Hava Nargileh – CO poisoning from smoking a water pipe

September 6, 2011, 10:36 pm


Carbon monoxide poisoning associated with water pipe smoking. Türkmen S et al. Clin Toxicol 2011;49:697-698.


Although often thought to be safer than cigarette smoking, the consumption of tobacco by using a water pipe (also called a hookah, shisha, or nargileh) can actually deliver smoke equivalent to that from several hundred cigarettes. And if this weren’t enough, the user is exposed to carbon monoxide both from burning tobacco and the coals used to heat it.

This paper from Turkey reports on two cases of carbon monoxide poisoning and syncope brought on by smoking a water pipe. A letter in the same issue of Clinical Toxicology describes 3 additional cases. (Clin Toxicol 2011;49:702). With hookah use becoming more popular on many campuses around the United States, it is helpful to be reminded that this practice is not safe, that passing tobacco smoke through water does not filter out harmful ingredients, and that the risk of carbon monoxide toxicity in this setting is great.

[This article was upgraded from its original rating of 2.5 skulls.]











  1. Dr Hossein Sanaei-Zadeh Says:

    Dear Leon
    Would please see the similar article for more details:
    Arziman I, Acar YA, Yildirim AO, Cinar O, Cevik E, Eyi YE, Kaldirim U. Five cases of carbon monoxide poisoning due to narghile (shisha).Hong Kong j. emerg. med. 2011; 18(4): 254-257.

  2. Leon Says:

    Dr. Sanaei-Zadeh:

    Thank you for the lead. I have found the article online and will read it in the next several days.