Water-pipe smoking is as bad as deeply inhaling cigarette smoke when it comes to causing respiratory problems, according to a study.
Researchers led by Mohammad Hossein Boskabady at Masshad University of Medical Sciences in Iran monitored lung functions among 57 local water-pipe smokers, 30 deep-inhalation cigarette smokers and 51 normal-inhalation smokers.
How the study was done
They also studied 44 non-smokers for a comparison. Wheezing occurred among 23% of the water-pipe users, 30% of the deep-inhalation and 21.6% of normal-inhalation cigarette smokers, but only among 9.1% of non-smokers.
Coughing occurred among 21%, 36.7%and 19.6%of the smoking groups, compared with 6.8 % of non-smokers, according to the probe, which measured smokers over three months in two consecutive years.
Sputum production, meanwhile, was found in 14%, 10%, 3.9% respectively among the various smoking groups, but among 6.8 % of the non-smoking group.
Blow to hookah smokers
The results, published in the peer-reviewed journal Respirology, adds a further scientific blow to the defenders of shisha who claim that water pipes are safer because they filter out tobacco toxins.
The water pipe, often used with sweet or fruit-flavoured tobacco, is a centuries-old tradition in the Middle East but in recent years has become fashionable among young westerners, particularly women.
"Our findings reveal that there were profound effects of water-pipe smoking on lung function values, which were similar to the effects observed in deep-inhalation cigarette smokers," Boskabady said in a press release.
"Normal" inhalation cigarette smoking had less of an effect compared to the water pipe, but still contributed significantly to respiratory disorders, the paper stressed.
According to a 2005 study by the UN World Health Organisation (WHO), water pipe smoke has high concentrations of toxic compounds, including carbon monoxide, heavy metals, cancer-causing chemicals and potentially addictive levels of nicotine.
Cigarette smokers typically take eight to 12 puffs over five to seven minutes, inhaling a total of 0.5 to 0.6 of a litre of smoke.
In contrast, waterpipe sessions typically last 20-80 minutes, during which the smoker may take 50-20 puffs which each range from 0.15 to one litre each.
"The waterpipe smoker may therefore inhale as much smoke during one session as a cigarette smoker would inhale consuming 100 or more cigarettes," the WHO said.
The Iranian research used a gadget called a spirometer to measure how deeply smokers inhaled and retained the puff. "Normal" inhalers typically inhaled less than 10% above a benchmark of lung inflation called tidal volume. For "deep" inhalers, it was typically more than 30%, and for water-pipe smokers it was usually 40%above tidal volume.