Hookah Tobacco (Shisha or Waterpipe Tobacco)
On this page:
- What are Hookah Tobacco Products?
- Are You Looking for General Health and Safety Information Related to Hookah Tobacco Products?
- Are You a Manufacturer of Hookah Tobacco Products?
- Are You a Retailer of Hookah Tobacco Products?
What are Hookah Tobacco Products?
Hookah tobacco is a type of tobacco product which produces smoke that people inhale when a hookah device is heated. Hookah tobacco (also known as waterpipe tobacco, maassel, shisha, narghile, or argileh) typically contains a mixture of tobacco, sweeteners, and flavoring.
The hookah device (or waterpipe) used to smoke the hookah tobacco works by passing charcoal or electric heated air through the tobacco mixture and ultimately through a water-filled chamber.
Are You Looking for General Health and Safety Information Related to Hookah Tobacco Products?
There are no safe tobacco products. Using any tobacco product —including hookah tobacco products—can harm your health. Annually, FDA and the Centers for Disease Control and Prevention releases information on youth use of tobacco products, including hookah tobacco, through the National Youth Tobacco Survey.
Exposure to Harmful Chemicals and Environments
- The heat source (charcoal or electric heater), length of the hose, the composition of the tobacco used, and the time spent using hookah can all affect the chemical mixture a user is exposed to. One concerning chemical is carbon monoxide, which gets absorbed into a persons’ blood and contributes to a light-headed sensation and hypoxia. People who use tobacco from a hookah absorb more carbon monoxide than people who smoke cigarettes.
- Research shows that people who use a hookah may absorb even more of the toxic chemicals found in cigarette smoke because of the length of the smoking session.
- Water does not filter smoke clear of harmful chemicals. The smoke from a hookah still contains high levels of toxic chemicals [such as carbon monoxide, metals, and cancer-causing chemicals].
- Studies show that patrons of hookah lounges are exposed to elevated concentrations of indoor air pollutants and air quality ranges known to pose health risks.
Risk of Addiction
- Hookah smoking delivers the addictive drug nicotine. Nicotine can change the way the brain works, causing cravings for more of it.
Health Effects
- Hookah use is linked to many of the same adverse health effects as cigarette smoking, such as oral, lung, and esophageal cancer, as well as chronic obstructive pulmonary disease.
- Short-term hookah use is associated with acute health effects, including increased heart rate and blood pressure, reduced pulmonary function, and hypoxia from carbon monoxide exposure.
- Hookah use can cause sudden and potentially dangerous changes in blood pressure and heart rate of people who have had heart attacks.
- People who use a hookah can breathe in bacteria that live in its hose. Using a hookah with bacteria in its hose may transmit infectious diseases from person to person.
Resources in the FDA Tobacco Education Resource Library
The FDA Tobacco Education Resource Library, from FDA's Center for Tobacco Products, provides educational resources about tobacco health risks. This site offers digital and print content for state and local health officials, nonprofit organizations, and schools to support public outreach efforts.
Reporting Adverse Experiences and Product Violations
If you have experienced undesired health or quality problems with any tobacco product, including hookah tobacco, you can report it to FDA. Knowing more about adverse experiences can help FDA identify concerning trends and causes or contributors for particular incidents or health or quality problems beyond those normally associated with tobacco product use. You can read some tobacco-related adverse experience reports on the Tobacco Product Problem Reports page.
If you think hookah tobacco or other tobacco products are being sold to underage users, or you see another potential violation of the FD&C Act or FDA’s tobacco regulations, please report the potential tobacco product violation.
Are You a Manufacturer of Hookah Tobacco Products?
If you make, modify, mix, manufacture, fabricate, assemble, process, label, repack, relabel, or import any tobacco product, then you are considered a tobacco product manufacturer. Importers of finished tobacco products are regulated as tobacco product manufacturers, distributors, or both. If you are a tobacco product manufacturer, find out more information on complying with FDA’s tobacco products regulation on CTP’s Manufacturing webpage.
CTP’s Office of Small Business Assistance can answer specific questions about requirements of small businesses and how to comply with the law. This office also provides online educational resources to help regulated industry understand FDA regulations and policies.
FDA Regulation of Hookah Tobacco Products
In 2016, FDA finalized a rule extending regulatory authority to cover all tobacco products, including hookah tobacco. FDA regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of hookah tobacco. This includes components and parts of tobacco products regulated by the 2016 rule, but excludes accessories such as lighters, tongs, or external burners.
“Components” or “parts” include, among other things, software or an assembly of materials intended or reasonably expected to alter or affect the tobacco product’s performance, composition, constituents, or characteristics; or to be used with or for the human consumption of a tobacco product. For more information about components, parts, and accessories, please read Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act. Examples of components and parts that are regulated include, but are not limited to:
- Hookah
- Flavor enhancers
- Hose cooling attachments
- Water filtration base additives (including those that are flavored)
- Charcoal made from wood, coconut shell or other materials, as well as electric heating systems
- Bowls, valves, hoses, and heads
Are You a Retailer of Hookah Tobacco Products?
Tools for Retailers
“This is Our Watch” is an education program with resources to help tobacco retailers better understand and comply with FDA tobacco regulations. Tobacco retailers play a direct role in protecting kids from nicotine addiction and the deadly effects of tobacco use.
Learn what tobacco retailers need to do to comply with the rules designed to prevent our nation's youth from becoming the next generation of Americans to die prematurely from tobacco-related disease.
Retail Sales of Tobacco Products offers more information about federal rules that retailers must follow as well as information on regulations, guidance, and webinars for retailers.
Did You Know?
It is illegal for a retailer to sell any tobacco product – including hookah tobacco, cigarettes, and e-cigarettes – to anyone under 21.