Frequently Asked Questions of Hookah

Is enjoying hookah the same as smoking cigarettes?

No. All tobacco products have risks but comparing hookah to cigarettes is erroneous and misleading.

Hookah is heated at a temperature that is four times cooler than a burning cigarette and creates an aerosol that is 75% water (60%) and glycerol (15%). By contrast, cigarette smoke is 75% tar, carbon monoxide, and nicotine .

Most people enjoy hookah in moderation, far less often than typical smokers light up a cigarette. In the United States, for example, 90% of people who enjoy hookah do so no more than once per month. In comparison, the average American cigarette smoker will smoke 14 cigarettes per day.

Hookah takes time to prepare and cannot be transported easily or used “on the go.” Hookah is a unique cultural and social experience, whose history, ingredients, and use make it incomparable to other tobacco products characterized by high frequency use.

Does the water bowl act to purify the hookah aerosol?

No. Water does not purify the aerosol. Its purpose is purely functional. Without the water, the aerosol from the hookah head cannot be drawn into the pipe.

Is a one-hour hookah session the same as smoking 100 or 200 cigarettes ?

No. Hookah aerosol and cigarette smoke are fundamentally different from each other.

A study commissioned by Al Fakher and published by the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA) found that a popular hookah brand- which has a much lower tobacco content than cigarettes – generates an aerosol that is 75% water (60%) and glycerol (15%). This is completely different from cigarette smoke that is 75% tar, nicotine and carbon monoxide. The same study found that flavored hookah molasses are heated at much lower temperatures, and create aerosol with far lower concentrations of nicotine and other constituents compared to cigarette smoke

Cooperation Centre for Scientific Research Relative to Tobacco. A Preliminary Comparison of flavoured waterpipe tobacco aerosol with cigarette smoke. Wilkinson, Oct 2019 CDC, National Health Interview Survey (NHIS), Press Release, Thursday, January 18, 2018 Arabian Business 7 Nov 2019. Is hookah really as bad for you as the world health experts say? New report from UAE-based manufacturer shines light on 'misleading' comparisons between hookah and cigarettes.
Cooperation Centre for Scientific Research Relative to Tobacco. A Preliminary Comparison of flavoured waterpipe tobacco aerosol with cigarette smoke. Wilkinson, Oct 2019

For example, in the CORESTA study the aerosol generated from one hour of heating the tested flavored hookah product contains less nicotine than two cigarettes.

Innovations in heating hookah molasses can decrease chemicals in the aerosol even further and are worth further study.

Is hookah contributing to youth tobacco use?


Evidence from United States health agencies show very few teens have tried hookah compared to other adult orientated products, including cigarettes and vapes. For example, the U.S. Centers for Disease Control (CDC) found that just 2.6% of teenagers used hookah in the last 30 days. More than ten times as many teenagers use e-cigarettes (27.5%).

Hookah waterpipe devices are generally around three feet tall on average and cannot be easily transported or concealed. Politicians throughout the United States, including the Governor of California, have publicly stated that hookah is “not the problem” for teens .

Is there a difference between flavored and unflavored hookah?

Yes. Flavored hookah is a completely different product from unflavored hookah. Unflavored hookah is uncommon, contains a fundamentally different ingredients mix, including a higher tobacco content, and can only be consumed by burning tobacco and releasing tobacco smoke.

For example, black molasses from Egypt, which are unflavored, contain much higher levels of tobacco and nicotine. Their glycerin content is low and because of this, they can only be smoked by placing charcoal directly on the tobacco mixture, thereby burning it and releasing higher levels of toxicants.

NHCA members do not produce or sell any unflavored hookah. Our flavored hookah products include around 40% glycerin and cannot be consumed by direct application of charcoal to the hookah. Glycerin is a critical component in our member’s hookah products because it enables consumption without burning the mixture.

CDC, National Youth Tobacco Survey - Tobacco Product Use Among Middle and High School Students — United States, 2019.
L.A. County Board of Supervisors Unanimously Votes for Tobacco Flavor Ban Despite Pleas for Hookah Cultural Exception,, 01 Oct 2019

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