Water Pipe Smoking May Increase Risk for Cancer

Young adults who smoked water pipes in hookah bars had elevated levels of nicotine, cotinine, tobacco-related cancer-causing agents, and volatile organic compounds in their urine, and this may increase their risk for cancer and other chronic diseases, according to a study published in Cancer
Epidemiology, Biomarkers & Prevention.¹

“This study reports systemic intake of tobacco-specific nitrosamines and [volatile organic compounds] after a typical water pipe-smoking session in a hookah bar setting, thus making the findings generalizable to most water pipe users in the United States,” said Gideon St.Helen, PhD, postdoctoral fellow in the Division of Clinical Pharmacology and the Center for Tobacco Control Research and Education at the University of California, San Francisco.

After a single evening of water pipe smoking in a hookah bar, young men and women had in their urine a 73-fold increase in nicotine; fourfold increase in cotinine; twofold increase in NNAL, a breakdown product of a tobacco-specific nitrosamine, NNK, which can cause lung and pancreatic cancers; and 14% to 91% increase in the breakdown products of compounds such as benzene and acrolein that are known to cause cancer and cardiovascular and respiratory diseases.

“There was also a substantial increase in nicotine levels, which raises concerns about the potential addictiveness of water pipe smoking and possible effects on the developing brains of children and youths who use water pipes,” added Dr. St.Helen. “Water pipe smoking is generally perceived to be a safe alternative to cigarette smoking, even for children and youths. Our study shows that water pipe use, particularly chronic use, is not risk-free.” ■

Disclosure: The study was funded by the National Institutes of Health and the California Tobacco-related Disease Research Program. Dr. St.Helen reported no potential conflicts of interest.

Reference

1. St.Helen G, et al: Nicotine and carcinogen exposure after water pipe smoking in hookah bars. Cancer Epidemiol Biomarkers Prev. May 16, 2014 (early release online).