Hookah bars are emerging as an important consideration for smokefree air efforts in many communities. As more municipalities and states go 100% smokefree in workplaces, restaurants, bars, and casinos, establishments seeking to violate the law look for loopholes wherever they can. Most frequently, establishments claim to be "retail tobacco shops", by transforming themselves into hookah bars. If this tactic to skirt your smokefree law appears in your community, contact ANR for lessons learned and tips.
What is a hookah?
A hookah, also known as a narghile, shisha or hubble-bubble, is a waterpipe of Middle Eastern origin that is used to smoke sweet, often flavored, tobacco. The smoke is filtered through water in the base of the hookah's pipe. There is a common misconception that hookah smoke is less harmful than cigarette smoke, or not at all harmful, since the smoke passes through water before being inhaled or emitted as secondhand smoke. This is not true. The science shows that smoke from a hookah contains many of the same harmful and carcinogenic components as cigarette smoke. Hookahs should not be considered a safer alternative to cigarette smoking. Secondhand hookah smoke is not less harmful than secondhand cigarette smoke.
In 2005, the World Health Organization (WHO) issued an Advisory Note on Waterpipe Tobacco Smoking. This Advisory Note states:
How did the hookah fad start?
Hookah bars or cafes have been in the U.S. for many years, primarily in communities with Middle Eastern populations, and serve as social centers for many people. Traditional hookah establishments are not bars in the typical sense, as they primarily serve hookah-smoking and not alcohol-drinking patrons. In fact, most traditional hookah establishments do not serve alcohol at all, in keeping with Muslim practice.
However, hookah bars are gaining popularity around the U.S., particularly among college age individuals. Eighteen to 22-year-olds often find these establishments appealing for social reasons and because of the widespread misconception that there are reduced health risks associated with both active hookah smoking and secondhand hookah smoke. Hookah bars targeting the college age population often serve alcohol and can serve as an introduction to smoking among people who may not otherwise smoke.
Hookah News | Research Studies
Ugly Truths of Smoking Hookah
experts, colleagues explain dangers of hookah smoking
causes Leukemia: study
as Health Risk, Still Qualifies as Smoking
Deliver Toxic Benzene in Every Puff
smokers and nonsmokers exposed to secondhand smoke ...
Bars: Does the Smoking Ban Apply?
lounge violated permit conditions: VGN
1 in 5 high school seniors have tried hookah
Fayetteville ordinance could snuff out rapid growth of tobacco shops
bars have higher indoor air pollution
College Students, Hookahs Are Bad for You
pipe smoking causes significant exposure to nicotine and cancer-causing
finds cigarette alternatives may not be safer than cigarettes
alternatives may not be 'safe' tobacco
fines hookah lounges, orders them to curtail smoking
city officials ban hookah bars
smoking delivers carcinogens and carbon monoxide
Carbon Monoxide, Benzene In Hookah Smoke Than Cigarettes, Study Says
intended for hookah lounges backfires
OKs smoking definition to include hookah
In 3 College Students Has Smoked Hookah
Unfortunately, smoking hookah delivers the same chemical compounds
as smoking a cigarette. In fact, one session (usually about 45 to 60
minutes) delivers approximately 100 times the smoke as a single cigarette,
with 40 times the tar and 10 times the carbon monoxide. ...
lounges under fire
...Organizations like Americans for Nonsmokers' Rights (ANR) and smokefreewashington.com advocate against these hookah lounges as well as casinos that allow ...
Banning Hookah and E-Cigarette Use Clears Another Hurdle
(KCPW News) A bill banning the use of hookahs and e-cigarettes in public places under the Utah Indoor Clean Air Act will be debated by the full senate after ...
passes ban on using e-cigarettes, hookahs in public
The Utah House approved a proposal Tuesday to ban the smoking of hookah pipes and e-cigarettes in public places, after opponents held a hookah pipe smoking ...
House committee OKs hookah ban
By Robert Gehrke A House committee approved a bill Thursday banning the use of hookahs and electronic cigarettes in public places, but gave a five-year...
panel forwards ban on hookah, e-cigarettes
more underage hookah smoking
lawmakers: Smoking hookah OK in bars and clubs
Utahns can continue to smoke tobacco from water pipes after all. ...
HOOKAH BAN: Controversial hookah ban goes into effect in Utah
A controversial ban on hookah bars in the state goes into effect today.
Hookah Bars Illegal?
gives hookah the hook
Starting in mid-September, Utah bars and clubs cannot allow patrons
to smoke most hookah products indoors. ...
bars are catching on in Rhode Island
Hookah lounges arrived in Rhode Island in 2005. Instead of burning
out, the fad appears to have grown increasingly popular, with a half-dozen
hookah lounges on Federal Hill alone. ...
over for San Francisco hookah lounges
lounges: S.F. health officials seek closure
Public health department officials are threatening to shut down hookah
lounges, whose owners, they say, have refused to obey state and local
laws that ban indoor smoking, despite mailed and in-person warnings
over the past year. ...
"Reducing hookah use: a public health challenge for the 21st century," BACCHUS Network, .
This white paper report from the BACCHUS Network described the history
of hookah use, its growing popularity among young people in the United
States, the reasons for its popularity, marketing tactics by manufacturers,
media coverage, health risks of use, attitudes to use, and tobacco policy
to control use.
health officials proposing rule to ban hookah smoking in public places,
A proposed rule by Utah health officials would prohibit hookah smoking
in popular bars and other public places. ...
County's ban on e-cigarettes, hookahs begins next Monday
Beginning Monday, June 6, Madison County will enforce an amended smoking ban that includes electronic cigarettes. The Madison County Board of Health voted in April to include e-cigarettes and hookahs (water pipes) in its indoor smoking restrict
a Crimp in the Hookah
bar slips through legislative loophole
If Oregon lawmakers pass House Bill 2726, new hookah bars would be
banned from opening, but the 62 existing lounges statewide plus any
established before July would be grandfathered in. ...
lawmakers try to plug loophole allowing hookah lounges
Al Narah, Eugene's newest hookah lounge, may have opened in the nick of time. ...
bars, popular with teens, put on notice
Safer Than Cigarettes? A Pipe Dream
Lots of people who quit cigarettes to escape the dangers of nicotine
are turning to water pipe smoking, wrongly assuming that toking on "hookahs"
is safer, new research indicates. ...
Lounge Ban Narrowly Passes Committee Vote
Lounges Face Possible Changes
A bill that prohibits smoking in Connecticut hookah lounges, except those open before the end of last year, is facing a key legislative vote. ...
Votes to Place Restrictions on Hookah Bars
Reveals Higher CO Levels With Hookah Smoking
Use Widespread Among College Students Study Reveals Mistaken Perception
Councilman wants to ban creation of new hookah bars in city, says smoke
A lawmaker wants to snuff out the growth of the city's hookah bars - saying herbal smoke from the lounges' water pipes is just as dangerous as cigarettes.
City Councilman Vincent Gentile (D-Brooklyn) will press this week to extend a smoking ban to include all smoking, including now-legal herbal shisha smoke from hookahs.
Existing hookah bars would be exempt, but new indoor ones would be banned in 2012. The dozens already open would have to register with the city Health Department, and wouldn't be able to expand or change locations.
Gentile argues that hookah smoke, which contains tar and carbon monoxide, can be just as dangerous as cigarettes. ...
County OKs hookah policy
Provo To the Utah County Board of Health, hookah pipes are the same as cigarettes and cigars.
The board unanimously voted Monday to adopt a policy treating hookah pipes like any other tobacco product, fully subject to the Indoor Clean Air Act.
The policy will act as a placeholder. Its expected the state Department of Health will issue an administrative rule declaring hookah pipes subject to Utahs indoor-smoking law.
Joseph Miner, Utah County Health Departments executive director, said the county is following the lead of Davis County, which recently enacted an identical policy.
Were doing what common sense tells us, Miner said. But until the state acts, we need some guidelines." ...
for hookah bars in Davis County goes up in smoke
FARMINGTON Before any hookah bars open in the county, the Davis County Board of Health plans on halting them at the border by using the states Clean Air Act.
The board gave a directive to health department director Lewis Garrett to put together a policy which would ban such establishments because of the effects of second-hand smoke hookahs would generate. . . .
Sam North, a health educator with the county, told board members that for many, smoking a hookah is a social event.
Hookah bars are gaining in popularity in the United States, especially among college-age students. Here in Utah there are such bars in Salt Lake County and elsewhere. Utah County is looking at its first.
North told board members that statistics from studies conducted in 2005 and 2006 for a national Tobacco-Related Disease Program, show that those smoking hookahs get 72 times the tar, four times the nicotine and 11 times the carbon monoxide of those smoking cigarettes. ...
City rejects proposal to allow hookah lounges
The move comes in response to at least four inquiries the city has received this fall from entrepreneurs seeking to fill North County's void of hookah lounges, where customers smoke flavored tobacco through communal pipes.
Area residents have been forced to travel to Sorrento Valley or San Diego's Gaslamp District to smoke hookah pipes in a public setting since the only lounge in North County, Hubbly Bubbly in San Marcos, closed about a year ago.
Proponents have said that allowing such lounges in Escondido could reduce the growing number of downtown vacancies, help fill the city's void of activities for young people, bring new energy to Grand Avenue and possibly bolster nearby restaurants and retail shops.
Councilman Sam Abed and Councilwoman Olga Diaz said they were open to allowing hookah lounges if the city adopted significantly tougher restrictions than other cities have ...
tobacco smokers inhale same toxicants as cigarette smokers
Smoking tobacco through a waterpipe exposes the user to the same toxicants
-- carbon monoxide and nicotine -- as puffing on a cigarette, which
could lead to nicotine addiction and heart disease, according to a study
led by a Virginia Commonwealth University researcher published in the
December issue of the American Journal of Preventive Medicine.
"The results are important because they provide concrete, scientific evidence that contradicts the oft-repeated myth that waterpipe tobacco smoking does not involve users inhaling the same harmful chemicals that cigarette smokers do," said principal investigator Thomas Eissenberg, Ph.D., professor in the VCU Department of Psychology.
"We hope that these results will be used by physicians and public health officials to inform waterpipe tobacco smokers that they risk tobacco-induced nicotine addiction and cardiovascular disease," he said.
Smoking hookah not worth the health risk - Feature
Smokers who think that trying hookah as a healthier alternative to cigarettes are way off base. Hookah smokers inhale a greater volume of smoke, worsening the effects of the chemicals in the tobacco.
"Data from several different countries reveals that a single hookah-use episode lasts for about 45 minutes and can easily involve over 100 puffs," said Thomas Eissenberg, professor of psychology at Virginia Commonwealth University, whose research is funded by a grant for the National Cancer Institute.
"Each puff is about 500 ml in volume, while a single cigarette-use episode lasts about 5 minutes and can involve about 10-12 puffs of about 30-50 ml each. We are talking 100 times the smoke inhalation for a hookah-use episode, 50,000 ml total volume relative to a single cigarette-use episode, 500 ml total volume." . .
While it is widely known that cigarette smoking is bad for your health, hookah is possibly even worse. Hookah smoking is becoming popular across the country with hookah cafes opening up in many cities. Last semester, a hookah bar opened on Marshall Street but closed after just a few months. I guess the cost to expose one's self to cancer must have not worked well in this economy. ...
Area hooked on hookah
Across the Bay Area and nation in recent years, hookah lounges have
become increasingly popular gathering places for college students too
young to drink legally, transplanted Middle Easterners looking to indulge
in a familiar pastime and even for veterans of the Iraq war, who learned
to enjoy hookahs while overseas. The practice is believed to have originated
in India and spread to the Middle East hundreds of years ago.
"It's more fun to be in the social atmosphere here," he said at Da Hookah Spot. "I don't smoke cigarettes, but I smoke from a hookah pipe once or twice a week."
The lounges are often classified as tobacco shops, allowing them to get around California's 1998 statewide ban on smoking in bars. Most cities prohibit the sale of food in such establishments. The sale of nonalcoholic beverages, however, is typically allowed as long as they do not make up a significant portion of revenues, and alcohol is prohibited, according to officials at the city attorney's offices in Palo Alto, Hayward and San Francisco.
waves goodbye to hookah bars
hookah bar, no smoking
The College Station City Council decided Thursday not to make an exception to the city's smoking ordinance for a hookah bar. Hookah Station in the Northgate district had requested an exclusion from the city ordinance that was revised early this year ...
smokers at high risk of catching virus
Sheesha smokers could be contributing to the spread of the swine flu, it has been claimed.
According to the Bahrain Anti-Smoking Society, sheesha pipes are an ideal tool for users to catch the virus since they are often passed from person to person.
'This is a real threat and all sheesha users should be careful,' said society vice-president Dr Kadhem Al Halwachi.
'We have already been told smokers are at an increased risk of getting complications from the swine flu because a smoker's lungs are already compromised.'
Health officials last week added smokers to a list of 'high risk' individuals who could contract the H1N1 virus. ...
no to hookah bars, yes to tattoos in Menifee
The Menifee Planning Commission started tackling the question on Tuesday of how to regulate hookah lounges, tattoo parlors and cell phone towers, all of which are temporarily banned in the city.
After recommending a ban on hookah lounges, most commissioners leaned in favor of allowing but tightly regulating, tattoo and body piercing parlors.
Four of the five commissioners expressed reservations about hookah lounges, saying they could promote smoking or encourage crime or "smoking other things," as Commissioner Marc Miller put it.
Commissioner Bill Zimmerman supported allowing hookah lounges "in the interest of being fiscally sound."
"If Menifee wants to send a message to the public that we are business friendly, an outright ban on certain businesses might not send the right message," he said. ...
'as harmful as cigarettes'
Smoking a shisha pipe is as bad for people as smoking tobacco, the Department of Health and the Tobacco Control Collaborating Centre has found.
People who smoke shisha, or herbal tobacco, can suffer from high carbon monoxide levels, its research revealed.
It found one session of smoking shisha resulted in carbon monoxide levels at least four to five times higher than the amount produced by one cigarette.
High levels of carbon monoxide can lead to brain damage and unconsciousness. . . .
The study found shisha smokers had 40-70 ppm of CO in their breath - affecting 8-12% of their blood.
Dr Hilary Wareing, director of the Tobacco Control Collaborating Centre, told the BBC's Asian Network she was shocked by the results of the research. . . .
"You never see it in the news - 'that is terrible, don't do it'
- there's no shock tactics like (there is with) cigarettes," said
one young woman.
It was this misconception - and finding dangerous levels of carbon monoxide in a pregnant woman who had stopped smoking tobacco, but continued to smoke shisha - which prompted the research.
"We found one session of smoking shisha - that's 10 milligrams
(of fruit tobacco) for 30 minutes - gave carbon monoxide levels that
were at the lowest four and five times higher than having a cigarette,"
said Dr Wareing. ...
Exemption for Hookah Bars
A bill to exempt hookah bars from the North Carolina smoking ban was
withdrawn from the House at the request of hookah bar owners.
"I tried to make it very clear that our window of opportunity was now, which was last week, and once the decision was made not to go forward with the bill, that killed it for this session."
Tarleton says the owners asked him to withdraw the bill because of amendments that would greatly restrict their businesses. ...
of Hookah Establishments in North Carolina
After the successful passage of a statewide law to prohibit smoking in all NC restaurants and bars, discussion of the laws impact on hookah bars was brought up by legislators and hookah establishment owners. This report provides a description of hookah, the health impact of hookah use, and results of a survey of hookah establishments in North Carolina. ...
law may put flames out at Wilmington Hookah Bars
Wilmington is home to about one-fifth of all hookah bars in North Carolina, but the state smoking ban would effectively put them all out of business.
A bill approved Tuesday by a judiciary committee could change the rules
for hookah bars like Wilmington's Juggling Gypsy on Castle Street.
for hookah bars OK'd by NC House panel
Establishments where patrons smoke tobacoo using a water pipe could
remain open in North Carolina in legislation heading to the full House.
Cruz bans hookah lounges near kid hot spots
City leaders cracked down on hookah lounges Tuesday night, saying the couch-filled shops that sell sessions with flavored tobacco and a water pipe need to stay away from schools, and that only one more will be allowed within city limits.
"It occurred to us that this was really more of a public health issue," said City Attorney John Barisone. "This particular type of business appeals to young people."
Right now only one hookah lounge, Smoke This! Hookah Lounge next to the Teen Center on Laurel Street, is open in Santa Cruz. That's down from a height of three in 2007. While Smoke This! will be grandfathered in until the year 2014, new rules will not allow lounges within 1,000 feet of schools, parks or recreation centers. ...
leader hopes to curb hookah use among minors
chillum smoking more toxic than cigarette: Study
JAIPUR: Traditional hookah and chillum are more injurious to health than cigarette, a study has said.
The study underlines that the old mode of smoking is much more toxic than cigarette smoke as carbon monoxide (CO) level is higher in it, the study conducted by a group of pulmonary doctors of the SMS Hospital Medical College and the Asthma Bhawan here said.
The study assumes significance in the wake of ongoing debates on the ill effects of smoking and the countrywide ban on lighting up the rolled tobacco at public places, which came into force on Thursday.
Professor of medicine Virendra Singh, who was a part of the study claims that the traditional smoking ways can be fatal.
Smoking on College Campuses May Contribute to Growing Public Health
More and more U.S. college students are smoking tobacco using waterpipes or hookahs and its becoming a growing public health issue, according to a new study led by a Virginia Commonwealth University researcher.
The findings offer important insight into the prevalence and perceptions related to waterpipe tobacco smokers and are reported in the May issue of the Journal of Adolescent Health. The article is also featured in an editorial in the same issue.
These results should serve as an alarm bell to anyone interested in public health in the United States. Preventing tobacco-caused death and disease means remaining alert to new forms of tobacco smoking and then understanding the health risks of these new forms and communicating these risks to public health workers, policy makers, and to smokers themselves, said principal investigator Thomas Eissenberg, Ph.D., associate professor in the VCU Department of Psychology. . . .
Water pipe smoking a significant TB risk
The smoking of the traditional `shisha' water pipe is increasingly emerging as a significant health risk in Egypt, due to air-borne tuberculosis (TB) transmission from pipe sharing and uncontrolled, manual preparation of the pipe.
Rania Siam, professor of microbiology at the American University in Cairo (AUC), said the most important risk factor for TB infection was close household contact with a TB case, but she said water pipe smoking (WPS) and the sharing of the pipe with someone with pulmonary TB led to a great risk of TB transmission, especially among young adolescents.
"`Shisha' [smoking] is Egyptian culture, where people smoke tobacco and inhale directly from this device. If I smoke `shisha', some bacteria may reside in it.
officials warn of hookah-smoking hazard: Two CSU students contracted oral herpes
Cases of two Colorado State University students who might have contracted oral herpes from recent trips to a hookah bar are prompting health officials to remind people of the dangers of sharing saliva.
Anything from mononucleosis to an infectious cold sore can be passed through sharing soft drinks or passing around a mouthpiece at a hookah smoking session. "People shouldn't share spit," said Paul Poduska, infections control coordinator at Poudre Valley Hospital.
|Hookah News | Research Studies|
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|Barnett, T.E.; Forrest, J.R.; Porter, L.; Curbow, B.A., "A multiyear assessment of hookah use prevalence among Florida high school students," Nicotine and Tobacco Research [Epub ahead of print], December 17, 2013.|
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|Lee, Y.O.; Mukherjea, A.; Grana, R., "Hookah
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Tobacco Control 22 (2): 136-137, March 2013.
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|Maher, J.E.; Morris, D.S.; Girard, K.E.; Pizacani, B.A., "Consequences of clean indoor air exemptions in Oregon: the hookah story," Tobacco Control [Epub ahead of print], December 12, 2012.|
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|Ashurst, J.V.; Urquhart, M.; Cook, M.D., "Carbon monoxide poisoning secondary to hookah smoking," Journal of the American Osteopathic Association 112(10): 686-688, October 2012.|
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|Jarrett, T.; Blosnich, J.; Tworek, C.; Horn, K., "Hookah use among U.S. college students: results from the National College Health Assessment II," Nicotine and Tobacco Research 14(10): 1145-1153, October 2012.|
|Cobb, C.O.; Khader, Y.; Nasim, A.; Eissenberg, T., "A multiyear survey of waterpipe and cigarette smoking on a US university campus, " Journal of American College Health 60(7): 521-527, October 2012.|
|Abughosh, S.; Wu, I.H.; Rajan, S.; Peters, R.J.; Essien, E.J., "Waterpipe smoking among students in one US university: predictors of an intention to quit," Journal of American College Health 60(7): 528-535, October 2012.|
|Fiala, S.C.; Morris, D.S.; Pawlak, R.L., "Measuring indoor air quality of hookah lounges," American Journal of Public Health [Epub ahead of print], September 20, 2012.|
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