Hookah has a glass base that holds the water, a head that holds the tobacco or herbal shisha, a stem that connects the two, and, one or more hoses with mouthpiece(s). Tobacco or shisha is covered with a pierced tinfoil and a piece of charcoal. When the shisha is lit, smoke travels down the stem to the glass base and the user inhales using the mouthpiece.

Hookah is not less harmful than cigarettes. Consider the pros and cons below and YOU be the judge.


  • Shisha is often mixed with molasses and other sweet flavours that may make smoking more pleasant than smoking traditional tobacco cigarettes.2
  • Hookah is often smoked in a group setting, making it a social activity.2


Truth be told – the sweet taste of shisha is only hiding what’s truly there.

  • Just like cigarette smoke, both herbal shisha and tobacco smoke contain toxins and chemicals. So, actually, the cancer-causing chemicals do not get filtered by the water.2
  • Because a single hookah session can last between 20-80 minutes, the user takes in as many puffs and inhales as much smoke as smoking 100 cigarettes!3 There is also more exposure to carbon monoxide (16x more)4, tar, and toxins when using hookah.3 There’s also more of that nasty stuff in second-hand hookah smoke and even just by lighting it up.5
  • Tobacco shisha contains nicotine and can be addictive just like smoking cigarettes.3
  • Some of the known health risks of hookah smoking are like cigarette smoking and include lung cancer, oral cancer, respiratory illness, and cardiovascular disease.6
  • Since shisha is unregulated, shisha mixtures and blends can be mislabeled (you might not know what you are smoking!) = health risks of smoking hookah may vary and can also be affected by the amount of smoke you inhale and how often you smoke.7
  • A hookah pipe is often shared in a group setting. As the mouthpieces get passed around and the hoses may not be disinfected before each use, this raises concerns surrounding cleanliness and the spread of infectious diseases.6

The verdict is clear. Hookah is not a safer alternative to smoking cigarettes. Containing nicotine and harmful ingredients, hookah should be avoided, especially among non-smokers and individuals trying to quit.

Don’t believe us? See what others are saying:



  1. The Ontario Tobacco Research Unit. (2014). Waterpipe Use in Ontario. Retrieved May 29, 2014 from http://otru.org/wp-content/uploads/2014/04/update_apr2014.pdf.
  2. Jukema, J.B., Bagnasco, D.E., & Jukema, R.A. (2014). Waterpipe smoking: not necessarily less hazardous than cigarette smoking: Possible consequences for (cardiovascular) disease. Netherlands Heart Journal, 22 (3), 91-99.
  3. World Health Organization (Tobacco Free Initiative). (2005). Advisory Note. Waterpipe Tobacco Smoking: Health Effects, Research needs and Recommended Actions by Regulators. Retrieved June 9, 2014 from http://www.who.int/tobacco/global_interaction/tobreg/Waterpipe%20recommendation_Final.pdf.
  4. Jacob III, P., Abu Raddaha, A.H., Dempsey, D., Havel, C., Peng, M., Yu, L., & Benowitz, N.L. (2013). Comparison of nicotine and carcinogen exposure with water pipe and cigarette smoking. Cancer Epidemiology, Biomarkers & Prevention, 22 (5), 765-772.
  5. Daher, N., Saleh, R., Jaroudi, E., Sheheitli, H., Badr, T., Sepedjian, E., Al Rashidi, M., Saliba, N., & Shihadeh, A. (2010). Comparison of carcinogen, carbon monoxide, and ultrafine particle emissions from narghile waterpipe and cigarette smoking: Sidestream smoke measurements and assessment of second-hand smoke emission factors. Atmospheric Environment, 44 (1), 8-14.
  6. Centers for Disease Control and Prevention. (2013). Smoking and Tobacco Use. Hookahs. Retrieved June 9, 2014 from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm
  7. Vansickel, A.R., Shihadeh, A., & Eissenberg, T. (2012). Waterpipe tobacco products: nicotine labelling versus nicotine delivery. Tobacco Control, 21 (3), 377-379.