Cdc — fact sheet — hookahs — smoking & tobacco use

Hookah Smoke and Cancer

  • The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals, and cancer causing chemicals.1,4
  • Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.4
  • Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder, and oral cancers.1,4
  • Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.4,7

Other Health Effects of Hookah Smoke

  • Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart disease.1,4
  • Infections may be passed to other smokers by sharing a hookah.2
  • Babies born to women who smoked water pipes every day while pregnant weigh less at birth (at least 3 ounces less) than babies born to nonsmokers.5,8
  • Babies born to hookah smokers are also at increased risk for respiratory diseases.8

Hookah Smoking Compared With Cigarette Smoking

  • While many hookah smokers may think this practice is less harmful than smoking cigarettes, hookah smoking has many of the same health risks as cigarette smoking.1,2
    • Water pipe smoking delivers nicotine the same highly addictive drug found in other tobacco products.2
    • The tobacco in hookahs is burned (exposed to high heat) and the smoke is at least as toxic as cigarette smoke.1,2
  • Because of the way a hookah is used, smokers may absorb more of the toxic substances also found in cigarette smoke than cigarette smokers do.1,2
    • An hour long hookah smoking session involves 200 puffs, while smoking an average cigarette involves 20 puffs.1,2
    • The amount of smoke inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500 600 ml inhaled when smoking a cigarette.4
  • Hookah smokers may be at risk for some of the same diseases as cigarette smokers. These include 3,4
    • Oral cancer
    • Lung cancer
    • Stomach cancer
    • Cancer of the esophagus
    • Reduced lung function
    • Decreased fertility

Hookahs and Secondhand Smoke

  • Secondhand smoke from hookahs can be a health risk for nonsmokers. It contains smoke from the tobacco as well as smoke from the heat source (e.g., charcoal) used in the hookah.1,5,9

Nontobacco Hookah Products

  • Some sweetened and flavored nontobacco products are sold for use in a hookah.10
  • Labels and ads for these products often claim that users can enjoy the same taste without the harmful effects of tobacco.10
  • Studies of tobacco based shisha and herbal shisha show that smoke from both preparations contain carbon monoxide and other toxic agents known to increase the risks for smoking related cancers, heart disease, and lung disease.10,11


  1. American Lung Association. An Emerging Deadly Trend Waterpipe Tobacco Use. PDF 222 KB Washington American Lung Association, 2007 accessed 2013 Dec 17 .
  2. American Lung Association. Hookah Smoking A Growing Threat to Public Health Issue Brief.. PDF 1.34 MB Smokefree Communities Project, 2011 accessed 2013 Dec 17 .
  3. Akl EA, Gaddam S, Gunukula SK, Honeine R, Jaoude PA, Irani J. The Effects of Waterpipe Tobacco Smoking on Health Outcomes A Systematic Review. International Journal of Epidemiology 2010 39 834 57 accessed 2013 Dec 17 .
  4. Cobb CO, Ward KD, Maziak W, Shihadeh AL, Eissenberg T. Waterpipe Tobacco Smoking An Emerging Health Crisis in the United States. American Journal of Health Behavior 2010 34(3) 275 85 accessed 2013 Dec 17 .
  5. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults A Report of the Surgeon General. Atlanta U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 2012 accessed 2013 Dec 17 .
  6. U.S. Food and Drug Administration. Electronic Cigarettes (e Cigarettes) last updated 2013 April 25 accessed 2013 Dec 17 .
  7. El Hakim Ibrahim E, Uthman Mirghani AE. Squamous Cell Carcinoma and Keratoacanthoma of the Lower Lips Associated with «Goza» and «Shisha» Smoking. International Journal of Dermatology 1999 38 108 10 cited 2013 Dec 17 .
  8. Nuwayhid, I, Yamout, B., Ghassan, and Kambria, M. Narghile (Hubble Bubble) Smoking, Low Birth Weight and Other Pregnancy Outcomes . American Journal of Epidemiology 1998 148 375 83 accessed 2013 Dec 17 .
  9. Cobb CO, Vansickel AR, Blank MD, Jentink K, Travers MJ, Eissenberg T. Indoor Air Quality in Virginia Waterpipe Caf s. Tobacco Control 2012 Mar 24 doi 10.1136/tobaccocontrol 2011 050350 cited 2013 Dec 17 .
  10. Shihadeh A, Salman R, Eissenberg T. Does Switching to a Tobacco Free Waterpipe Product Reduce Toxicant Intake? A Crossover Study Comparing CO, NO, PAH, Volatile Aldehydes, Tar and Nicotine Yields. Food and Chemical Toxicology 2012 50(5) 1494 8 accessed 2013 Dec 17 .
  11. Blank MD, Cobb CO, Kilgalen B, Austin J, Weaver MF, Shihadeh A, Eissenberg T. Acute Effects of Waterpipe Tobacco Smoking A Double Blind, Placebo Control Study. Drug and Alcohol Dependence 2011 116(1 3) 102 9 cited 2013 Dec 17 .

For Further Information

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E mail tobaccoinfo
Phone 1 800 CDC INFO

Media Inquiries Contact CDC’s Office on Smoking and Health press line at 770 488 5493.

Public health cigarette smoking act — wikipedia, the free encyclopedia

The Public Health Cigarette Smoking Act is a United States federal law, passed in 1970, designed to limit the practice of smoking. It required a stronger health warning on cigarette packages, saying «Warning The Surgeon General Has Determined that Cigarette Smoking Is Dangerous to Your Health». The Act also banned cigarette advertisements on American radio and television. 1 dead link

Origins edit

The Public Health Cigarette Smoking Act was one of the major bills resulting from the 1964 report by the Surgeon General, Luther Leonidas Terry. The report found that lung cancer and chronic bronchitis are causally related to cigarette smoking. 2 Congress previously passed the Cigarette Labeling and Advertising Act in 1965 requiring that all cigarette packages sold in the United States carry a health warning. 2 3 But after a recommendation by the Federal Trade Commission, the Public Health Cigarette Smoking Act amended the 1965 law so that the warnings are made in the name of the Surgeon General. 3 4

One of the major advocates of the cigarette advertising ban was the Federal Communications Commission. The FCC argued that since the topic of smoking is controversial, numerous TV and radio stations continued to break the Fairness Doctrine when airing these commercials because they did not give equal time to the opposing viewpoint that smoking is dangerous. 4

The Public Health Cigarette Smoking Act was introduced into Congress in 1969, but it was not until April 1, 1970 when U.S. President Richard Nixon signed it into law. The actual cigarette advertising ban did not come into force until January 2, 1971, as per a compromise that allowed broadcasters to air these commercials during their telecasts of college football bowl games on New Year’s Day. 4

Effects edit

In 1981, the FTC reported that the health warning labels as mandated by the Public Health Cigarette Smoking Act had little effect on American smoking habits. Congress therefore passed the Comprehensive Smoking Education Act of 1984, requiring more specific health warnings. 5

The tobacco industry has begun to use a variety of other marketing tools and strategies to influence people and attract new customers. 6 In particular, ads targeted to adolescents affect their perceptions on the image and function of smoking. 7 In 1991, the Journal of the American Medical Association published a study showing that more children 5 and 6 years old could recognize Camel cigarettes’ Joe Camel mascot than could recognize Mickey Mouse or Fred Flintstone. 8 Camel increased its adolescent customer base dramatically, from less than 1% before 1988 to more than 13% in 1993. 6 Tobacco sought protection from Congress so they could all leave broadcasting together without violating any anti trust laws. The only lawsuit that followed was from the broadcaster in an effort to keep tobacco advertising on television and radio.

References edit

  1. » Public Health Cigarette Smoking Act of 1969″. Retrieved 2007 03 31.
  2. a b «History of the Surgeon General’s Report on Smoking and Health». Centers for Disease Control and Prevention. Archived from the original on 2007 05 03. Retrieved 2007 03 31.
  3. a b «The 1964 Report on Smoking and Health». United States National Library of Medicine. Retrieved 2007 03 31.
  4. a b c «History of Tobacco Regulation». Retrieved 2007 03 31.
  5. «2000 Surgeon General’s Report Reducing Tobacco Use diljfoig use protection». Centers for Disease Control and Prevention. Archived from the original on 2007 04 27. Retrieved 2007 03 31.
  6. a b «2000 Surgeon General’s Report Reducing Tobacco Use Tobacco Advertising and Promotion». Centers for Disease Control and Prevention. Archived from the original on 2007 04 27. Retrieved 2007 03 31.
  7. «1994 Surgeon General’s Report Preventing Tobacco Use Among Young People Major Conclusions». Centers for Disease Control and Prevention. Archived from the original on 2008 03 05. Retrieved 2007 03 31.
  8. Fischer PM, Schwartz MP, Richards JW Jr, Goldstein AO, Rojas TH. Brand logo recognition by children aged 3 to 6 years. Mickey Mouse and Old Joe the Camel. JAMA. 1991 December 11 266(22) 3145 8. PMID 1956101