl 1: i44–i53. doi:10.1136/tobaccocontrol-2014-051910. PMID 25492935.
  88. 1 2 Asfar, T; Al Ali, R; Rastam, S; Maziak, W; Ward, KD (June 2014). "Behavioral cessation treatment of waterpipe smoking: The first pilot randomized controlled trial.". Addictive behaviors 39 (6): 1066–74. doi:10.1016/j.addbeh.2014.02.012. PMID 24629480.
  89. ↑ Rastam, S; Eissenberg, T; Ibrahim, I; Ward, KD; Khalil, R; Maziak, W (May 2011). "Comparative analysis of waterpipe and cigarette suppression of abstinence and craving symptoms.". Addictive behaviors 36 (5): 555–9. doi:10.1016/j.addbeh.2011.01.021. PMID 21316156.
  90. ↑ Ward, KD; Hammal, F; VanderWeg, MW; Eissenberg, T; Asfar, T; Rastam, S; Maziak, W (February 2005). "Are waterpipe users interested in quitting?". Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 7 (1): 149–56. doi:10.1080/14622200412331328402. PMID 15804687.
  91. ↑ Maziak, W; Eissenberg, T; Ward, KD (January 2005). "Patterns of waterpipe use and dependence: implications for intervention development.". Pharmacology, Biochemistry, and Behavior 80 (1): 173–9. doi:10.1016/j.pbb.2004.10.026. PMID 15652393.
  92. ↑ Dogar, O; Jawad, M; Shah, SK; Newell, JN; Kanaan, M; Khan, MA; Siddiqi, K (June 2014). "Effect of cessation interventions on hookah smoking: post-hoc analysis of a cluster-randomized controlled trial.". Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 16 (6): 682–8. doi:10.1093/ntr/ntt211. PMID 24376277.
  93. ↑ Maziak, W; Ward, KD; Eissenberg, T (17 October 2007 [update in press]). "Interventions for waterpipe smoking cessation.". The Cochrane database of systematic reviews (4): CD005549. doi:10.1002/14651858.CD005549.pub2. PMID 17943865. Check date values in: |date= (help);

External links

Wikimedia Commons has media related to Hookahs.
Wikisource has the text of the 1911 Encyclopædia Britannica article Hookah.
This article is issued from Wikipedia - version of the Wednesday, May 04, 2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.