From the Guidelines
Hookah smoking causes higher carbon monoxide levels than cigarette smoking due to the combustion of charcoal, longer exposure time, and deeper inhalation of smoke. The combustion process of charcoal used in hookah smoking produces additional carbon monoxide beyond what is produced by the tobacco itself 1. A typical hookah session can last 45-60 minutes, which is significantly longer than the 5-10 minutes it takes to smoke a cigarette, resulting in greater smoke inhalation and increased carbon monoxide exposure. Some key factors contributing to higher carbon monoxide levels in hookah smoking include:
- The use of charcoal, which generates carbon monoxide as a byproduct of combustion
- Longer smoking sessions, leading to increased exposure to carbon monoxide
- Deeper inhalation of smoke, which allows more carbon monoxide to enter the lungs
- The misconception that the water in the hookah filters out carbon monoxide, when in fact it does not
- The enclosed spaces where hookah is often used, which can lead to higher ambient carbon monoxide levels The increased carbon monoxide exposure from hookah smoking can lead to reduced oxygen transport in the blood, causing symptoms such as headaches, dizziness, and in severe cases, carbon monoxide poisoning 1. It is essential to recognize that hookah smoking is not a safer alternative to cigarette smoking and poses significant health risks, including the potential for carbon monoxide poisoning. In terms of carbon monoxide levels, studies have shown that hookah smokers can have significantly higher carboxyhemoglobin levels than cigarette smokers, which is a measure of the amount of carbon monoxide in the blood 1. Overall, the evidence suggests that hookah smoking is associated with higher carbon monoxide levels than cigarette smoking due to the unique characteristics of hookah smoking, including the use of charcoal and longer exposure times.
From the Research
Carbon Monoxide Levels in Hookah Smoking
- Hookah smoking causes higher carbon monoxide levels than cigarette smoking due to the combustion of charcoal used to heat the tobacco 2.
- The combustion of charcoal in hookah smoking releases large amounts of carbon monoxide, a potent vasodilator molecule that can mask the acute endothelial dysfunction caused by smoking 2.
- Studies have shown that hookah smoking can lead to significant increases in carbon monoxide levels, with some cases resulting in carbon monoxide poisoning 3, 4.
- The use of charcoal in hookah smoking is a major contributor to the high levels of carbon monoxide produced, with electrically heated hookah smoking producing significantly lower levels of carbon monoxide 2.
Comparison to Cigarette Smoking
- Cigarette smoking also produces carbon monoxide, but at lower levels than hookah smoking 2, 5.
- The combustion of tobacco in cigarettes releases carbon monoxide, but the levels are generally lower than those produced by the combustion of charcoal in hookah smoking 5.
- Studies have shown that hookah smoking can lead to higher levels of carbon monoxide than cigarette smoking, with some cases resulting in severe carbon monoxide toxicity 3.
Health Risks
- The high levels of carbon monoxide produced by hookah smoking can lead to serious health risks, including carbon monoxide poisoning, secondary polycythaemia, and provoked thrombosis 4, 6.
- The use of hookah smoking can also lead to nicotine dependence and progression to cigarette use, as well as increased risk of transmission of infectious diseases 5.
- Practitioners should be aware of the health risks associated with hookah smoking and advise patients to stop their consumption 4.