Typically, the mixture in shisha (hookah tobacco) is one-third tobacco and two-thirds flavorings. The flavorings may include molasses, dried fruit, honey and other ingredients. The resulting aroma was likened to a baking apple pie by one hookah-selling website.

Sounds pretty benign, doesn’t it? It isn’t. Like many fads, it has been hyped with false claims in order to increase its “Popularity and Profits.”

Tobacco is tobacco, no matter how you cut it, and tobacco smoke is hazardous. In fact, hookah smokers get more smoke than cigarette smokers, and here’s why. Cigarette smoke is uncomfortably hot if you inhale it deeply. Hookah smoke is cooled as it passes through the water. In addition, you have to inhale hard to draw the smoke through the hookah. The result is cooler smoke going farther into your lungs. Add that to the duration of a typical hookah session, and the result is a huge volume of smoke being deposited into your lungs. Research has shown that one hour of smoking a hookah is equal to 100-200 times the volume of smoke of a single cigarette. This is according to a report available at The Bacchus Network’s website, http://www.bacchusnetwork.org. In addition, a study done by the World Health Organization showed that one hookah session of a mere few hours can deliver as much harmful smoke into your lungs as 100 cigarettes – that’s five packs. It’s a rare cigarette smoker who smokes that much in one day.

Contrary to popular belief, the water in the hookah has no ability to “cleanse” or “purify” the smoke of any of its harmful components. Tobacco smoke contains nicotine, a highly addictive substance that is not filtered out by water. In addition to nicotine, you are pulling other dangerous substances through that hose. Tar is not water-soluble, so it comes on through the pipe, the same amount in one session as in a whole pack of cigarettes. Tar causes cancer. Other carcinogens – cancer-causing agents – also make it through, like heavy metals and carbon monoxide. In fact, because of the charcoal that is burned on top of the tobacco mixture, hookah smoke has a higher level of heavy metals and carbon monoxide than cigarette smoke. Hookah smokers risk cancer of the lung, lip, tongue and bladder as much as cigarette smokers or even more.

Tobacco smoke affects the cardiovascular system, increasing blood pressure, heart rate and the risk of heart attack and stroke. Smoke of any kind is also a lung irritant, which can trigger asthma and allergies. And, of course, there are all the secondhand smoke issues to consider.

In addition to the tobacco, there are the smoked flavorings to consider. Unfortunately, nobody has yet studied the effects of inhaling burning apricots, but I would bet they aren’t all good.

Finally, think about sharing the mouthpiece. It’s like kissing everyone in the group. Hookah exposes smokers not only to toxins and carcinogens but also other health risks such as H1N1, hepatitis, mouth herpes, mononucleosis, seasonal flu, strep throat, a cold and even tuberculosis, which can be contracted when people share a hose.

I’m a big believer in social gatherings and relaxation time. By all means, gather away, and relax like crazy. But if you are concerned with the health of your lungs, think about gathering around a cup of tea or relaxing with exercise and a hot tub instead of a water pipe.