Hookah is the enemy of your general and oral health

Sophie Sanber

Hookah also known as Water Pipe, Argileh, Shisha, Hubble Bubble, Goza has a long flexible tube that draws smoke through water in a bowl.

Hookah use was first seen in the western world. These days, it has become more visible in India. It is also found in Iran, Turkey and the Arab world. The use of hookah is an emerging trend in the Indian population in particular. We see here that young people are more attached to it than the older generation.

Its use is less harmful than cigarettes. The availability of appealing flavors is considered to be one of the main reasons for this emerging trend. But users are however exposed to many toxic compounds, by-products of cigarette users. Its heavy use could lead to more serious negative health effects. In fact, hookah users are at a higher risk for infections, cancers, lung disease, and other medical conditions. Additionally, due to the overlapping toxic and chemical profile of conventional cigarettes, the effects of hookah on the cardiovascular system and oral health are higher.

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Reasons for use

Many factors seem to favor the spread of hookah. They include the use of flavored aromatic tobacco, curiosity, peer pressure, fashion, higher socioeconomic status, and the need for entertainment. One factor that has significantly contributed to the increase in hookah use is the misperception of health risks. The majority of users believe in the absence or less harmfulness of hookah compared to cigarettes. This particular belief could be related to the myth that intermittent hookah use reduces harm compared to constant cigarette use. The passage of the smoke in the water would filter it and the less addictive nature of the hookah. Some users claim that they do not inhale the smoke and therefore protect themselves from nicotine. However, they do not know that nicotine can be easily absorbed through the mucous membrane or the oral cavity. The habit has acquired positive attributes as it is used for socializing, relaxation, and the good taste and smell of smoke.

Smoking or hookah, as well as the consumption and abuse of alcohol, are considered the most common etiological factors for the appearance of diseases of the oral cavity such as changes in the color of the lips, tongue, stomatopyroses , glossopyrosis and candidiasis.

Above all, it is important to note that this is not a trivial habit. Many studies highlight the harmful nature of hookah smoking besides causing changes in overall health. It also leads to changes in mucous membrane and mouth cancer, esophageal cancer and dry socket.

Hookah smoking leads to:

  • Increased risk of lung and stomach cancer
  • Reduced lung function
  • Increased risk of stroke and heart disease
  • Decreased fertility in both men and women


Hookahs are mistakenly perceived as a healthier alternative, but that’s simply not true. While a cigarette usually takes 5-7 minutes or 40-70 puffs to smoke, a hookah can last an hour and a half or around 50-200 puffs. A typical hookah session is around 90,000 milliliters compared to the 600 milliliters inhaled while smoking a cigarette. Tobacco in waterpipes is also exposed to high heat from burning charcoal and the smoke is found to be at least as toxic as cigarette smoke.

Oral Health Risks

1) Any tobacco use, including hookah, decreases the production of saliva which is the mouth’s natural cleanser. A dry mouth makes you more susceptible to cavities and a high risk of tooth decay.
2) Smoking of any kind causes bad breath. Although the smell of tobacco is sweet once it is processed in water and in your mouth, it still stinks. The more tobacco you smoke, the worse your breath will be.

Constantly smoking hookah is terribly bad for your oral health. So the advice is not to smoke hookah. If you are already noticing some of the effects of hookah, consult your doctor immediately, preferably a dentist.

Dr. Syeda Sofia Sanober is a young Dental Surgeon based in Hyderabad who is passionate about spreading oral health knowledge to the general public.

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