1. a b c d Greenwald, Matthew. “Cigarettes and Chocolate Milk”. Allmusic. Retrieved 2009 05 05.
  2. Aizlewood, John (2001 06 08). “Come pose with me”. The Guardian. Guardian Media Group. Retrieved 2009 04 25.
  3. Tangari, Joe (2001 10 07). “Rufus Wainwright Poses”. Pitchfork Media. Retrieved 2009 04 24.
  4. “Cigarettes and Chocolate Milk”. Interscope Records. 2001 12 20. Retrieved 2009 04 27.
  5. “Live at the World Cafe Volume 15, Handcrafted CD”. WXPN. Retrieved 2008 11 16.
  6. “Discography 107.1 KGSR Radio Austin Broadcasts Vol.10”. 2007 05 18. Retrieved 2008 12 06.
  7. “The Last Kiss Original Soundtrack”. Allmusic. Retrieved 2009 05 05.
  8. “Yellow Lounge Compiled by Rufus Wainwright”. Allmusic. Retrieved 2009 05 05.
  9. “A Sky With No Clouds”. Orange Music Inc. Retrieved 2009 05 05.

Cdc – fact sheet – hookahs – smoking & tobacco use

Cigarettes online Blog Archive Who here smokes additive- free cigarettes? name your brand
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.