Carcinogens Found in Water Pipe Smoking May Increase Risk for Cancer
Researchers investigating the effects of water pipe smoking on the health of young adults have found elevated levels of nicotine, cotinine, tobacco-related cancer-causing agents, and volatile organic compounds, including benzene and acrolein, in the urine of users. Given the significant intake of nicotine and carcinogens, chronic water pipe use could put users at an increased risk for cancer and other chronic diseases, reported the researchers. The study by St. Helen et al is published in Cancer Epidemiology, Biomarkers & Prevention.
Study Methods and Results
This was a naturalistic study of water pipe smokers in hookah bars or lounges. The study enrolled 55 healthy and experienced water pipe smokers (43.6% female) with an average age of 24.5 years (range, 18–48), and an average body mass index of 23.3. Study participants were instructed not to engage in any type of smoking for a week. At the end of that period, they provided a urine sample before going out to a hookah bar of their choice in the San Francisco Bay area and smoked water pipes as desired.
Immediately after returning home, study participants provided an “after” urine sample and filled out a detailed questionnaire on their smoking session, including total time spent smoking, number of bowls smoked, and number of shared users. Participants also provided a first-voided urine sample the next morning.
On average, the study participants spent 74 minutes smoking water pipes and smoked an average 0.6 bowls of water pipe tobacco per person.
After a single session of water pipe smoking, researchers found that, on average, study volunteers had a 73-fold increase in nicotine; fourfold increase in cotinine; twofold increase in the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), which can cause lung and pancreatic cancers; and 14% to 91% increase in the breakdown products of volatile organic compounds, which are known to cause cancer and cardiovascular and respiratory diseases.
Chronic Hookah Smoking Is Not Risk-Free
“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 brains of children and youths who use water pipes,” Gideon St. Helen, PhD, lead study author and Postdoctoral Fellow in the Division of Clinical Pharmacology and the Center for Tobacco Control Research and Education at the University of California, San Francisco, said in a statement. “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.”
According to the Centers for Disease Control and Prevention, hookah use by youth and college students is increasing and hookah cafes are gaining in popularity around the world.
Peyton Jacob III, PhD, of the University of California, San Francisco, is the corresponding author of the Cancer Epidemiology, Biomarkers, & Prevention article.
This study was funded by the National Institutes of Health and the California Tobacco-related Disease Research Program. Dr. St. Helen reported no conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
