Hookah vs. Cigarettes: Is Smoking Hookah Safer for Your Mouth?

friends smoking hookah on a river bank

You may have heard that fewer and fewer people are smoking cigarettes these days. The World Health Organization (WHO) reports that around 1.1 billion people smoked in 2015 and that cigarette smoking is, in general, declining worldwide. In the U.S., the Centers for Disease Control and Prevention (CDC) reports that just 14 percent of adults over 18 smoked in 2017 — a drop from nearly 21 percent in 2005.

Cigarette use might be dropping, but other forms of tobacco are gaining in popularity, especially among younger people. One particular debate that keeps popping up: the safety of hookah vs. cigarettes.

History of Hookah

Hookah smoking isn't exactly new; people have been smoking this water pipe-based tobacco product for centuries, according to the CDC. In recent years, hookah cafes have popped up around the world, contributing to its increased popularity. The CDC notes that the practice has attracted younger students in particular. In a 2018 report, 1 out of every 100 middle school students admitted to smoking hookah within the prior 30 days, and for the high school population, that number increased to 4 in 100.

While many people perceive hookah to be safer than cigarettes, it's important to understand how the two are different and what each one can mean for your oral and overall health.

Hookah vs. Cigarettes: How Are They Different?

Hookah and cigarettes differ in how they're used and how much nicotine and smoke they deliver to the user. When someone smokes a cigarette, they light one end, place the opposite end in their mouth and take a puff. When someone smokes hookah, the tobacco is heated with the use of a water pipe, and the smoke passes through water and travels up a tube or pipe into a person's mouth.

Hookah tobacco is often flavored, which may make the habit seem innocent compared with smoking cigarettes. Since the smoke can taste like strawberries or vanilla, people may think that they are getting less of the "bad stuff," such as nicotine, tar and carbon monoxide. The CDC explains that water pipes deliver nicotine, the same addictive drug found in cigarettes, and that the smoke from water pipes is at least as toxic as cigarette smoke. What's more, hookah users might actually take in more toxic substances than cigarette users because of how hookah pipes are used.

Those who partake in hookah smoking may be exposed to more harmful substances than cigarette smokers because smoking hookah takes longer. The American Dental Association (ADA) points out that the average hookah smoking session lasts for nearly an hour and a half. During a session, a person might take as many as 200 puffs of smoke. Meanwhile, it takes the average cigarette smoker about five minutes to finish a cigarette, during which time they're likely to take around 40 to 75 puffs. In addition to taking more puffs, hookah users may inhale more smoke. During a typical hookah session, the CDC calculates that a person might inhale up to 90,000 milliliters of smoke, compared with up to 600 milliliters when smoking a single cigarette.

Hookah vs. Cigarettes: How Do They Affect Your Health?

Both cigarette and hookah smoking can contribute to oral and dental health problems. A review of studies published in the Journal of the American Dental Association found that smoking hookah may contribute to problems in the mouth, such as:

The oral health problems associated with hookah are very similar to those caused by cigarettes. The ADA notes that the use of any tobacco product can contribute to problems such as gum disease, slow healing after surgery or a tooth extraction, staining of the teeth and bad breath. The CDC stresses that any type of tobacco use increases a person's risk of developing gum disease.

The way people typically smoke hookah can also lead to other health problems. Since hookah pipes are often shared among users, there's a risk of spreading herpes and respiratory illnesses, such as tuberculosis, reports the American Thoracic Society.

Protecting Your Oral Health

If you're worried about the effects that smoking hookah may be having on your oral health, one of the best things you can do is quit any use of tobacco products. Your dentist is a great resource to turn to if you're looking to stop using tobacco or if you're concerned about oral health issues associated with tobacco use. They can provide you with tools to help you quit and diagnose and treat any dental issues that have developed. Additionally, your dentist can help you set up a good oral care routine at home to keep your mouth as healthy as possible going forward.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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How Is Tobacco a THREAT TO ORAL HEALTH?

Tobacco's greatest threat to your health may be its association with oral cancer. The American Cancer Society reports that:

  • About 90 percent of people with mouth cancer and some types of throat cancer have used tobacco. The risk of developing these cancers increases as people smoke or chew more often or for a longer time.

  • Smokers are six times more likely than nonsmokers to develop these cancers.

  • About 37 percent of patients who continue to smoke after cancer treatment will develop second cancers of the mouth, throat or larynx. While only 6 percent of people who quit smoking will develop these secondary cancers.

  • Smokeless tobacco has been linked to cancers of the cheek, gums and inner surface of the lips. Smokeless tobacco increases the risk of these cancers by nearly 50 times.7