Hookah and Health

How Hookah Works

The hookah waterpipe consists of a head, body, water bowl, and hose, although they can vary in size and shape. The hookah waterpipe uses special tobacco (also called shisha) that is heated by charcoal to produce smoke, which passes through water before being drawn through a hose. Hookah is often used in social settings, with the same mouthpiece passed from person to person. (Source: TobaccoFreeKids.org)

Flavored Hookah Attracts Youth

Hookah is available in a wide variety of kid-friendly flavors like bubble gum, cola, blueberry, strawberry cream and watermelon. These flavors are highly appealing to youth. They are also sold through many online retailers that lack adequate age verification.

88.7% of youth who have ever smoked hookah started with a flavored product and more than three-quarters (78.9%) of youth hookah users report that they use hookah “because they come in flavors I like.” (Source: TobaccoFreeKids.org)

Hookah is Linked to Serious Health Harms

Although many hookah users think it is less harmful, hookah smoke contains many of the same toxic agents found in cigarette smoke that are known to cause lung, bladder, and oral cancers. Hookah is not a safe alternative to cigarette smoking.

Hookah also contains nicotine, an addictive drug that can have lasting damaging effects on adolescent brain development and has been linked to a variety of adverse health outcomes for the developing fetus.

Because the flavors and the smoking technique create a more soothing experience, hookah smokers can inhale more deeply and spend more time in a hookah session, exposing the user to more smoke over a greater period of time than what occurs when smoking a regular cigarette.

The burning of charcoal to heat hookah tobacco can also pose additional health risks because it produces dangerous substances like carbon monoxide. (Source: TobaccoFreeKids.org)

County Superior Court Decision: Indoor Smoking Prohibited in Snohomish County

In 2013, following a two-day trial in Snohomish County Superior Court, downtown Everett's Hideout Hookah Lounge, also known as the Wetmore Cafe, was ordered to comply with the law by prohibiting indoor smoking by its patrons. In addition, the court levied fines of $89,100 against the business owners for intentionally violating the law for months and ignoring repeated warnings from the Snohomish County Health Department, which brought the lawsuit.

The Snohomish County Health Department then adopted Washington State’s Smoking In Public Places law (SIPP), located in Chapter 70.160 in the Revised Code of Washington, and added language in the local code to make it clear that the law applies to marijuana and hookah smoking in addition to cigarettes. This is now reflected in Chapter 13 of the Sanitary Code (PDF). Snohomish County Health Department employees continue to work with county and city staff to ensure that potential business owners and code enforcement officers understand that Smoking In Public Places law (SIPP) prohibits smoking in all public places and in places of employment.