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Hookahs And Health: Tobacco Vs. Tobacco-Free

Last week, the Village of Great Neck Board of Trustees approved a hookah lounge to open in the Old Village, based on the promise that the concoction to be smoked would be “tobacco free.” But, from a health standpoint does that really matter? 


Researchers just beginning to study the differences in the products being smoked are saying, “No.”


In a study conducted by Shihadeh, Salman, Eissenberg et. al. at the American University of Beirut and the Virginia Commonwealth University published in Food and Chemical

Toxicology, they found that the only significant difference in the toxins in the smoke analyzed from the tobacco filled pipes and the tobacco free pipes was nicotine, the addictive additive.


Otherwise, smoke from a tobacco-free preparation yielded nearly the same amount of carbon monoxide, nitric oxide, volatile alderhydes (like formaldehyde and acetaldehyde), tar and polycyclic aromatic hydrocarbons as tobacco based products. These compounds are known to contribute to the risk of tobacco-caused cancer, cardiovascular disease, and lung disease.


The study concludes, “These findings contradict advertising messages that ‘herbal’ waterpipe products are a healthy alternative to tobacco.”


In an email from one of the researchers, Dr. Thomas Eissenberg from Virginia University he stated, “Results were unambiguous: there is no reason to believe that inhaling smoke from the non-tobacco preparation presents any less disease risk than smoke from a tobacco preparation.”


Dr. Mark Travers a researcher at the Roswell Park Cancer Institute who has also done work on hookah smoking said, “It’s a common misperception that it’s only the additives in tobacco that cause all kinds of health problems. It’s the smoke.”


Of particular concern are the toxins released by burning charcoal. Travers recounted cases of young people in hookah lounges being rushed to emergency rooms for acute carbon monoxide poisoning.


“Right now,” Dr. Travers said, “these products being smoking are not regulated by the FDA... their ingredients are not listed, there are no warnings or restrictions in the packaging...and it’s a fabrication, no, it’s an outright lie that non-tobacco products are for the ‘health conscious’ individual.” He indicated that the regulations have not caught up with the science.


And Dr. Travers raised the issue of enforcement. 


Will there be any restrictions on a hookah bar and who will enforce them?


The village did not set any age restrictions.


Theodore Horishny of the Nassau County Fire Marshal’s office said that they had not received paperwork from the village, but that the Fire Marshal’s office was only responsible for making sure the lounge has the proper occupancy for the space and has the proper fire detection and fire suppression systems in place. He added that such a place would be required to have a sprinkler system and carbon monoxide detectors. He added, “I can’t tell you more than that because we haven’t seen an application...but we aren’t responsible for determining exactly what is being smoked.”


Nassau County Health Department spokesperson, Mary Ellen Lorraine explained that the health department’s role is very limited in this matter. Since pre-packaged desserts are proposed to be served, the Clean Air Act, which governs the health department’s responsibilities are nullified. We confirmed this with the New York State Health Department. Ms. Lorraine stated that Nassau County bans the selling of tobacco products to those under 19.


We asked Mayor Ralph Kreitzman about how the enforcement will be handled. He stated, “If they’re violating any laws, we’ll respond and take appropriate actions.”