How harmful is hookah?

Nils Große •Updated April 23, 2025 •2 min

Symbolic image on the question of how harmful smoking hookah is

Short summary of the article

Smoking hookah is not harmless, harmful substances like carbon monoxide and benzene are produced.
Compared to a cigarette, the exposure can even be higher due to deeper inhalation and longer smoking time.
The water only filters a small part of the pollutants, the majority remains.
Health risks: respiratory diseases, cardiovascular problems, increased cancer risk.
Occasional consumption is less harmful than daily smoking, but it is not entirely without risk.

Why does this topic even matter?

We all care about our health, and if you smoke, you should at least know what you are getting into. There are many articles on the topic, but unfortunately hardly any good long-term studies on hookahs. That makes it hard to really compare objectively.

Still: everything you inhale that is not fresh air will over time have some influence on your body. That is something to be aware of.

What exactly makes the hookah harmful?

Hookah vs. cigarette: ingredients compared

Some harmful substances contained in cigarettes do not occur in hookah tobacco or only in smaller amounts.
Other substances, e.g. carbon monoxide, tar and nicotine, are much more highly concentrated in the hookah, which is also due to the amount of tobacco in the bowl.
Benzene, a particularly carcinogenic substance, is often present in higher concentration in hookah tobacco.

Carbon monoxide: the underestimated risk

Carbon monoxide is produced by the charcoal and by burning tobacco. Especially in enclosed spaces, that can quickly become dangerous. Typical symptoms of poisoning:

Dizziness
Nausea and vomiting
Confusion and drowsiness
In extreme cases: unconsciousness or even danger to life

Important: If you feel dizzy, then ventilate, stop smoking and get some fresh air. It is best never to light charcoal in enclosed spaces.

Further health effects

Smoking hookah can lead to serious health problems:

Respiratory diseases
Chronic bronchitis (COPD)
Cardiovascular diseases and high blood pressure
Increased cancer risk

Is smoking hookah worse than cigarettes?

Inhalation: hookah vs. cigarette

With hookahs you draw deeper and longer on the mouthpiece. The smoke is cooler due to the water, so you get it deeper into the lungs and hold it there longer than cigarette smoke.

Is the smoke filtered by the water?

Only partly. The water filters out some substances, but the majority stays in. The smoke feels softer, but that does not make it more harmless.

Conclusion: how dangerous is smoking hookah?

In the long term, the risk of chronic lung diseases and cancer rises, and the nicotine is addictive. As with all stimulants: consume consciously and make sure there is good ventilation when you smoke.

Final thoughts: the dose makes the poison

Health damage from tobacco does not happen overnight but over time. So if you smoke one or two bowls with friends now and then, that is not the same as the daily consumption of a pack of cigarettes.

Nonetheless: the healthiest consumption is no consumption. And if you smoke, then do it responsibly.

FAQ: how harmful is hookah?

Is smoking hookah really more harmful than cigarettes?

Smoking hookah can even be more harmful than smoking cigarettes due to the longer smoking time and deeper inhalation. Even though some pollutants occur in smaller amounts, carbon monoxide, tar and nicotine are often much more highly concentrated.

What exactly makes the hookah harmful?

The main causes are high amounts of carbon monoxide, benzene and nicotine as well as the large amount of tobacco. The heat of the charcoal additionally promotes the formation of toxic gases, which becomes dangerous especially in poorly ventilated rooms.

Is the smoke filtered by the water?

Yes, but only partly. Most substances are not water-soluble, so the water only filters out a few. Many pollutants therefore still reach the lungs. The smoke seems softer but is no less harmful.

What health risks are there with smoking hookah?

There is an increased risk of respiratory diseases, COPD, cardiovascular problems, high blood pressure and cancer. The dangers increase with the frequency and intensity of consumption.

Is occasional hookah smoking harmless?

Occasional smoking is less harmful than daily consumption, but not risk-free. Health damage develops gradually, even with irregular consumption. The safest option remains to abstain from smoking entirely.