Water pipe smoking causes significant exposure to nicotine and cancer-causing agents


May 17, 2014
Health

Young adults who smoked water pipes in hookah bars had elevated levels of nicotine, cotinine, tobacco-related cancer-causing agents, and volatile organic compounds (VOC) in their urine, and this may increase their risk for cancer and other chronic diseases, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

“This study reports systemic intake of tobacco-specific nitrosamines and VOCs after a typical water pipe-smoking session in a hookah bar setting, thus making the findings generalizable to most water pipe users in the United States,” said Gideon St.Helen, Ph.D., postdoctoral fellow in the Division of Clinical Pharmacology and the Center for Tobacco Control Research and Education at the University of California, San Francisco.

After a single evening of water pipe smoking in a hookah bar, young men and women had in their urine a 73-fold increase in nicotine; fourfold increase in cotinine; twofold increase in NNAL, a breakdown product of a tobacco-specific nitrosamine, NNK, which can cause lung and pancreatic cancers; and 14 to 91 percent increase in the breakdown products of VOC such as benzene and acrolein that are known to cause cancer and cardiovascular and respiratory diseases.

“There was also a substantial increase in nicotine levels, which raises concerns about the potential addictiveness of water pipe smoking and possible effects on the developing brains of children and youths who use water pipes,” added St.Helen. “Water pipe smoking is generally perceived to be a safe alternative to cigarette smoking, even for children and youths. Our study shows that water pipe use, particularly chronic use, is not risk-free.”

St.Helen and colleagues recruited 55 healthy, experienced water pipe smokers, ages 18 to 48 years, to the study. Participants were instructed to refrain from any type of smoking for a week.

At the end of this period they provided a “before” urine sample and smoked water pipes at a hookah bar of their choice in the San Francisco Bay area. Soon after the visit, they provided the “after” urine sample, and filled a form to provide detailed information on their smoking session including total time spent smoking, number of bowls smoked, and number of shared users. They also provided a first-voided urine sample the next morning, which helped researchers estimate the clearance of the tobacco-related chemicals of interest.

The study participants spent on average 74 minutes smoking water pipes and smoked an average 0.6 bowls of water pipe tobacco per person.

The researchers found that the elevated levels of nicotine, cotinine, and NNAL, which were detected immediately after the water pipe-smoking session, remained significantly elevated in the next-day urine samples, compared with the “before” samples: Nicotine was 10.4-fold higher; cotinine, 3.2-fold; and NNAL, 2.2-fold.

Water pipe-smoking duration correlated significantly with the increase in post-exposure urine nicotine levels, and number of bowls smoked per person significantly correlated with the increase in post-exposure and next-day urine cotinine levels, respectively. The average increase in nicotine levels was comparable to levels obtained after smoking at least one cigarette, explained St.Helen.

“I have seen entire families, including young children, smoking water pipes. I have even been offered a smoke by my friend who thought water pipe smoking was ‘totally safe,’” St.Helen added. “Our study provides evidence that water pipe smoking leads to significant intake of tobacco-related addictive and harmful substances, and is therefore not without risk, particularly among children and youths.”


2 Responses to Water pipe smoking causes significant exposure to nicotine and cancer-causing agents

  1. Michaela May 20, 2014 at 12:47 am #

    Teenagers today are influenced by the common phenomena of peer pressure. Smoking,whether it is ‘hookah’ or cigarettes, has become somewhat ‘cool’ to do. Interesting enough teenagers are usually aware of the consequences of smoking cigarettes but choose to ignore it or try find a ‘safer’ option that still feeds the addiction but rids the guilt. Being a teenager I can definitely say that smoking is a social thing, just as alcohol is and that many teenagers rely on such things to have what their definition of a ‘good time’ is. The passage is very insightful because it gives detailed statistics that actually prove the harmfulness of smoking hookah and it also proves the myth that hookah is safer or healthier wrong. These consequences need to be emphasised because usually it’ll be too late to do anything about it.

  2. u11260701 May 18, 2014 at 11:17 pm #

    Very informative passage. Water pipe smoking has became an every day thing to young people and they r not aware of the negative effect of it. In the above text its clearly stated and after reading it one would definitely stop smoking the water pipe

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