Shisha smoke linked to diabetes and obesity in a major study

‘Single session’ of shisha is worse than a WHOLE packet of cigarettes: Hookah smoke linked to diabetes and obesity in a major study

  • Inhaling hookah smoke is more dangerous than cigarette smoke, study showed 
  • It was also linked to metabolic syndrome and dyslipidemia, researchers found
  • Experts warned the popular leisure activity is not as ‘healthy’ as it seems 
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Smoking shisha ‘significantly increases’ the risk of diabetes and obesity and is worse than a whole packet of cigarettes, a study has found.

People who inhaled the sweet-smelling fumes of ‘hookah’ smoke were more likely to gain weight and develop type 2 diabetes in comparison to those who didn’t.

Cigarette smoking was not linked to obesity, metabolic syndrome, dyslipidemia or diabetes, the research also uncovered.

The negative effects are said to be the equivalent or worse than smoking a pack of cigarettes, experts at the Brighton and Sussex Medical School warned.

People who inhaled the sweet-smelling fumes of ‘hookah’ smoke were more likely to gain weight and develop type 2 diabetes in comparison to those who didn’t or who smoked cigarettes, a study of almost 10,000 Iranians by the Brighton and Sussex Medical School found

The results of the study, which involved academics at a university in Iran, were published in Diabetology and Metabolic Syndrome.

Shisha is a leisure activity, hailing from the Middle East. It is often considered to be a more ‘healthy’ alternative to smoking.  

But while shisha may not contain many of the carcinogenic additives in cigarettes, mounting evidence suggests the water pipe tobacco is still not safe.

The research involved 9,840 participants – a mixture of smokers, non-smokers, ex-smokers, cigarette smokers and hookah smokers.

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The participants, from Iran, took a questionnaire which investigated their smoking history, cardiovascular risk factors and anxiety and depression. 

This was then measured against their biochemical results, analysed by taking blood tests.  

‘Obesity, metabolic syndrome, diabetes and dyslipidemia were positively associated with hookah smoking while negatively associated with cigarette smoking,’ the authors wrote.  


The flavourings in electronic cigarettes may damage blood vessels in the same way as heart disease, according to research published in June. 

The chemicals used to give the vapour flavours, such as cinnamon, strawberry and banana, can cause inflammation in cells in the arteries, veins and heart.

They causes the body to react in a way that mimics the early signs of heart disease, heart attacks or strokes, the study by Boston University found. 

Other recent studies have also suggested smoking e-cigarettes could cause DNA mutations which lead to cancer, and enable pneumonia-causing bacteria to stick to the lungs easier. 

Researchers at New York University subjected human bladder and lung cells to e-cigarette vapor, which is marketed as being healthier than tobacco.

They found the cells mutated and became cancerous much faster than expected and mice exposed to the vapour also suffered significant DNA damage. 

In another study, scientists at Queen Mary University, London, found vaping makes users more likely to catch pneumonia – just like smoking tobacco or breathing in traffic fumes.

The vapour from e-cigarettes helps bacteria which cause the condition to stick to the cells that line the airways, they said.

The effect occurs with traditional cigarette smoke and those who are exposed to air pollution high in particulates from vehicle exhausts.  

‘In contrast with the public belief that hookah eliminates the toxicity of tobacco in comparison with cigarettes, we found that the adverse effects of hookah smoking could be even greater than cigarette.’ 

Professor Gordon Ferns, of Brighton and Sussex Medical School, told The Telegraph: ‘A single session of hookah smoking may be equivalent to more than a packet of cigarettes, and the inhaled toxic compounds may be even greater.

‘It is unclear why hookah smoking is associated with obesity and diabetes. 

‘It is possible that the toxins in the smoke stimulate an inflammatory response that causes tissues to become resistant to the effects of the hormone insulin, that regulates glucose in the blood. 

‘However, it is also possible that hookah smoking is associated with other social behaviours that lead to weight gain.

‘There is now good evidence that hookah smoking is not harmless. The risks of hookah smoking with respect to some types of cancer is well established, and the evidence for an association with cardiovascular disease is growing.’

The ancient form of smoking, also called narghile, waterpipe, or hubble bubble smoking, uses charcoal-heated tobacco or non-tobacco based shisha smoke which is passed through water before inhalation.

It is often seen as less toxic compared to cigarettes, alongside e-cigarettes and vaping. 

The sweet flavours available make shisha smoking desirable, especially the young people –  around half of smoking that teenagers do are is in this way. 

Hookah smokers can spend long periods of time in lounges and bars inhaling the fumes.

A typical hookah session lasting one hour involves 200 puffs, which results in 90,000 milliliters of smoke being inhaled.

Smoking a cigarette involves 20 puffs, resulting in 500 – 600 milliliters of smoke being inhaled, according to the Centers for Disease Control and Prevention.  

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