25 September 2026 Punjab Khabarnama Bureau : As World Lung Day 2026 is observed on September 25 with the theme “A Lifetime of Lung Health,” doctors and health experts are highlighting the risks associated with tobacco smoke, including a common misconception that hookah or shisha is safer than cigarettes.
Medical evidence shows that hookah smoking is not a safe alternative to cigarettes. Hookah smoke contains many of the same toxic substances found in cigarette smoke, while the longer duration of a typical hookah session can result in significantly greater exposure to smoke and carbon monoxide.
Is Hookah Worse Than Cigarettes?
The answer depends on how exposure is measured.
It would be misleading to say that every hookah session is automatically more harmful than every cigarette. However, one typical hookah session can expose a person to far more smoke than smoking a single cigarette.
The CDC says a one-hour hookah session can involve inhaling about 90,000 ml of smoke, compared with roughly 500–600 ml from a single cigarette. A hookah user can also be exposed to nearly nine times more carbon monoxide and 1.7 times more nicotine than from one cigarette during a session.
Water Does Not Make Hookah Safe
One of the biggest misconceptions about hookah is that water filters the smoke.
It does not.
The smoke passes through water before being inhaled, but harmful substances such as carbon monoxide, heavy metals, tar and cancer-causing chemicals remain in the smoke. The charcoal used to heat the tobacco also produces additional carbon monoxide and other toxic substances.
Nicotine Addiction Remains a Risk
Hookah tobacco contains nicotine, the addictive chemical also found in cigarettes.
Regular hookah use can therefore lead to nicotine dependence, even when the tobacco is flavoured or marketed as a smoother alternative to conventional smoking. The FDA notes that there are no safe tobacco products.
Cancer and Lung Disease Risks
Hookah smoking has been associated with many of the same serious health problems linked to cigarette smoking.
These include lung, oral and oesophageal cancers, heart disease and chronic obstructive pulmonary disease (COPD). Hookah smoke can also impair lung function and expose users to toxic particles and chemicals.
Charcoal Adds Another Danger
Unlike cigarettes, traditional hookahs commonly use burning charcoal to heat the tobacco.
That charcoal generates carbon monoxide and other harmful chemicals, creating an additional source of exposure. Carbon monoxide reduces the blood’s ability to carry oxygen and can cause symptoms ranging from headache and dizziness to potentially serious poisoning at high exposure levels.
Second-Hand Smoke Also Matters
People sitting around a hookah are not necessarily protected simply because they are not smoking themselves.
Second-hand hookah smoke contains emissions from both the tobacco and the charcoal. People in enclosed hookah lounges or poorly ventilated spaces can therefore be exposed to harmful pollutants.
Sharing a Hookah Can Spread Infections
Hookah smoking is often a social activity in which several people share a pipe or mouthpiece.
Using an unclean or shared mouthpiece can increase the risk of transmitting infections. Health authorities have specifically warned about possible transmission of illnesses through shared hookah equipment.
Even ‘Herbal’ Hookah Is Not Risk-Free
Switching from tobacco-based shisha to products marketed as herbal or tobacco-free does not necessarily eliminate the danger.
The CDC notes that smoke from both tobacco-based and some “herbal” preparations can contain carbon monoxide and other toxic substances because combustion itself produces harmful chemicals.
What About Occasional Hookah Smoking?
Occasional use does not make hookah harmless.
The level of risk depends on factors including frequency, duration, tobacco content, charcoal exposure and ventilation. Longer sessions can result in substantially greater smoke exposure than a single cigarette.
For people who already use tobacco, avoiding tobacco and seeking evidence-based help to quit remains the most effective way to reduce long-term health risks. The World Health Organization states that all forms of tobacco use are harmful and there is no safe level of exposure.
Why World Lung Day Matters
This year’s World Lung Day theme, “A Lifetime of Lung Health,” focuses attention on protecting respiratory health throughout life.
In India, lung health is affected not only by tobacco but also by second-hand smoke, household smoke, outdoor air pollution and workplace exposures. Doctors are therefore urging people to reduce avoidable exposure to harmful substances and pay attention to persistent respiratory symptoms.
Watch for Persistent Symptoms
A persistent cough, unexplained breathlessness, wheezing or a noticeable change in breathing should not be ignored.
Such symptoms do not necessarily mean a person has a serious disease, but persistent or worsening respiratory problems warrant medical evaluation.
The Bottom Line
Hookah should not be considered a safer substitute for cigarettes. The water does not remove the toxic substances in smoke, and the long duration of many hookah sessions can result in very high exposure to smoke, nicotine and carbon monoxide.
For lung health, the safest approach is to avoid tobacco smoke altogether.