Hookah use not as safe as you may think

hookah photoPhoto © Shutterstock

There are some very definite health risks to hookah smoking, but you’d never know it from the postings and ads on social media, and a new study cautions that the one-sided promotion of hookah smoking can normalize its use, creating a public health hazard. 

In the study, published in Health Education & Behavior, researchers examined nearly 300 Instagram posts.  They randomly selected 279 posts from 11,517 posts tagged #hookah or #shisha within a four-day period. Out of the reviewed hookah-related posts:

  • 99.6% indicated positive sentiments towards hookah use;
  • Only one post (0.4%) mentioned negative health effects associated with hookah use;
  • 63.8% were promotional in nature; and
  • Most posts were associated with nightlife, community, and hookah identity.

“A growing body of evidence suggests that hookah smoking can lead to nicotine dependence and many other known smoking-related illnesses such as cancer, cardiovascular disease, and respiratory disease,” according to the researchers. The Centers for Disease Control and Prevention (CDC) warns that hookah smoking “poses serious health risks to smokers and others exposed to the smoke from the hookah.”

Hookah use has become increasingly popular among young people, many of whom believe the smoke is safer because it passes through water, but the CDC warns that:

  • The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals.
  • Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.
  • Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder, and oral cancers.
  • Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.

“Badge of honor”

The researchers noted that 10% of all posts used the hashtag #HookahAddiction, signaling that nicotine addiction is not perceived as a health risk that would discourage potential users, but instead referred to ironically or as a “badge of honor.” The researchers commented that policymakers and others should explore approaches for reducing the number of promotional posts, for example, by creating campaigns to counter-market positive themes presented on social media.

“This study represents an important step in identifying hookah-related themes on Instagram and demonstrates the value in using data from this social platform to complement and extend our understanding of health behaviors,” wrote authors Ben Taleb et al. “These findings can inform the design of future tobacco control media campaigns aimed at countering the normalization of hookah use on social media.”

The research also suggests that this is a global phenomenon, with a majority of the posts coming from Russia (38.5%), the United States (18.6%), and Germany (10.7%).

The researchers were drawn from Florida International University, the University of Wisconsin, the University of Miami, the Syrian Center for Tobacco Studies, and the University of Pittsburgh.


About the Author

Truman Lewis
Truman has been a bureau chief and correspondent in D.C., Los Angeles, Phoenix and elsewhere, reporting for radio, television, print and news services, for more than 30 years. Most recently, he has reported extensively on health and consumer issues for ConsumerAffairs.com and FairfaxNews.com.