hookah

hookah, apparatus used to heat and vaporize tobacco for inhalation. The word hookah is derived from the Hindustani huqqa and the Arabic huqqah, meaning “vase” or “vessel.” The practice of smoking tobacco from a hookah likely originated in India or the Middle East. Today it is used worldwide and is especially popular in parts of Asia and Africa and in the Middle East; its use has also expanded to the smoking of other substances, such as cannabis and hashish. An estimated 100 million people participate in hookah smoking every day.

Parts and mechanism

The hookah generally appears as a long flexible pipe—or series of pipes—attached to a large central bowl, usually of glass or porcelain, that is filled with water. Some hookahs are stylized with long necks decorated with ornate images or metalwork. Modern hookahs are often equipped with covers to prevent wind from accelerating the tobacco-burning process as well as valves to release smoke that has not been inhaled. A rounded tobacco receptacle is placed atop the rig, with a larger ashtray just below.

Tobacco is placed on top of hot coals in the receptacle and burned. The user inhales from a metal or plastic mouthpiece attached to the end of the pipe, which creates an oxygen vacuum in the instrument that forces smoke from the burning tobacco to flow downward. The smoke passes through the water, cooling the smoke on its path toward the user. Hookah tobacco is often compressed into specific molds so as to better fit the hookah rig and to prolong burning.

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There are three common types of tobacco that are smoked out of a hookah: Mu’assel, Jubak, and Tumbak. Mu’assel is typically described as honeyed, since it consists mostly of honey or sugarcane and a relatively small percentage of tobacco; it is often flavored. Jurak contains tobacco mixed with a smaller amount of sugarcane, relative to Mu’assel, and contains dried fruits and other spices. Tumbak is a pure tobacco that is smoked over coals prior to use.

History

European tobacco and pipes were first introduced from Europe to northwestern Mughal India in the latter half of the 16th century. Early accounts suggest that Akbar, the third Mughal emperor (reigned 1556–1605), was the first to try the substance. Akbar’s physician, worried about the health effects of directly inhaled smoke, created a pipe that forced the smoke to pass through water before inhalation; it was claimed that this process purified the smoke. Other historical accounts suggest, however, that the hookah may have been introduced earlier, in the Middle East. Regardless of its precise origins, the apparatus—originally of rudimentary build, consisting of a straw or bamboo pipe inserted into a coconut shell—spread relatively rapidly throughout India, northern Africa, and central Asia. The modern pipe shape, with extended neck and mouthpiece, evolved as hookah use spread through Persia and the Ottoman Empire in the 17th century.

Hookah smoking became a social activity in many cultures, as well as a status symbol, often reserved for the wealthy and for nobility. In social settings hookahs were set up to have many separate pipes attached, allowing multiple people to smoke from a single apparatus. The communal aspect of hookah smoking remains popular and is seen often in the form of hookah bars and cafes, where patrons pay to sit at tables and smoke tobacco from a shared hookah.

Health effects

Hookah smoking is associated with various health risks, resulting from exposure to nicotine and other harmful substances that are present in tobacco smoke, as well as hydrocarbons and heavy metals that are present in the charcoal. Because hookah tobacco can be inhaled at a higher, steadier rate than a cigarette, it can give users an increased buzz, often making them lightheaded, dizzy, or relaxed. Overuse, however, can cause nausea and headache.

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Moreover, evidence suggests that in a single smoking session, hookah users inhale significantly greater amounts of nicotine, carbon monoxide, tar, and smoke than they would from smoking a single cigarette. Many of these substances—particularly carbon monoxide in tobacco smoke and heavy metals and hydrocarbons in charcoal—are carcinogenic, and thus exposure to them in hookah smoke is associated with an increased risk of cancer, especially lung cancer, bladder cancer, and oral cancer. Inhalation of tobacco smoke and chemicals in charcoal is also linked to cardiovascular disease, gum disease, and respiratory disease, and sharing of hookah pipes or mouthpieces increases the risk of transmission of infectious diseases such as tuberculosis, hepatitis, herpes, and influenza.

In addition, secondhand smoke from burning tobacco and charcoal in hookahs poses significant health risks for nearby nonsmokers.