Although hookah lounges are becoming more popular, smoking flavored tobacco through water pipes creates hazardous concentrations of indoor air pollution, according to a new study from the Institute for Global Tobacco Control at the Johns Hopkins University's Bloomberg School of Public Health.
In fact, airborne particulate matter and carbon monoxide levels exceeded those found in restaurants and bars that allowed cigarette smoking, the study found.
"There is a mistaken notion that because the tobacco smoke is drawn through the water, it's somehow cleaner or not as bad," Patrick Breysse, a professor in the department of environmental health sciences and the study's senior author, said in an interview.
To the contrary, Breysse said, the research shows "it's as bad or worse than venues that allowed cigarette smoking." Indoor airborne concentrations of carbon monoxide were markedly elevated, posing health risks for patrons and employees of hookah lounges, according to the study.
The level of nicotine concentration in the air was not as high as in places that allowed cigarette smoking, but they were elevated, according to the study.
The air quality in seven Baltimore-area water pipe bars was analyzed over a nine-month period as part of the research. From December 2011 to August 2012, researchers measured carbon monoxide levels, airborne nicotine content and respirable particulate matter. The business owners were not aware of the data collection, Breysse said.
Calls and emails sent to various hookah lounges in the Baltimore area were not returned.
Some of the researchers' measurements showed that the lounges didn't meet air quality standards set by the U.S. Environmental Protection Agency and the World Health Organization. The findings appeared in the April 16 online edition of the Journal of Exposure Science and Environmental Epidemiology.
The researchers are continuing to study the impacts of hookah use and are now collecting data from hookah lounges in Turkey, Egypt and Russia, he said.
"Public education efforts need to be developed to educate users about the hazards of water pipe use and tobacco control policies need to be strengthened to include water pipes," Christine Torrey, senior research specialist in the Department of Environmental Health Sciences and the study's lead author, said in a statement.