Smoking a Water Pipe / Hookah Leads to Carbon Monoxide Poisoning

A case report in the Medical Journal of Australia describes a patient with levels of high carbon monoxide in the blood due to the use of water pipe or hookah. Carbon monoxide poisoning could lead to many irreversible neurological disorders as well as myocardial toxicity among others.

There is quite a bit of awareness about cigarette smoking and its subsequent health problems in an individual and the community. Harmful effects of smoking on lungs and other systems has made smoking a public health issue. While many people give up smoking cigarettes, there are several others who look for alternatives which they assume are less harmful.

One of the alternatives is the hookah or water pipe. It is called water pipe because the smoke that is generated passes through water before it can be inhaled. Once commonly used in the Middle East and India, smoking hookah is often considered a social statement, with hookah lounges gaining nation-wide popularity. Unfortunately, what people fail to understand is that the smoke that is inhaled in one session could equal to smoking around 50 to 100 cigarettes. Therefore, it is far from true that the water pipe is safer in any way. Though tobacco-free hookahs are being popularized especially among youngsters, inhalation of the smoke is still not safe.

A recently documented case report indicates that carbon monoxide poisoning can occur following the use of hookah. Since the combustion in the hookah chamber takes place under low-oxygen conditions, carbon monoxide is generated, which is then inhaled by the user. Carbon monoxide binds tightly to hemoglobin, and therefore, does not allow oxygen to attach itself to the red blood cells. Therefore, enough oxygen cannot reach the tissues. The brain and the heart in particular require a continuous supply of oxygen; these organs are most severely affected by the poisoning, which can even result in death.

The case report describes a young lady of 20 years who experienced severe light-headedness along with some headache and nausea which appeared an hour after using the hookah. She was a frequent user of the hookah and smoked for around an hour on most days of the week. She had experienced similar symptoms earlier after smoking cigarettes, but had not required medical attention.

Physical examination of the patient and various tests carried out were normal except for the carbon monoxide level which was very high in the blood. The patient was administered high-flow of oxygen. The oxygen displaces the carbon monoxide from the red blood cells, thus bringing the oxygen-carrying capacity of blood back to normal. The lady did show some changes on ECG, which returned to normal following treatment.

This case report highlights the importance of getting correct facts about smoking. Smoking of tobacco in any form is harmful – whether as cigarette, cigar, pipe or hookah. All these forms of smoking are associated with the risks of the same illnesses – lung disease including cancer, heart disease and other problems. Unless a reputed body like the FDA states that a particular form is safer, statements from tobacco companies claiming that their products are safe to use, should be looked upon with caution. The only fool-proof way to avoid complications due to smoking is to avoid smoking in every form.

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Source-Medindia