Health Risks of Hookah Pens

IMAGE: optumhealth.com 

There is a growing trend among my 13 year old daughter's friends that alarms me: Hooka pens.

Up until a few weeks ago I had never heard of them. Apparently it is a little tiny hooka-a water pipe (AKA "bongs" when I was growing up) crammed into a stick the size of a pen. When I asked her where she heard about these, she told me that one of her friends had one at school. Great. Now I had to explain to my daughter what a Hooka is and what its for. 

The kids seem to think its safe because "its just water vapor", but when I explained the science of how the vapor carries the fruit-flavored tobacco-and other toxins - into the lungs, she started to realize that these are not for kids. 

After seeing some of her classmates posting pictures of themselves on Instagram smoking these, my first question to myself is 'why would anyone want to encourage kids to smoke?' And then I realized the world I live in, and that its not about whats good for kids, its about moving product.

The appeal of these "wands" is that there is no traditional smoke odor so teens can "smoke" without giving it away to parents or watchful adults.

My second question: 'are they safe?' My medical/scientific background instinctively tells me they are not. So I did some quick and informal research. One article I found (that did not list any medical studies) got my attention:

"There is a common misconception prevailing among people that smoking tobacco through a hookah pipe is safer than smoking through cigarette. People mistakenly believe that the water content present in the hookah pipe captures the toxin stuff and so the smoker is not exposed to them. Of course, the water does cool the smoke, making it feel less harsh. But cooler smoke does not mean that it is safer smoke. In fact, smoking tobacco from a hookah could be possibly more detrimental than smoking cigarettes."

The article lists the following as health risks:

Health effects of Hookah

• In a hookah pipe, charcoal is used to heat the tobacco and this charcoal increases the health risks by generating high levels of CO (carbon monoxide), tar, metals, and various cancer-causing chemicals.
• Hookah holds approximately five times more cancer-causing agents compared to cigarettes. The tobacco and smoke coming from hookah contains a number of toxic materials that can even cause bladder, lung, and oral cancers.
• Hookah smokers are also exposed to several toxic substances that can cause clogged arteries and heart diseases.
• Sharing of hookah’s waterpipe among several smokers can significantly increase the risk of contracting some infectious diseases like meningitis, tuberculosis, or meningitis.
• One of the harmful effects of hookah is the problem of infertility.
• Majority of the hookah smokers are found to suffer from the problem of breathing difficulties and wrinkling of skin.
• It has been found that women who smoke hookah one or more times a day during pregnancy give birth to low-birth weight infants than women who are nonsmokers. Plus, babies born to smokers are at an increased risk for respiratory diseases.
• Hookah smoke delivers nearly the same amount of nicotine as cigarette does, leading to nicotine addiction in the user.

Source: sweetadditions.net Read Full Article Here


Then I dug deeper to find some studies. Here's what I came up with:



The American Lung Association (ALA) identifies hookah smoking as a major health risk. 

The following are the health risks of hookah smoking: 

• Lung cancer, oral cancer 
• Gastric and esophageal carcinoma 
• Impaired pulmonary function 
• Heart disease 
• Reduced fertility
• Low birth weight of the babies 
• Hepatitis or herpes (caused due to the sharing of hookah among smokers)

From Cancer.org:

"Hookah smoking is no safer than cigarette smoking. If you read no further, that is the take-home message for this blog -- no matter what you may have heard or read, the scientific evidence is clear that hookah smoking is not a safe alternative to smoking cigarettes."





From smokefree.gov, 

(Department of Health and Human Services website created by the National Cancer Institute:)


Q: Some hookahs have labels stating that they include "0% tar". Is this accurate information?

A: No, this is deceptive. No tobacco contains tar before it is smoked; tar is produced by burning tobacco. It should be noted that a single standard hookah smoking session is associated with 46.7 times the amount of tar relative to a single cigarette [17].

Q: Is hookah smoking addictive?

A: Yes. Tobacco is used in the hookah and contains nicotine. Hookah smokers are therefore exposed to the addictive substance, nicotine [19]. The amount of tobacco smoked in one head of hookah has the nicotine content contained in 70 regular cigarettes [20].

17. Cobb, C., K.D. Ward, W. Maziak, A.L. Shihadeh, and T. Eissenberg, Waterpipe Tobacco Smoking: An Emerging Health Crisis in the United States. In press

19. Eissenberg, T. and A. Shihadeh, Waterpipe Tobacco and Cigarette Smoking: Direct Comparison of Toxicant Exposure. In press.

20. Hadidi, K.A., and F.I. Mohammed, Nicotine content in tobacco used in hubble-bubble smoking. Saudi Med J, 2004. 25: p. 912-917.

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I found a wealth of information & study links at the 

Global Advisory on Smoke-Free Policy:

The World Health Organization Advisory Note issued in 2005 cites:

"Waterpipe smoke contains numerous toxicants known to cause lung cancer, heart disease and other diseases, adverse effects on pregnancy. Same secondhand smoke disease risks caused by cigarette smoking. In one waterpipe smoking session, waterpipe smoker may inhale up to equivalent of 100 cigarettes."

Here are 2 more:


Hookah Smoking No Less Harmful than Cigarettes-(University of California Study)

Hookahs (CDC.gov)



What is your experience with Hooka Pens? Have you seen your kids or students with these? Does your school have a policy on the use of Hookah Pens? Tell us in the comments area below.