The practice of hookah smoking, or waterpipe smoking, has been around for centuries.
Originating in Africa and Asia, hookah smoking has become a worldwide phenomenon in the past few decades — particularly among teenagers.
The practice is widely perceived and marketed as a safer alternative to traditional cigarettes.
However, the World Health Organization (WHO) warn that "contrary to ancient lore and popular belief, the smoke that emerges from a waterpipe contains numerous toxicants known to cause lung cancer, heart disease, and other diseases."
A new study conducted by researchers at the University of California Los Angeles (UCLA) supports the WHO's conclusion. Specifically, the researchers show the effects of just one session of hookah smoking on heart rate, blood pressure, and arterial stiffness.
The researchers — led by Mary Rezk-Hanna, an assistant professor at UCLA — published their findings in the American Journal of Cardiology.
Hookah smoking and cardiovascular health
Rezk-Hanna and her colleagues investigated the cardiovascular effects of hookah smoking in 48 healthy young adults who were not in the habit of smoking traditional cigarettes.
To examine these effects, the researchers took the following measurements: heart rate, peripheral and central blood pressure, a measure of arterial stiffness called "carotid-femoral pulse wave velocity," and an index of aortic enlargement.
Arterial stiffness, or the loss of arterial elasticity, is a reliable predictor of stroke. The enlargement of the aorta — which is the main artery that transports blood from the heart to the rest of the body — is a condition that can be fatal if left untreated.
Both aortic enlargement and artery stiffness can increase the risk of heart attack and other adverse cardiovascular events.
In the new study, the researchers also looked at blood levels of nicotine, as well as the levels of exhaled carbon monoxide.
Not a more healthful alternative to cigarettes
After only 30 minutes of hookah smoking, the participants' heart rates increased by 16 beats per minute, and their blood pressure rose.
Additionally, the researchers found hookah smoking to heighten arterial stiffness to a degree comparable with the damage caused by smoking one traditional cigarette.
The results are concerning given that the study tested only the effects of half an hour of smoking, whereas most people smoke hookahs for several hours.
The authors report additional concerns. "We know that flavored tobacco products are frequently the first kind of tobacco product used by youth," says the study's lead author.
"One of the major issues with hookah is the fact that the tobacco is flavored with fruit, candy, and alcohol flavors, making hookah the most popular flavored tobacco product among this audience."
"Our findings challenge the concept that fruit-flavored hookah tobacco smoking is a healthier tobacco alternative. It is not."
To the authors' knowledge, this is the first time that a study has examined the effects of hookah smoking on the elasticity of the arteries.