The research team found that hookah smokers inhale more often and for longer periods than typical cigarette smokers. Scientists estimate that by puffing longer and in greater volume, a waterpipe smoker inhales the equivalent of 100 cigarettes or more during a single waterpipe session. Proponents of hookah smoking argue that it isn't necessary to inhale the smoke into the lungs. Instead they puff as if on a pipe-and believe this reduces the health hazards.
However, studies indicate that hookah smokers are absorbing high levels of toxins and carcinogens that may contribute to heart disease, lung cancer, and respiratory disease. And although some nicotine is filtered through the water contained at the base of the pipe, scientists conclude that waterpipe smokers are still exposed to enough nicotine to become addicted.
Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter, suggests that until more is known about how to help hookah smokers quit, clinicians and smokers should be aware of the potential dangers.