Home page Psychology blog Bad Habits Substance Abuse Cigarettes VS hookah: how one addiction replaces another

Cigarettes VS hookah: how one addiction replaces another

24.09.2019 Author: Psychologist Pavel Khoroshutin

Many people give up cigarettes in favor of hookah, believing that fragrant smoke does not cause any harm to health. However, this is not the case — one addiction simply replaces another, and the body suffers the same way. In the article we will discuss important issues: why is hookah harmful and how to deal with the formed addiction?


Hookah Harm: 3 good reasons to say no to fragrant smoke

cigarette vs hookah

The hookah is a smoking vessel that allows cooling and moisturizing of inhaled tobacco smoke and various smoking mixes. The device may be filled with water, milk or wine. A tube is loaded into the container, through which smoke enters the liquid, and then goes through another tube and enters the smoker’s lungs.

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What harm does hookah cause and why should it be abandoned?

  1. Negative effects of nicotine and flavorings

A ban on smoking tobacco in public places has been introduced. However, hookah mixes containing nicotine have remained in the menu of bars and restaurants. And that could be compared to traditional tobacco smoking. While the amount of nicotine in cigarettes can be roughly “calculated” following the manufacturer’s labeling on the pack, everything is much more difficult with hookah mixes. The volume of nicotine amongst the total mass of components is not always indicated on the packaging.

What if the preference will be given to tobacco-free smoking mixes? However, the harm of hookah without nicotine does not decrease. In such mixes there is a high concentration of synthetic flavors, which, when heated, break down into carcinogenic substances and enter the bloodstream, poisoning the body. Even if the packaging of the mixture has a full list of components, are you sure that the manufacturer is honest with you and uses natural high-quality flavorings?

  1. Lack of hygiene

Hookah smoking is a collective activity, which involves serious hygiene violations. Few visitors to the bars pay attention to whether the device is clean and whether the tubes in it have been changed after the previous use. This can lead to serious harm from hookah smoking. 

The bars should offer disposable individual mouthpieces. However, hygiene is often forgotten in the process. It is impossible to be sure that the staff of the bar properly disinfect the vessels, thoroughly washing them. Hookahs are transferred from table to table, and meanwhile diseases such as hepatitis, herpes and tuberculosis could easily be transmitted through the tube of the device. [1]

  1. The danger of becoming addicted

Many experts believe that the main harm of hookah for humans is the possible development of addiction. Developed habit can make a non-smoker take a cigarette. Why is this happening? A man gets used to hookah. And when there is no opportunity to draw down the fragrant smoke, there is a desire to smoke at least a regular cigarette to relieve tension and stress. It is physical and psychological dependence.

The harm from hookah for non-smokers is as strong as for those who periodically inhale fragrant smoke. Long stay in a room, literally soaked in hookah “fog” is akin to participating in the process. The harm of passive hookah smoking for pregnant women is especially strong. When a woman inhales a portion of smoke (even if there is no nicotine in the mixture), brain of the fetus experiences an acute oxygen deficiency, which is extremely harmful to its normal development.

Hookan on wine, milk, and water: is there any difference?

There is an opinion that the liquid in the tank — milk, water, tea, wine and juice – filters harmful substances, and, accordingly, a much smaller amount of combustion products gets in the lungs. However, this is untrue. Any type of hookah is potentially harmful to the body.

Indeed, the concentration of many carcinogens in hookah smoke is reduced compared to cigarette smoke. But, as studies, confirm, potentially dangerous for health substances such as carbon monoxide, heavy metals, formaldehyde, acetaldehyde and benzene remain there. There are more than 27 carcinogenic substances in total.

Wine, milk and water, which are often used to refill hookah, cannot be considered as effective filters. Conventional water clears the mixture of nicotine by only 5%. The wine (especially not the best quality one) enriches the smoke with products of ethanol decay. [1]

The effect of hookah smoking on the human body

hookah smoking

Many studies confirm the harm of hookah to the human body. Heavy smokers may have serious health problems.

Cardiovascular diseases

Smoke inhalation (whether nicotine is in the composition or not) narrows the blood vessels, which can increase blood pressure and disrupt blood flow to the heart. [1]


Frequent intake of carcinogenic substances in the blood significantly increases the risks of developing malignant tumors in the lungs, mouth, stomach and bladder. [2]

Decreased visual acuity

Inveterate hookah smokers often complain of painful sensations in the eyes. They’re watering, reddening and itching. There is a risk of developing inflammation of the eye membrane and even reduced visual acuity. [2]

Teeth deterioration

According to American scientists, hookah smoking worsens the condition of teeth. It can trigger many diseases, such as periodontitis, tooth decay, enamel hyperesthesia (thinning of the tooth surface, the appearance of cracks on it).

Hookah can cause disruptions in the normal functioning of the reproductive system of men and women. Experts believe that the harm hookah causes the body of a man is associated with the possible development of his sexual dysfunctions such as impotence and premature ejaculation. These are the same negative consequences that tobacco smoking has. The harm of hookah for women is in the increased risk of hormonal failures, which threaten to disrupt the menstrual cycle. There are also risks of infertility. [1]

How often can I smoke a hookah?

At a time when hookah smoking has not yet become so popular, doctors advised limiting it to a maximum of 2 uses of smoking mixes per day. There has been very little research on whether there is any harm from a hookah.

Now more and more people consider hookah a harmless activity, which relaxes people and sets for friendly communication. Experts are particularly concerned about the rapidly developing dependence on hookah among teenagers. They then switch to e-cigarettes and then to regular cigarettes. It is especially important for the growing body of a teenager to avoid inhaling carcinogenic substances and nicotine.

How often can you smoke a hookah without harming your health? According to experts, the frequency of use of hookah should be reduced to no more than 2 times a week! At the same time, it is important not to “delay” the process — it is not recommended to inhale fragrant vapors for more than 20-30 minutes. It is also important not to smoke on an empty stomach or under the influence of alcohol since harmful substances in these cases get into the bloodstream much faster. These recommendations will help to minimize the harm from periodic hookah smoking to human health. [2]

However, it is better to give up smoking of mixes altogether for the sake of your health.

What is more harmful: hookah or cigarettes?

Experts correlate harm for men and women from hookah with possible health risks from long-term tobacco smoking. Even nicotine-free mixes do not make the process safe. The main difference between hookah and cigarettes is in the composition of inhaled smoke.

Hookah smoke contains fewer carcinogens since 80-90% consists of vapors of the substance that is poured into the device tank. But then again the question arises whether hookah is harmful at all. It is important to take into account not only the composition of the steam, but the duration of the process. A man smokes a cigarette in 2-3 minutes. But gatherings with hookah last 30-80 minutes. So the number of potentially dangerous substances entering the body is quite high. 

The amount of smoke with carcinogenic substances, which a person inhales, also affects health. The device with a smoking mix generates more vapors, which means that in one whiff lungs receive more potentially dangerous components. According to experts, during one session of hookah smoking lungs process through about 90,000 ml of smoke, while when smoking cigarettes this amount equals to 500-600 ml. [1]

Studies of scientists from California show that an hour-long session with a hookah is equivalent to 2 smoked cigarettes. Meaning that a person can become addicted, even not wanting it. People who smoke hookah daily have significantly increased rate of nicotine absorption into the bloodstream. Scientists believe that in this case, an hour-long session of smoking hookah is equivalent to 10 cigarettes.

How to give up hookah addiction?

to give up smoking

Tobacco addicts think that hookah without nicotine will help them to get rid of the existing dependence on cigarettes. It’s a myth that you should stop believing in. This way you’re only making things worse. You may abandon the habit of smoking cigarettes, but it will be replaced by another addiction — to inhale fragrant poisonous smoke again and again.

To reduce the harm of hookah to the body, young men and women need to give up the bad habit as soon as possible. It will be much easier to deal with it in the early stages of addiction development.

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If hookah smoking has already become an unhealthy behavior pattern, try the 7Spsy behavior modification technique course. This is a patented technique based on the theories of I.P. Pavlov, B.F. Skinner, A.A. Ukhtomsky, and others.

During training you will be able to change the unhealthy behavior pattern. You will understand that relaxation and pleasant communication is possible without hookah smoking and that personal negative mindset is dragging you into a network of bad habits. You’ll realize the harm hookah causes to health and that there are safer ways to relieve physical and emotional stress. A positive mindset and special tools will help to say no to hookah, freeing you from addiction forever.

The 7Spsy Behavior Modification Technique training is designed for up to 6 weeks. Classes are held in a convenient remote mode, when you receive all the necessary specialist advice by phone and e-mail, and in online chat rooms. It is unnecessary to inform anyone that you are actively fighting your addiction. The program takes place in a strictly confidential mode.


  1. «O vrede kal’yanokureniya» (zhurnal «Vestnik Kazanskogo gosudarstvennogo energeticheskogo universiteta», 2012 g., №1), E. V. Nasyrova (https://cyberleninka.ru/article/v/o-vrede-kalyanokureniya).
  2. «Vrednye privychki i ih profilaktika: uchebnoe posobie», 2017 g, I. Gorskaya.