A new study, led by Dr Mohammad Boskabady of the Mashhad University of Medical Sciences, Iran, has revealed that water pipe smoking affects lung function and respiratory symptoms as much as cigarette smoking.

A bedouin is seen smoking a water pipe in a coffee house in Deir ez-Zor, Syria, in 1920s
A water pipe, also known as a hookah, narghile, or qalyan, is a device for smoking flavored tobacco in which the smoke is passed through a water basin.
Most users of water pipes and many physicians believe that smoking through a water pipe filters out the toxic components of tobacco and is considerably less harmful than smoking cigarettes.
Dr Boskabady’s team set out to compare lung function and respiratory symptoms among water pipe smokers, deep or normal inhalation cigarette smokers, and non-smokers.
Three groups of smokers, including 57 water pipe smokers, 30 deep inhalation cigarette smokers (S-DI), and 51 normal inhalation cigarette smokers (S-NI), were identified and studied. In addition, 44 non-smokers were studied as a control group.
A questionnaire was administered to assess the prevalence and severity of respiratory symptoms and lung function tests performed on smokers and control subjects using a spirometer.
The results, published in the journal Respirology, show an increased prevalence and severity of respiratory symptoms among water pipe smokers and cigarette smokers. Similareffects of water pipe smoking and deep inhalation cigarette smoking on respiratory status were found.
Wheezing was present in 23% of water pipe smokers, 30% in S-DI, and 21.6% in S-NI. Chest tightness was present in 36.8% of water pipe smokers, 40% in S-DI, and 29.4% in S-NI. Cough was present in 21% of water pipe smokers, 36..7% of S-DI, and 19.6% of S-NI. Wheezing, chest tightness, and cough only occurred in non-smokers 9.1%, 13.3% and 6.8% respectively.
“Our study is the first report regarding the importance of the method of cigarette smoke inhalation with respect to effects on the respiratory system,” Dr Boskabady said.
“Our findings reveal that there were profound effects of water pipe smoking on lung function values, which were similar to the effects observed in deep inhalation cigarette smokers.”
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Bibliographic information: Boskabady et al. 2012. Comparison of pulmonary function and respiratory symptoms in water pipe and cigarette smokers. Respirology, vol. 17, no. 6, pages 950–956; doi: 10.1111/j.1440-1843.2012.02194.x