Can you get addicted to hookah?

Yes, you can get addicted to the drug nicotine by smoking hookah. Hookah smoking is NOT a safe alternative to smoking cigarettes. We review hookah addiction and other health risks here.

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Yes, smoking hookah can get you hooked on nicotine. And although it feels like a clean smoke, hookah is not better for you than smoking cigarettes. We review the health risks of hookah and the signs of hookah addiction here.

What’s dangerous about hookah?

Smoke from waterpipes contains significant amounts of nicotine, tar and heavy metals. In fact, a 60 minute hookah session will expose you to 100-200 times the volume of smoke inhaled from a single cigarette. In addition, smoking tobacco through water does not filter out cancer causing chemicals (carcinogens) such as carbon monoxide. Filtered tobacco smoke that you pull through a hookah can damage the lungs and heart as much as cigarette smoke.

Hookah and nicotine

Nicotine is one of the most addictive chemicals out there. And it is 100% present during a hookah session. Hookah smokers actually inhale more nicotine than do cigarette smokers because of the massive volume of smoke they inhale. Nicotine increases levels of dopamine in the reward circuits of the brain. This reaction is similar to a feeling of euphoria or getting high and is thought to underlie the pleasurable sensations experienced by many smokers. For many tobacco users, continued nicotine exposure results in chemical changes in the brain and can result in addiction.

Nicotine withdrawal symptoms

Nicotine withdrawal symptoms usually begin within a few hours after you last use tobacco, peak within the first few days of smoking cessation and usually subside within a few weeks. For some people, however, symptoms of withdrawal may persist for months. Symptoms of withdrawal from the nicotine contained in hookah include:

  • anxiety
  • attention deficits
  • craving
  • depression
  • increased appetite
  • irritability
  • impaired cognitive skills
  • sleep disturbances

Signs of hookah addiction

Smoking tobacco produces a rapid distribution of nicotine in the brain, with drug levels peaking within 10 seconds of inhalation. However, the acute effects of nicotine dissipate quickly, as do the associated feelings of reward. This cycle of up-and-down causes a tobacco smoker to continue dosing to maintain the pleasurable effects and prevent withdrawal and cravings and is the basis for hookah addiction. But hookah addiction is characterized by a number of factors, including compulsive drug seeking and use, even in the face of negative health consequences. In other words, you may be addicted to hookah if you:

  1. You spend significant time, energy or money on hookah sessions or hookah related activities
  2. You experience nicotine withdrawal symptoms when you stop smoking
  3. You continue to smoke from a hookah despite negative consequences to your health, work, social or family obligations
  4. You think obsessively about hookah

Questions about hookah addiction

Hookah has been popular in Mediterranean and Eastern cultures for many thousands of years. But the popularity of hookah is rather new in the West. If you have questions about hookah use, abuse or even just want to share your story … please leave us a comment. We respond to all comments personally and have an active community who discusses issues in addiction. We would LOVE to hear from you!

Reference sources: CDC Smoking & Tobacco Use info on Hookah
NIDA Research Report Series: Is Nicotine Addictive?
The effects of waterpipe tobacco smoking on health outcomes: a systematic review : International Journal of Epidemiology, Volume39, Issue3, Pp. 834-857.
American Lung Association Update on Tobacco Waterpipe Use
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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