Water pipe smoking, such as hookah or bong smoking, has a negative impact on lung function and respiratory symptoms, similar to the effects of cigarette smoking, according to new research published in the journal Respirology.

Water pipe users and even physicians have believed that smoking through a water pipe filters out the toxic components of tobacco, making it less harmful than smoking cigarettes.

A water pipe, such as hookah, is an instrument for smoking flavored tobacco. However, before inhalation, the smoke is passed through a water basin.

In order to compare lung function and respiratory symptoms among water pipe smokers, deep or normal inhalation cigarette smokers, and non-smokers, Mohammad Hossein Boskabady, MD, PhD, of Mashhad University of Medical Sciences and his colleagues evaluated these three different groups of smokers.

The research consisted of 57 water pipe smokers, 30 deep inhalation cigarette smokers (S-DI), and 51 normal inhalation cigarette smokers (S-NI). Forty-four non-smokers were also observed as a control group.

A questionnaire was given to subjects to evaluate the prevalence and severity of respiratory symptoms, while lung function tests were performed on smokers and control subjects by using a spirometer.

Among both water pipe smokers and cigarette smokers, results showed an increased prevalence and severity of respiratory symptoms.

Water pipe smoking and deep inhalation cigarette smoking were shown to have similar effects on respiratory status.

Analysis showed that wheezing was found in:
  • 23% of water pipe smokers
  • 30% in S-DI
  • 21.6% in S-NI
  • 9.1% in non-smokers
Chest tightness was found in:
  • 36.8% of water pipe smokers
  • 40% in S-DI
  • 29.4% in S-NI
  • 13.3% in non-smokers
Cough was found in:
  • 21% of water pipe smokers
  • 36.7% of S-DI
  • 19.6% of S-NI
  • 6.8% in non-smokers
Boskabady concluded:

"Our study is the first report regarding the importance of the method of cigarette smoke inhalation with respect to effects on the respiratory system. Our findings reveal that there were profound effects of water pipe smoking on lung function values, which were similar to the effects observed in deep inhalation cigarette smokers."

Written by Sarah Glynn