One Hookah Smoking Session Delivers 25 Times the Tar of a Single Cigarette: Study

By Epoch Newsroom
Epoch Newsroom
Epoch Newsroom
January 12, 2016 Updated: January 12, 2016

A new study has found that one hookah smoking session delivers 25 times the amount of tar of a single cigarette.

It also delivers 125 times the smoke, 2.5 times the nicotine, and 10 times the carbon monoxide. 

“Our results show that hookah tobacco smoking poses real health concerns and that it should be monitored more closely than it is currently,” said lead author Brian A. Primack, M.D., Ph.D., assistant vice chancellor for health and society in Pitt’s Schools of the Health Sciences, in the study announcement.

The finds were drawn when the researchers did a meta-analysis, or a mathematical summary of previously published data, of 542 scientific articles potentially relevant to cigarette and hookah smoking. Seventeen of these studies were ultimately utilized for the analysis.

“A strength of meta-analysis is that it enables us to provide more precise estimates by synthesizing the currently available data from individual studies,” said co-author and expert in meta-analysis Smita Nayak, M.D., research scientist at the Swedish Center for Clinical Research and Innovation.



The study was done soon after the the Centers for Disease Control and Prevention recently reported that for the first time, U.S. high school students started smoking hookah more than cigarettes.

Still, the analysis does have a weakness–the comparison between a hookah smoking session and a cigarette smoking session typically differs in length and frequency, with people smoking hookah doing so much longer but many fewer times a day.

“It’s not a perfect comparison because people smoke cigarettes and hookahs in very different ways,” said Dr. Primack.

“We had to conduct the analysis this way—comparing a single hookah session to a single cigarette—because that’s the way the underlying studies tend to report findings. So, the estimates we found cannot tell us exactly what is ‘worse.’ But what they do suggest is that hookah smokers are exposed to a lot more toxicants than they probably realize. After we have more fine-grained data about usage frequencies and patterns, we will be able to combine those data with these findings and get a better sense of relative overall toxicant load.”

The analysis was published in the journal Public Health Reports.