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While often portrayed as safe alternatives to traditional cigarettes, both vaping and hookah smoking carry significant health risks—and are far from safe. Clever marketing strategies and misinformation have led many, particularly the youth, to believe that these methods are harmless. In social settings, vaping and hookah often appear trendy or modern, but growing scientific evidence consistently reveals the dangers they pose to both immediate and long-term health.
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Not water vapour
One of the most common misconceptions about vaping is that it produces nothing more than harmless water vapour. In reality, vaping devices work by heating a liquid that usually contains nicotine, flavourings, and a cocktail of other chemicals. The process creates an aerosol that users inhale, and this aerosol is far from safe. It can contain nicotine, which is highly addictive, along with heavy metals such as lead, volatile organic compounds, and chemicals like diacetyl, which has been linked to severe lung disease.
The health concerns associated with vaping are alarming. In recent years, cases of lung injuries linked to vaping have been reported, with a serious condition called EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury) emerging as one of the most concerning outcomes. For adolescents, vaping carries an even greater risk, since nicotine exposure can interfere with brain development. Beyond this, research is increasingly pointing to associations with chronic lung disease, asthma, and even cardiovascular conditions. What makes vaping particularly concerning is that its long-term effects are still under investigation, meaning the full scale of potential damage may only become clear years from now. Early findings, however, are troubling enough to raise red flags among health professionals worldwide.
Hookah is harmful
Hookah smoking, often glamourised as a cultural or social activity, involves inhaling smoke from a water pipe, usually combined with flavoured tobacco. A persistent belief is that the water through which the smoke passes acts as a filter, removing toxins and making lipthe practice safer than cigarette smoking. This assumption could not be further from the truth. The water cools the smoke, which makes it easier to inhale deeply, but it does nothing to eliminate the harmful substances. As a result, hookah smoke continues to carry high levels of tar, carbon monoxide, heavy metals, and carcinogens.
The health risks associated with hookah use are serious and well documented. A typical one-hour hookah session can expose a person to far more nicotine, carbon monoxide, and toxic smoke than a single cigarette. This dramatically increases the likelihood of developing lung cancer, oral cancers, heart disease, chronic obstructive pulmonary disease (COPD), and even carbon monoxide poisoning. Beyond these risks, the social nature of hookah smoking, where multiple people often share the same mouthpiece, introduces the possibility of spreading infectious diseases such as tuberculosis, herpes, and hepatitis.
Even as traditional hookah use shows signs of decline in some parts of the world, electronic hookahs are gaining popularity. Unfortunately, these newer alternatives carry many of the same risks and may even introduce additional ones, further complicating the public health challenge.
Busting myths
The persistence of myths surrounding both vaping and hookah plays a large role in their continued popularity. Many people continue to believe that vaping is completely harmless, when in reality it exposes the lungs to chemicals that can cause damage and potentially contribute to long-term illnesses. Similarly, the idea that water in a hookah filters out harmful toxins remains widespread, even though scientific evidence shows that tar, nicotine, and carbon monoxide continue to pass through unfiltered. Another damaging misconception is that hookah is not addictive. In truth, hookah tobacco contains nicotine, making it just as addictive as cigarette smoking. These myths create a false sense of safety, encouraging more people—particularly the younger generation—to experiment with these practices, unaware of the health risks they are taking on.
Neither vaping nor hookah smoking can be considered safe alternatives to traditional cigarettes. Both expose users to harmful substances and carry significant short- and long-term health risks, including addiction. What makes them especially concerning is not just their chemical content, but the cultural and social narratives that present them as less dangerous than cigarettes. This misleading perception has the potential to fuel a silent but growing public health crisis.
The reality is clear: vaping and hookah are not harmless trends or safer substitutes. They are health hazards that can have lasting consequences, and it is crucial for both individuals and communities to recognise the risks before they become entrenched habits.
(Dr Piyush Goel is senior consultant, pulmonology, Narayana Hospital, Gurugram. piyush.goel.dr@narayanahealth.org)
Published – August 23, 2025 12:02 pm IST
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