Have a Narghile

USA Today views the hookah fad with alarm, warning that "new popularity of traditional water pipes poses challenge for smoke-free movement." In addition to an interesting discussion of how hookahs are treated under various smoking bans, the story includes some typical fudging on the health hazards of the habit:

"There's a myth that the smoke is filtered by the water," says Thomas Eissenberg, a psychology professor at Virginia Commonwealth University and co-author of a hookah study. The smoke passes through gurgling water before the user inhales it, but, he says, "Every risk of cigarette smoking is also associated with water pipes." Examples:

• Eissenberg says a hookah, which is smoked for about 45 minutes, delivers 36 times more tar than a cigarette, 15 times more carbon monoxide and 70% more nicotine.
• A study in the Journal of Periodontology found that water pipes smokers were five times more likely than non-smokers to show signs of gum disease.
• In a June 2004 study, Jane Henley, an epidemiologist at the American Cancer Society, found that men who smoked water pipes had five times the risk of lung cancer as non-smokers.

Note that even if "every risk of cigarette smoking is also associated with water pipes," that does not mean the level of risk is the same. The June 2004 study to which USA Today refers was not a study of "men who smoked water pipes." It was a study of pipe smokers generally, and it's not clear that any of them smoked hookahs. In any case, the study found that "pipe smoking confers a risk of tobacco-associated disease similar to cigar smoking"–i.e., the risks are "generally smaller than those associated with cigarette smoking." That much is apparent from the risk ratio cited by USA Today: A five-fold increase in lung cancer risk is half or less what you would expect to see in pack-a-day cigarette smokers. For the occasional hookah smokers quoted by USA Today, the risks are probably negligible (as seems to be the case for occasional cigar and pipe smokers).

The American Cancer Society's dodgy warning about hookahs is telling:

[Hookah smoking] is marketed as being a safe alternative to cigarettes because the percent of tobacco in the product smoked is low. This claim for safety is not true. The water does not filter out many of the toxins, and hookah smoke contains varying amounts of nicotine, carbon monoxide, and other hazardous substances. Several types of cancer, as well as other health effects, have been linked to hookah smoking.

All forms of tobacco are dangerous. Even if the health risks were smaller for some tobacco products as opposed to others, all tobacco products contain nicotine, which can lead to increased use and addiction. Tobacco cannot be considered safe in any amount or form.

Hence ACS implicitly concedes that hookah smoking is less dangerous than cigarette smoking but insists (like the World Health Organization) that no amount of tobacco-related risk is acceptable. This is a moral judgment (and a rather arbitrary one) masquerading as science.