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Study: Hookah Increases Chemical Associated With Leukemia Risk

People who go to hookah lounges register higher levels in their body of benzene, a chemical associated with an increased risk for leukemia — whether they smoke or not, according to results of a study announced Friday by San Diego State University.

The research, published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, found that a benzene metabolite in the urine of smokers who go to hookah lounges was four times higher than normal. It was double the usual amount for nonsmokers who went to hookah lounges.

"Hookah smoking involves the use of burning charcoal that is needed to heat the hookah tobacco to generate the smoke that the smoker inhales," said Nada Kassen, the associate director at the Center for Behavioral Epidemiology and Community Health at SDSU.

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"In addition to inhaling toxicants and carcinogens found in the hookah tobacco smoke, hookah smokers and nonsmokers who socialize with hookah smokers also inhale large quantities of charcoal combustion-generated toxic and carcinogenic emissions," Kassem said.

For the study, Kassem and colleagues analyzed levels of the metabolite, S-phenylmercapturic acid, in the urine of 105 hookah smokers and 103 nonsmokers. They obtained urine samples the morning of and the morning after participants attended a hookah-only smoking event at a hookah lounge or a private home.

The researchers found that S-phenylmercapturic acid levels were also significantly higher in hookah smokers after attending the private home event.

Kassem said the results indicate that smoking hookah is no safer than other kinds of tobacco smoking — and that regulations should reflect that reality.

"In contrast to what is believed, hookah tobacco smoking is not a safe alternative to smoking other forms of tobacco," Kassem said. "Because there is no safe level of exposure to benzene, our results call for interventions to reduce or prevent hookah tobacco use, regulatory actions to limit hookah- related exposure to toxicants including benzene, and include hookah smoking in clean indoor air legislation."

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The study was supported by the American Cancer Society and Flight Attendant Medical Research Institute.