You are here:

Water pipes: Each puff carries a risk

05/2009, 23.04.2009

High levels of carbon monoxide in water pipe smoke are harmful particularly for pregnant women and cardiovascular patients

Water pipes, also called shishas, are popular mainly amongst adolescents in Germany. After evaluating the data available at the time, the Federal Institute for Risk Assessment already announced in 2005 that the smoking of water pipes did not mean scarcely any lower health risks than smoking cigarettes. New data from sources including the Institute’s own research work now indicate that users of water pipes take in far higher levels of carbon monoxide from the smoke than cigarette smokers. This toxic gas binds to the red blood pigment, haemoglobin, and can impede oxygen transport in the body. “Pregnant women and individuals suffering from cardiovascular diseases in particular should not, therefore, smoke water pipes”, says BfR President Professor Dr. Dr. Andreas Hensel. Pregnant women should not spend too much time in shisha cafes either.

The high levels of carbon monoxide in water pipe smoke are caused by the charcoal used to heat the tobacco in the water pipe. The carbon monoxide present in the smoke of a water pipe can already cause headaches and nausea in the users. As the gas can cross the placenta of pregnant women, it can reach the foetus and also impede oxygen supply there. Hence, pregnant women should not smoke water pipes. As carbon monoxide is also present in indoor air when water pipes are smoked, pregnant women should avoid spending longer periods in shisha cafes. The same holds for people suffering from cardiovascular diseases. 

According to the findings of a BfR research project, water pipe smoke contains, in addition to carbon monoxide, higher levels of other contaminants like the carcinogens benzo[a]pyrene and formaldehyde than cigarette smoke. There are also higher levels of nicotine in water pipe than in cigarette smoke. As this substance triggers the addictive effect of tobacco, it can be assumed that the addictive risks of water pipes are not lower than those of cigarettes, a claim that is often falsely made.

Following these studies on contaminant levels in the smoke of water pipes and cigarettes, there is a need for biomonitoring studies in order to clarify what amounts of the substances detected in smoke reach the human body and what effect they have there.



Date Title Size
BfR Updated Health Assessment No. 011/2009,
Health and addiction risks associated with water pipes 24.8 KB


Cookie Notice

This site only uses cookies to offer you a better browsing experience. Find out more on how we use cookies in our Data Protection Declaration.