Learning Objectives

  1. Learn about the parts of a waterpipe.
  2. Understand the risks associated with hookah use.


This module provides an understanding of the known health risks associated with hookah use. Many adolescents may not fully understand the risks of hookah use and believe that it is harmless. 



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Lesson 1.1: Understanding Hookah and its Risks


Discussion Guide

Last updated on September 5, 2018 at 4:45pm PDT.

Hookah Module Crash Course

A Quick Guide

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What is Hookah?

Hookah is tobacco that is smoked using a water pipe. They are large, table top pipes with a mouthpiece attached to a flexible hose. The bottom of the pipe is filled with water and the tobacco is heated with burning charcoal or embers. The smoke passes through the water pipe’s water bowl and is cooled as a result. Smoke is drawn through a hose to a mouth piece and the user inhales the vapor through the water.

The tobacco is usually sweetened and flavored using additivesOther common names include: Shisha, Goza, Argileh, Narghile (när’ɡə-lē’), Water Pipes and Hubble-Bubble.


What is the History of Hookah?

Hookah originated in North India and then spread to ancient Persia, the Ottoman Empire, and North Africa in the 16th and 17th centuries. Traditionally the bowl of the hookah was made out of coconuts and the hose out of bamboo tubes. Cultural rules and traditions played a huge role in smoking hookah: some hookahs were not allowed to be higher than others or ignited with candles. In the last decade, after a period of undesirability, hookah has gained popularity among Western society and as a result many bars/cafes have opened. 


What are the Harms of Hookah?

Hookah is not less harmful than smoking cigarettes. Despite the smoke being filtered through water, when you smoke hookah you expose yourself to the addictive chemical nicotine, heavy metals, and tar. The tobacco in hookah has been shown to cause oral, lung, and bladder cancers, heart disease, and respiratory disease.

Typically, hookah is smoked in a prolonged social session where the hose is used by multiple people, potentially causing smokers to expose their bodies to more toxic substances than cigarette smokers. When multiple people use the same hose, they are at risk for infectious diseases, including colds, influenza, mononucleosis, and even Tuberculosis, Herpes.


Hookah and Youth

While there have been declines in cigarette use among youth, hookah use among middle and high school students have been on the rise. The popularity of e-hookahs among youth is of concern for health professionals, educators, and parents, in part because teenagers often think hookah pipes are harmless and also because long-term consequences of hookah use are still not known. Keeping yourself current on accurate information is worthwhile so that you can be a trusted source of information for youth.