Study Finds Hookah Smoke Contains Cancer-Causing Chemicals

By McCarton Ackerman 12/09/14

Smoking hookah isn't the safe alternative to cigarettes that most people think.

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Smoking a hookah has long been considered a safer alternative to nicotine use, but a new study has found that hookah smoke also contains cancer-causing chemicals.

Those who either smoke a hookah or even inhale second-hand hookah smoke could be taking in a chemical known as benzene, which has been linked to an increase risk of leukemia and acute myeloid leukemia, a type of cancer of the blood and bone marrow. The research was led by Nada Kassem, an associate director at the Center for Behavioral Epidemiology and Community Health at San Diego State University, and published in last month’s issue of the journal Cancer Epidemiology, Biomarkers & Prevention.

Scientists collected urine samples from 208 people, 105 of whom had smoked a hookah and the remainder being exposed to second-hand hookah smoke. Observing levels of a compound called S-phenylmercapturic acid (SPMA), which forms when benzene is broken down in the body, the researchers found SPMA levels were four times higher among those who smoked at a hookah lounge and twice as high if they smoked at home. Even those who were merely around hookah smoke at lounges recorded SPMA levels which were 2.6 times higher than before they entered.

“In contrast to what is believed [by many people], hookah tobacco smoking is not a safe alternative to smoking other forms of tobacco,” said Kassem. "In addition to inhaling toxicants and carcinogens found in the hookah tobacco smoke, hookah smokers and nonsmokers who socialize with hookah smokers also inhale large quantities of charcoal combustion-generated toxic and carcinogenic emissions."

A study published in the same journal last May found that even a single night of smoking a hookah can result in a drastic increase in nicotine levels and exposure to cancer-causing agents. Before-and-after urine samples after smoking a hookah found a 73-fold increase in nicotine levels; a four-fold increase in continine levels, a metabolite of nicotine; a two-fold increase in NNAL, which can cause lung and pancreatic cancers; and an increase in benzene.

Lead researcher Gideon St.Helen, Ph.D., a postdoctoral fellow in the Division of Clinical Pharmacology and the Center for Tobacco Control Research and Education at the University of California, San Francisco, said the findings showed that hookah use “is not without risk, particularly among children and youths.”

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McCarton Ackerman is a freelance writer and editor living in Portland, Oregon. He has been a contributor for The Fix since October 2011, writing on a wide range of topics ranging from medical marijuana in Colorado to the world's sexiest drug smugglers. Follow him on Linkedin and Twitter.

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