Have a Narghile

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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.

NEXT: Friday Dead Link

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  1. You’re not going to smoke 2 packs a day through a hookah. It’s just not portable enough.

  2. Would injectable nicotine be a problem?

  3. “fuck the government and fuck all these anti smoking douche bag activists.”

    Haha I’ll raise my drink that, gaius! 😉

  4. *to that

    Will… use… preview…

  5. Would injectable nicotine be a problem?

    Only in that it would “lead to increased use and addiction”, which is of course immoral.

  6. Tobacco is an anti-depressant.

  7. (With apologies to Kid Rock):

    All you bastards in the IRS
    For the FDA, and its lackeys in the press
    For the cigarettes, the pipes and cigars
    The Red Man packets and smokers? bars
    For the hookahs we?re smokin? in Hollywood
    Tobacco is so misunderstood
    I said it’s all good and it’s all in fun
    So freshen that breath and try to love someone

    (That poem was just an excuse to say “hookahs” in a comical way)

  8. Smoke your double apples while ya got em’

  9. Hearty hurrahs all around. Another excellent article Mr. Sullum, and keep on smoking. It’s getting to where I don’t trust any of these shifty bastards that don’t smoke, and half that do.

    A couple cigarettes a day and a cigar a week never did me any harm. Moderation people, is it such a hard concept for these high-horse, moral legislators?

  10. “I smoked a hookah once. Yeah, the bitch wanted an extra $20 after the blowjob and…”

  11. Mr. Sullum:

    Since you’re keen on pointing out that the cited study was looking at “dry” pipe smoking and not hookah/water-pipe smoking, would you care to venture a guesstimate of how many “pipes” 45 minutes of drawing on a hookah represents?

    Your daily talking point — that infrequent casual smoking poses what many people would consider acceptable health risks — is a fair one. But by the same token, if a 4-6 pipe/day habit results in that fivefold risk of lung cancer you note is roughly half that of a twenty cigarette/day habit, is it fair to guess that 45 minutes spent sipping Turkish coffee and puffing on a hookah constitutes something more than one regular “pipe” or one cigarette?

    My other quibble with preemptively spinning hookahs as low-risk is that the increase in US hookah use is not just from hipsters doing it for some kind of irony once a month, but from a large spike in immigration from countries where hookahs are popular to begin with. If my years of living near 28th and Steinway in Queens were any indication, the Syrian and Lebanese guys who parked themselves at the same sidewalk cafe tables every night were smoking from hookahs more than occasionally and were doing so for significantly longer than it takes to get through a couple of cigarettes.

  12. Even if it is harmfull to there health why do we need to find validation in studies to prove that people should be allowed to do to themselves whatever they please

  13. I look forward to the day when tobacco is made an illegal drug.

    We do not have near enough criminals in America.

  14. Doublespeak asks:

    Even if it is harmfull to there health why do we need to find validation in studies to prove that people should be allowed to do to themselves whatever they please

    Good question, and one I’ve asked of Mr. Sullum before. For someone who has made himself the go-to guy for soundbites on why smoking/marijuana/junkfood are beautiful expressions of freedom, it’s funny that he spends so much time engaging in the same kind of highly selective, manipulative use of research data as his opposites on the New York City Council and at the American Cancer Society. If I didn’t know better, I’d think the “personal choice” riff was window dressing for a more pedestrian pro-tobacco-industry-for-its-own-sake agenda.

  15. Jacob, I’m sorry I have to ask, but these things are common these days: have you ever received any money from the tobacco industry for writing an op-ed or blog entry?

  16. s.m. and Ben,

    The follow-the-money argument is a thinly veiled ad hominem and is thus logically invalid. That said, there’s no way the “tobacco industry” wants hookahs to take off. As we saw in the Master Settlement, Big Tobacco will gladly accept anti-tobacco regulation if it means less competition.

  17. I did an experiment in college testing the mutatioanal effect of different substances.
    It was simple, just soaking a paper disk in something and putting it in a perti dish with bacteria which were not able to produce histamine. From what I remember, the more mutational the substance, the greater the amount of growing cells around the disk which had mutated to produce histamine again.

    So all sort of folks brought in disks soaked in soda, in a bowl wiht cigarettes, etc. My lab partner brought in a test tube of a nasty looking stuff which he said was bong (waterpipe) water.

    The bong water was the most mutational substance in the class, creating a zone of inhibition around the disk before filling the rest of the petri dish with bacteria. The teacher siad he had never seen that before in similar class experiments. He was quite surprised when told what the substance was.

    So no matter what the officals say, water pipes DO remove something from smoke which causes mutations

  18. koppelman:
    I’m always more suspicious of the agenda of someone who wants to limit my rights, than someone who wants to retain or expand them.

  19. s.m.,

    I think the reaction to the release of a new, highly effective anti-smoking aid a couple days ago was very illustrative of Reason’s pro-tobacco, rather than pro-choice, stance.

    Ron Bailey didn’t write a word about this being a postive development that will help individuals who choose to use it. Rather, he criticized on the grounds that someone might want to make it mandatory.

    Though, when pressed on the issue, he admitted that he had no objection to its use. I thought that was awful big of him.

    And crimethink, an ad homenim attack is the practice of delcaring someone’s argument to be untrue because of an alleged personal flaw. Pray tell, what statement did Mr. Koppelman claim was untrue?

  20. Oh, and, yeah, the weaselly language the ACS and the government use when describing the relative levels of risk is downright slimy.

  21. What if an analysis of cause-of-death data among persons who indulge in hookah smoking revealed a significant positive correlation to the likelihood of being blown up? It might.

    Would you then lay aside your hookah?

  22. joe,

    You only posted that because you’re a government employee, and thus want govt to control every aspect of our lives.

  23. Pray tell, joe, do you know where the term ad hominem comes from? It is any attack against the man, which does not pertain to his argument. As the question of where the arguer gets his money from has nothing to do with the validity of his argument, asking this question in lieu of discussing his argument can only be construed as an ad hominem.

  24. Joe, have you stopped beating your wife?

  25. Actually, neither myself, s.m., or Ben were engaging in direct ad hominem attacks. More a fallacy of interrogation.

  26. 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.

    I always love the various forms of this argument. What is the risk of lung cancer in a non-smoker who does not work in the asbestos industry? is it higher or lower than getting struck by lightning while riding a submarine? Five times virtually nothing still sounds pretty safe to me.

  27. Since none of those rude remarks suggested that my points were therefore wrong, or my logic invalid, they aren’t ad homenim fallacies. They’re just personal insults.

    The ad homenim fallacy is a statement that “Argument X is wrong because of…” some personal attack on the person making it.

  28. You are linking the hooka smoking to tobacco use. How many people do you think are really smoking tobacco out of a hooka. You must not know the college crowd.

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