View source for Hookah

{{Short description|Type of water pipe}}
{{other uses}}
{{pp-pc}}
{{Use dmy dates|date=July 2024}}
[[File:Rajput (Jodhpur) (8411728143).jpg|thumb|A [[Rajput]] man smoking through a hookah, [[Rajasthan, India]].]]

A '''hookah''' (also see [[#Names and etymology|other names]]),<ref name="TCALR1916">{{cite book|title=The Ceylon Antiquary and Literary Register, Volume 1|year=1916|work=[[The Times]]|page=111|quote=It has even drawn largely on English, and such words as daktar and platfarm, isteshan and tikat, trem-ghari and rel-ghari, registran karna and apil karna are as common as similar words are in Ceylon. To make up for it Hindustani has not only enriched the vocabulary of Anglo-Indian English with such words as topi and pugre, oheerot and hookah, dhoby and sepoy, ghary and tamasha, durbar and bukshish, Kachcheri and Punkah, but has contributed to it words like jungle, bazar, [and] loot.}}</ref><ref name="1994Pathak">{{cite book|last=Pathak|first=R. S.|title=Indianisation of English Language and Literature|year=1994|publisher=Bahri Publications|page=72|quote=Bhabani Bhattacharya, who uses Hindi words like ''taveez'', ''laddoo'', ''hookah'', ''vaid'' and ''halwai'', also makes deft employment of reverential term ''Bai'' for the heroine besides using exclamatory terms as ''Ho'', ''Han'' (yes) and ''Ram-Ram''.}}</ref><ref name="Environ. Health Prev. Med.">{{cite journal |last1=Qasim |first1=Hanan |last2=Alarabi |first2=A. B. |last3=Alzoubi |first3=K. H. |last4=Karim |first4=Z. A. |last5=Alshbool |first5=F. Z. |last6=Khasawneh |first6=F. T. |date=September 2019 |title=The effects of hookah/waterpipe smoking on general health and the cardiovascular system |url=https://environhealthprevmed.biomedcentral.com/track/pdf/10.1186/s12199-019-0811-y.pdf |url-status=live |journal=[[Environmental Health and Preventive Medicine]] |publisher=[[BioMed Central]] |volume=24 |issue=58 |page=58 |doi=10.1186/s12199-019-0811-y |doi-access=free |issn=1347-4715 |pmc=6745078 |pmid=31521105 |bibcode=2019EHPM...24...58Q |s2cid=202570973 |archive-url=https://web.archive.org/web/20210424161857/https://environhealthprevmed.biomedcentral.com/track/pdf/10.1186/s12199-019-0811-y.pdf |archive-date=24 April 2021 |access-date=8 September 2021}}</ref> '''shisha''',<ref name="Environ. Health Prev. Med."/> or '''waterpipe'''<ref name="Environ. Health Prev. Med."/> is a single- or multi-stemmed instrument for [[heating]] or [[vaporizing]] and then [[smoking]] either [[tobacco]], [[flavored tobacco]] (often ''[[muʽassel]]''), or sometimes [[Cannabis (drug)|cannabis]], [[hashish]] and [[opium]].<ref name="Environ. Health Prev. Med."/> The smoke is passed through a water basin—often glass-based—before inhalation.<ref name="Environ. Health Prev. Med."/><ref name="Devichand2007">{{cite news |last=Devichand |first=Mukul |url=https://news.bbc.co.uk/2/hi/uk_news/magazine/6238382.stm |title=UK &#124; Magazine &#124; Pipe dream |publisher=BBC News |date=2007-06-25 |access-date=2013-09-03 |quote=Despite being a recent addition to [[British culture]], shisha has a long history. Many believe that it originated in [[India]] (known there as "hookah") about a thousand years ago, when more often the shisha pipe was used to smoke opium rather than tobacco. |archive-date=19 August 2017 |archive-url=https://web.archive.org/web/20170819105721/http://news.bbc.co.uk/1/hi/magazine/6238382.stm |url-status=live }}</ref><ref name="Cyclopædia">{{cite book |url=https://books.google.com/books?id=yvNWAAAAMAAJ&pg=PA99 |title = The cyclopaedia of India and of Jordan and eastern and southern Asia, Volume 2 |publisher = [[Bernard Quaritch]] |quote=HOOKAH. Hindi. The Indian pipe and apparatus for smoking. |access-date = 2007-08-01 |year = 1885}}</ref><ref name="Encyclopædia Britannica">{{cite EB1911 |volume=13 |wstitle=Hookah |page=670}}</ref><ref name=who-ad>{{cite web |url=https://www.who.int/entity/tobacco/global_interaction/tobreg/Waterpipe%20recommendation_Final.pdf |title=WHO Study Group on Tobacco Product Regulation (TobReg) an advisory note Waterpipe tobacco smoking: dangerous health effects include risk to public safety if used by multiple users, research needs and recommended actions by regulators, 2005 |publisher=World Health Organization |access-date=2013-09-03}}{{dead link|date=December 2021|bot=medic}}{{cbignore|bot=medic}}</ref>

The major [[Health effects of tobacco|health risks of smoking tobacco]], [[Effects of cannabis#Related to smoking|cannabis]], opium and other drugs through a hookah include exposure to [[Toxicant|toxic chemicals]], [[carcinogens]] and [[Heavy metals#Toxicity|heavy metals]] that are not filtered out by the water,<ref name="Environ. Health Prev. Med."/><ref name="Arterioscler. Thromb. Vasc. Biol.">{{cite journal |last1=Alarabi |first1=A. B. |last2=Karim |first2=Z. A. |last3=Alshbool |first3=F. Z. |last4=Khasawneh |first4=F. T. |last5=Hernandez |first5=Keziah R. |last6=Lozano |first6=Patricia A. |last7=Montes Ramirez |first7=Jean E. |last8=Rivera |first8=José O. |date=February 2020 |title=Short-Term Exposure to Waterpipe/Hookah Smoke Triggers a Hyperactive Platelet Activation State and Increases the Risk of Thrombogenesis |journal=[[Arteriosclerosis, Thrombosis, and Vascular Biology]] |publisher=[[Lippincott Williams & Wilkins]] |volume=40 |issue=2 |pages=335–349 |doi=10.1161/ATVBAHA.119.313435 |doi-access=free |issn=1079-5642 |pmc=7000176 |pmid=31941383 |s2cid=210335103 }}</ref><ref name="Ann. Am. Thorac. Soc.">{{cite journal |last1=Patel |first1=Mit P. |last2=Khangoora |first2=Vikramjit S. |last3=Marik |first3=Paul E. |date=October 2019 |title=A Review of the Pulmonary and Health Impacts of Hookah Use |journal=[[Annals of the American Thoracic Society]] |publisher=[[American Thoracic Society]] |volume=16 |issue=10 |pages=1215–1219 |doi=10.1513/AnnalsATS.201902-129CME |doi-access= |issn=2325-6621 |pmid=31091965 |s2cid=155103502 }}</ref><ref name="Cancer Epidemiol. Biomark. Prev.">{{cite journal |last1=Etemadi |first1=Arash |last2=Blount |first2=Benjamin C. |last3=Calafat |first3=Antonia M. |last4=Chang |first4=Cindy M. |last5=De Jesus |first5=Victor R. |last6=Poustchi |first6=Hossein |last7=Wang |first7=Lanqing |last8=Pourshams |first8=Akram |last9=Shakeri |first9=Ramin |last10=Shiels |first10=Meredith S. |last11=Inoue-Choi |first11=Maki |last12=Ambrose |first12=Bridget K. |last13=Christensen |first13=Carol H. |last14=Wang |first14=Baoguang |last15=Ye |first15=Xiaoyun |last16=Murphy |first16=Gwen |last17=Feng |first17=Jun |last18=Xia |first18=Baoyun |last19=Sosnoff |first19=Connie S. |last20=Boffetta |first20=Paolo |last21=Brennan |first21=Paul |last22=Bhandari |first22=Deepak |last23=Kamangar |first23=Farin |last24=Dawsey |first24=Sanford M. |last25=Abnet |first25=Christian C. |last26=Freedman |first26=Neal D. |last27=Malekzadeh |first27=Reza |date=February 2019 |title=Urinary Biomarkers of Carcinogenic Exposure among Cigarette, Waterpipe, and Smokeless Tobacco Users and Never Users of Tobacco in the Golestan Cohort Study |journal=[[Cancer Epidemiology, Biomarkers & Prevention]] |publisher=[[American Association for Cancer Research]] |volume=28 |issue=2 |pages=337–347 |doi=10.1158/1055-9965.EPI-18-0743 |eissn=1538-7755 |issn=1055-9965 |pmc=6935158 |pmid=30622099 |s2cid=58560832}}</ref><ref name="WHO15">{{cite book|author=WHO Study Group on Tobacco Product Regulation|url=http://apps.who.int/iris/bitstream/10665/161991/1/9789241508469_eng.pdf?ua=1|title=Advisory note: waterpipe tobacco smoking: health effects, research needs and recommended actions by regulator|date=2015|publisher=World Health Organization|edition=2nd.|location=Geneva|access-date=13 June 2015|archive-date=7 January 2018|archive-url=https://web.archive.org/web/20180107210136/http://apps.who.int/iris/bitstream/10665/161991/1/9789241508469_eng.pdf?ua=1|url-status=live}}</ref> alongside those related to the transmission of [[infectious diseases]] when hookahs are shared or not properly cleaned.<ref name="Environ. Health Prev. Med."/><ref name="Ann. Am. Thorac. Soc."/><ref>{{cite journal|last1=Akl|first1=EA|last2=Gaddam|first2=S|last3=Gunukula|first3=SK|last4=Honeine|first4=R|last5=Jaoude|first5=PA|last6=Irani|first6=J|title=The effects of waterpipe tobacco smoking on health outcomes: a systematic review |journal=International Journal of Epidemiology|date=June 2010|volume=39|issue=3|pages=834–57|pmid=20207606|doi=10.1093/ije/dyq002|doi-access=free | issn = 0300-5771 }}</ref><ref name="ElZaatari15">{{cite journal|last1=El-Zaatari|first1=ZM|last2=Chami|first2=HA|last3=Zaatari|first3=GS|date=March 2015|title=Health effects associated with waterpipe smoking|journal=Tobacco Control|volume=24|issue=Suppl 1|pages=i31–i43|doi=10.1136/tobaccocontrol-2014-051908|pmc=4345795|pmid=25661414}}</ref> Hookah and waterpipe use is a global [[public health]] concern, with high rates of use in the populations of the [[Middle East and North Africa]] as well as in young people in the [[United States]], [[Europe]], [[Central Asia]], and [[South Asia]].<ref name="Environ. Health Prev. Med."/><ref name="Arterioscler. Thromb. Vasc. Biol."/><ref name="Ann. Am. Thorac. Soc."/><ref name="Cancer Epidemiol. Biomark. Prev."/><ref name="WHO15"/>

The hookah or waterpipe was invented by Abul-Fath Gilani, an Iranian physician of [[Akbar]], in the Indian city of [[Fatehpur Sikri]] during [[Mughal India]].<ref name="Ann. Am. Thorac. Soc."/><ref name= "Sivaramakrishnan4-5"/><ref name=Wealth>{{cite book |url=https://books.google.com/books?id=Hm1XAAAAMAAJ&q=hookah+isndia |title=The Wealth of India |quote=The smoking of hookah and hubble-bubble started in India during the reign of the great Moghul emperor, Akbar |publisher=Council of Scientific & Industrial Research |access-date=2007-08-01|year=1976 }}</ref> The hookah spread from the [[Indian subcontinent]] to Persia first, where the mechanism was modified to its current shape, and then to the Ottoman empire.<ref name="Aljarrah2009">{{cite journal|author=Khaled Aljarrah |author2=Zaid Q Ababneh |author3=Wael K Al-Delaimy|year=2009|title=Perceptions of hookah smoking harmfulness: predictors and characteristics among current hookah users|journal=Tobacco Induced Diseases|volume=5|issue=1|page=16|issn=1617-9625|doi=10.1186/1617-9625-5-16 |pmid=20021672 |pmc=2806861 |quote=Hookahs originated in India in the 15th century and then spread to the Near East countries. Hookahs spread first to Persia and underwent further changes to its original shape to the current known shape. In the middle of the 16th century, hookahs reached the Ottoman Empire, Egypt, and other Mediterranean regions. |doi-access=free }}</ref> Alternatively, it could have originated in the [[Safavid dynasty]] of [[Persia]],<ref name="Ann. Am. Thorac. Soc."/><ref>{{Cite web|url=http://www.iranicaonline.org/articles/galyan-|title=ḠALYĀN|website=Encyclopaedia Iranica|access-date=2019-05-29|quote=It seems, therfore, &#91;sic&#93; that Abu'l-Fatḥ Gīlānī should be credited with the introduction of the ḡalyān, already in use in Persia, to India.|archive-date=27 January 2012|archive-url=https://web.archive.org/web/20120127064634/http://www.iranicaonline.org/articles/galyan-|url-status=live}}</ref><ref>{{cite book |title=Charlemagne's tablecloth: a piquant history of feasting |author=Nichola Fletcher |publisher=Macmillan |date=1 August 2005 |page=10 |url=https://books.google.com/books?id=vMfEyKvR59sC&q=Charlemagne's+Tablecloth+hookahs&pg=PA10 |isbn=978-0-312-34068-1 }}</ref> from where it eventually spread to the Indian subcontinent.<ref name=common>{{cite book |title=Essential Concepts for Healthy Living Update |author=Sandra Alters |author2=Wendy Schiff|publisher=Jones & Bartlett Learning |date=28 January 2011 |url=https://books.google.com/books?id=EciU_y1JroMC&q=hookah+origin+persia+india&pg=PA353|isbn=978-0-7637-8975-6}}</ref><ref>{{cite book |title=Control of tobacco-related cancers and other diseases: proceedings of an international symposium, January 15–19, 1990, TIFR, Bombay |author=Prakash C. Gupta |publisher=Prakash C. Gupta |year=1992 |page=33 |url=https://books.google.com/books?id=-Zqo67BjH7UC&q=hookah+origin++India&pg=PA33|isbn=978-0-19-562961-3 }}</ref>

Despite tobacco and drug use being considered a [[taboo]] when the hookah was first conceived, its use became increasingly popular among nobility and subsequently widely accepted.<ref>{{Cite book |last1=Chopra |first1=H. K. |url=https://books.google.com/books?id=2WL0fAS-JDQC&q=hookah+india+history&pg=PA298 |title=Textbook of Cardiology (A Clinical & Historical Perspective) |last2=Nanda|first2=Navin C.|date=2012-12-30|publisher=JP Medical Ltd|isbn=978-93-5090-081-9}}</ref> Burned tobacco is increasingly being replaced by [[heated tobacco product|vaporizing]] flavored tobacco. Still the original hookah is often used in rural South Asia, which continues to use ''tumbak'' (a pure and coarse form of unflavored tobacco leaves) and smoked by burning it directly with charcoal.<ref>{{cite journal | vauthors = Qasim H, Alarabi AB, Alzoubi KH, Karim ZA, Alshbool FZ, Khasawneh FT | title = The effects of hookah/waterpipe smoking on general health and the cardiovascular system | journal = Environmental Health and Preventive Medicine | volume = 24 | issue = 1 | article-number = 58 | date = September 2019 | pmid = 31521105 | pmc = 6745078 | doi = 10.1186/s12199-019-0811-y | bibcode = 2019EHPM...24...58Q | doi-access = free }}</ref> While this method delivers a much higher content of tobacco and nicotine, it also incurs more adverse health effects compared to vaporizing hookahs.{{Citation needed|date=October 2020}}

The word hookah is a derivative of "huqqa", a [[Hindustani language|Hindustani]] word,<ref name="1994Pathak"/><ref>{{cite web|url=http://crossasia-repository.ub.uni-heidelberg.de/1896/1/Hindi_Urdu_Words_in_Oxford_Eng_Dictionaries_June_27_2011_1.pdf|title=The Socio-Cognitive Dynamics of Hindi/Urdu Lexemes in the Concise Oxford English Dictionary|last=Qadeer|first=Atlaf|year=2011|access-date=8 October 2016|archive-date=10 October 2016|archive-url=https://web.archive.org/web/20161010162345/http://crossasia-repository.ub.uni-heidelberg.de/1896/1/Hindi_Urdu_Words_in_Oxford_Eng_Dictionaries_June_27_2011_1.pdf|url-status=live}}</ref><ref name="Pathak1994">{{cite book|last=Pathak|first=R. S.|title=Indianisation of English Language and Literature|year=1994|publisher=Bahri Publications/|page=24|quote=In the domain of philosophy, religion and fine arts, particularly music, the words come entirely from Hindi-Sanskrit. The commonest ones are ''puja'', ''bhajan'', ''shastra'', ''purana'', ''karma'', ''vina'', ''raga'', etc. Finally, common festivals and socio-cultural institutions throughout the country provide such terms as ''Holi'', ''Dee(pa)wali'', ''brahmin'', ''sudra'', ''hookah'', ''bidi'', ''budmash'', ''shikari'' and so on.}}</ref> of [[Arabic]] origin (derived from {{lang|ar|حُقَّة}} ''ḥuqqa'', "casket, bottle, water pipe").<ref>{{cite book |last1=Steingass |first1=Francis Joseph |title=The Student's Arabic–English Dictionary |date=1884 |publisher=W. H. Allen |location=London |url=https://archive.org/details/cu31924026873194 |access-date=30 October 2019}}</ref> Outside its native region, hookah smoking has gained popularity throughout the world,<ref name="Aljarrah2009"/> especially among younger people.<ref>{{cite journal |last1=Brockman |first1=LN |last2=Pumper |first2=MA |last3=Christakis |first3=DA |last4=Moreno |first4=MA |title=Hookah's new popularity among US college students: a pilot study of the characteristics of hookah smokers and their Facebook displays |journal=BMJ Open |date=December 2012 |volume= 2|series=2 |issue=6 |doi=10.1136/bmjopen-2012-001709 |pmid=23242241 |article-number=e001709 |pmc=3533013}}</ref>

==Names and etymology==
[[File:Jahangirs huqqa close national museum india.JPG|thumb|upright|Mughal emperor [[Jahangir]]'s jade hookah, [[National Museum, New Delhi]], India.]]
[[File:Karimkhan.jpg|right|thumb|[[Karim Khan Zand|Karim Khan of Persia]] seated in his royal court in [[Shiraz]], using a Qaelyan (1755).]]

In the Indian subcontinent, the [[Hindustani language|Hindustani]] word ''huqqa'' (Devanagari: हुक़्क़ा, Nastaleeq: {{nq|حقّہ}}) is used and is the origin of the English word "hookah".<ref name="TCALR1916"/><ref>{{cite book|last=Dora-Laskey|first=Prathim-Maya |title=Postmodern Chic and Postcolonial Cheek: A Map of Linguistic Resistance, Hybridity, and Pedagogy in Rushdie's Midnight's Children|publisher=York University|pages=190–193}}</ref> The widespread use of the [[Languages of India|Indian]] word "hookah" in the English language is a result of the colonization in [[British India]] (1858–1947), when large numbers of expatriate Britons first sampled the water pipe.<ref name="Cook2010">{{cite book|last=Cook|first=Vivian|title=It's All in a Word: History, meaning and the Sheer Joy of Words|date=9 December 2010|publisher=Profile Books|isbn=978-1-84765-319-2|page=72|quote=Ever since the British went to India, many words from Indian languages have travelled in the reverse direction. The changing historical relationship between the two countries is shown in the different kinds of words that the English language borrowed at different periods, according to the Indian expert Subba Roa. In the seventeenth century, it was trade that counted. The names of Indian places were used for particular materials, such as ''calico'' (a city) or ''cashere'' (Kashmir). In the eighteenth century, though trade continued to bring in words such as ''jute'' and ''seersucker'', influences came from Indian culture, such as ''hookah'' (alias ''hubble-bubble'', a kind of smoking device), and the military, as in ''sepoy'' (native Indian soldier).}}</ref> [[William Hickey (memoirist)|William Hickey]], shortly after arriving in [[Calcutta]], India, in 1775, wrote in his ''Memoirs'':

::The most highly-dressed and splendid hookah was prepared for me. I tried it, but did not like it. As after several trials I still found it disagreeable, I with much gravity requested to know whether it was indispensably necessary that I should become a smoker, which was answered with equal gravity, "Undoubtedly it is, for you might as well be out of the world as out of the fashion. Here everybody uses a hookah, and it is impossible to get on without ...[I] have frequently heard men declare they would much rather be deprived of their dinner than their hookah."<ref>{{cite book|title=Memoirs of William Hickey|location=London|publisher=Hurst & Blackett|edition=Volume II|year=1918|page=136}}</ref>

Arabic أرجيلة ('arjīlah)<ref>{{Cite web|url=https://forvo.com/word/%D8%A3%D8%B1%D8%AC%D9%8A%D9%84%D8%A9/|title=أرجيلة pronunciation: How to pronounce أرجيلة in Arabic|first=Forvo|last=Team|website=Forvo.com}}</ref> is the name most commonly used in [[Lebanon]], [[Syria]], [[Palestine (region)|Palestine]], [[Jordan]], [[Uzbekistan]], [[Kuwait]] and [[Iraq]], while ''nargilah'' ({{langx|he|נַרְגִּילָה}}, {{langx|ar|نارجيلة}}) is the name most commonly used in [[Israel]]. It derives from ''nārgil'' ({{langx|fa|نارگیل}}), which in turn comes from the [[Sanskrit]] word ''nārikela'' ({{lang|sa|नारिकेल}}), meaning [[coconut]], suggesting that early hookahs were hewn from coconut shells.<ref>{{cite web | url=http://www.mymerhaba.com/en/main/content.asp_Q_id_E_1124 | title=Nargile | publisher=mymerhaba | access-date=2013-09-03 | archive-date=27 May 2009 | archive-url=https://web.archive.org/web/20090527162919/http://www.mymerhaba.com/en/main/content.asp_Q_id_E_1124 }}</ref><ref>{{cite news |url=http://www.lankanewspapers.com/news/2007/8/18197_space.html |title=Smoke like an Egyptian—Sri Lanka |publisher=Lankanewspapers.com |access-date=2010-08-22 |archive-date=19 January 2012 |archive-url=https://web.archive.org/web/20120119093639/http://www.lankanewspapers.com/news/2007/8/18197_space.html |url-status=live }}</ref>

In [[Serbia]], [[Bosnia and Herzegovina]], [[North Macedonia]], [[Greece]], [[Turkey]] and [[Bulgaria]], {{transliteration|bg|na[r]gile}} (на[р]гиле) or {{transliteration|bg|na[r]gila}} (на[р]гила) is used to refer to the pipe,<ref>{{cite web| url=http://www.ezglot.com/words.php?l=tur&w=nargile&lang=eng | title=Nargile on the map| publisher = ezglot | access-date=2017-04-29}}</ref> while ''šiša'' (шиша) refers to شیشه (šiše) meaning glass bottle in Persian. The pipes there often have one or two mouth pieces. The flavored tobacco, created by marinating cuts of tobacco in a multitude of flavored molasses, is placed above the water and covered by pierced foil with hot coals placed on top, and the smoke is drawn through cold water to cool and filter it. In [[Albania]], the hookah is called "lula" or "lulava". In [[Romania]], it is called ''narghilea''.

"Narguile"<ref>{{cite web |url=http://buscon.rae.es/draeI/SrvltConsulta?TIPO_BUS=3&LEMA=narguile |title=Diccionario de la lengua española – Vigésima segunda edición |language=es |publisher=Buscon.rae.es |access-date=2010-08-22 |archive-date=15 September 2011 |archive-url=https://web.archive.org/web/20110915083821/http://buscon.rae.es/draeI/SrvltConsulta?TIPO_BUS=3&LEMA=narguile |url-status=live }}</ref> is the common word in Spain used to refer to the pipe, although "cachimba"<ref>{{cite web |url=http://buscon.rae.es/draeI/SrvltConsulta?TIPO_BUS=3&LEMA=cachimba |title=Diccionario de la lengua española – Vigésima segunda edición |language=es |publisher=Buscon.rae.es |access-date=2010-08-22 |archive-date=17 March 2011 |archive-url=https://web.archive.org/web/20110317011622/http://buscon.rae.es/draeI/SrvltConsulta?TIPO_BUS=3 |url-status=live }}</ref> is also used, along with "shisha" by Moroccan immigrants in Spain. The word "narguilé" is used in Portuguese. "Narguilé" is also used in French, along with "chicha".

Arabic شيشة (šīšah), through Ottoman Turkish word شیشه (şîşe), itself a direct loanword from Persian شیشه (šīše) meaning "glass container", is the common term for the hookah in [[Egypt]], [[Sudan]] and also other [[Arab world]] regions such as [[Arab peninsula|Arab Peninsula]] (including [[Kuwait]], [[Bahrain]], [[Qatar]], [[Oman]], [[United Arab Emirates|UAE]], [[Yemen]] and [[Saudi Arabia]]), [[Algeria]], [[Tunisia]]. It is used also in [[Morocco]], [[Somalia]]<ref>{{cite web|title=تعريف و معنى شيشة في معجم المعاني الجامع|url=https://www.almaany.com/ar/dict/ar-ar/%D8%B4%D9%8A%D8%B4%D8%A9/|website=المعاني – معجم عربي عربي|publisher=Almaany|access-date=29 April 2018}}</ref> and [[Cyprus]]. In Yemen, the Arabic term مداعة (''madā`ah'') is also used, but for pipes using pure tobacco.

In [[List of countries and territories where Persian is an official language|Persian-speaking countries]], this kind of water pipe is called {{Langx|fa|غلیان|ghalyān}} which is a hypercorrection of {{Langx|ar|غليون|ghalyūn|pipe}}. It is included in the earliest European compendium on tobacco, the ''tobacologia'' written by Johan Neander and published in Dutch in 1622. It seems that over time water pipes acquired a Persian connotation as in eighteenth-century Egypt the most fashionable pipes were called ''Karim Khan'' after the Persian ruler of the day.<ref>{{cite book|title=The pursuit of pleasure: drugs and stimulants in Persian history, 1500-1900|author=Rudolph P. Matthee|publisher=Princeton University Press|year=2005|page=124|url=https://books.google.com/books?id=Kf0XfDMLndsC&q=persian+galyan&pg=PA124|isbn=978-0-691-11855-0}}</ref> This is also the name used in [[Azerbaijan]], [[Ukraine]], [[Russia]], [[Lithuania]] and [[Belarus]].<ref>{{cite web|title=hookah|url=https://dictionary.reverso.net/english-russian/hookah/forced|website=Reverso Dictionary|publisher=Reverso-Softissimo|date=2017|access-date=29 April 2018|archive-date=8 March 2021|archive-url=https://web.archive.org/web/20210308065349/https://dictionary.reverso.net/english-russian/hookah/forced|url-status=live}}</ref>

In [[Uzbekistan]] and [[Afghanistan]], a hookah is called {{transliteration|uz|[[chillum (pipe)|chillim]]}}.<ref>{{cite book|title=Hashish!|author=Robert Connell Clarke|publisher=Red Eye Press|year=1998|page=140|url=https://books.google.com/books?id=hblBKeAE9rgC&q=chillum+afghanistan|isbn=978-0-929349-05-3}}</ref>

In [[Kashmiri language|Kashmiri]], hookah is called "Jajeer".<ref>{{Cite web|url=http://m.greaterkashmir.com/news/opinion/my-teachers-and-jajeer/144609.html|title=My Teachers And Jajjeer|access-date=26 December 2016|archive-date=27 December 2016|archive-url=https://web.archive.org/web/20161227055431/http://m.greaterkashmir.com/news/opinion/my-teachers-and-jajeer/144609.html}}</ref>

In [[Maldives]], hookah is called "Guduguda".<ref>{{cite book|title=Countries and Their Cultures: Laos to Rwanda|author=Melvin Ember, Carol R. Ember|publisher=Macmillan Reference USA|year=2001|page=1377|url=https://books.google.com/books?id=D8sZAQAAIAAJ&q=Guduguda|isbn=978-0-02-864949-8}}</ref>

In Germany, Austria and Switzerland, hookah is called "Shisha".<ref>{{Cite web|url=https://www.duden.de/rechtschreibung/Shisha/|title=Duden: Shisha|website=Duden|language=de|access-date=2020-11-30|archive-date=4 February 2021|archive-url=https://web.archive.org/web/20210204220944/https://www.duden.de/rechtschreibung/Shisha|url-status=live}}</ref>{{better source needed|date=June 2018}}

In the [[Philippines]], hookah is called "hitboo" and normally used in smoking flavored [[marijuana]].<ref>{{cite book|title=Adrian Rosit's Guide to THC|author=John Adrian Rosit|publisher=Rex Bookstore|year=1969|page=33}}</ref>

In [[Sindhi language|Sindhi]], another language of [[South Asia]], it is called ''huqqo'' ({{nq|حُقو}} / {{lang|und-Deva|हुक़्क़ो}}).<ref>{{cite encyclopedia | url=http://dictionary.reference.com/browse/hookah | title=Online Etymology Dictionary | dictionary=Dictionary.com | access-date=30 June 2011 | archive-date=23 June 2011 | archive-url=https://web.archive.org/web/20110623033924/http://dictionary.reference.com/browse/hookah | url-status=live }}</ref>

In [[Vietnam]], hookah is called ''hookah shisha (''bình shisha) and shisha is called "shisha tobacco" (thuốc shisha).<ref>{{Cite web|author1=Dungktbms |date=12 November 2018|title=Hút shisha hay thuốc lá để đảm bảo sức khỏe|url=https://binhshishagiare.com/hut-shisha-hay-thuoc-la-de-dam-bao-suc-khoe/|website=Binhshishagiare.com|language=vi|access-date=3 August 2020|archive-date=9 August 2020|archive-url=https://web.archive.org/web/20200809024645/https://binhshishagiare.com/hut-shisha-hay-thuoc-la-de-dam-bao-suc-khoe/|url-status=live}}</ref>

==History==
[[File:Ernst Rudolf Smoking The Hookah.jpg|thumb|upright|''Smoking the Hookah,'' a painting by [[Rudolf Ernst]]]]
[[File:Painting of Bajirao And Mastani.jpg|thumb|Peshwa [[Bajirao I]] smoking a hookah ]]
In the [[India]]n city of [[Fatehpur Sikri]], Roman Catholic missionaries of the [[Society of Jesus]] arriving from the [[South India|southern part]] of the country introduced tobacco to the [[Mughal emperor]] [[Akbar the Great]] (1542–1605 AD).<ref name="Hookah India Chapman">{{cite book |last1=Rousselet |first1=Louis |title=India and Its Native Princes: Travels in Central India and in the Presidencies of Bombay and Bengal |edition=Reprint&nbsp;— Asian Educational Services 2005 |year=2005 |orig-date=1875 |publisher=Chapman and Hall |location=London |isbn=978-81-206-1887-9 |page=290 |chapter=XXVII&nbsp;— The Ruins of Futtehpore|quote=According to tradition, it was here that he received the Jesuits of Goa, who brought him the leaves and seeds of tobacco and it was a Futtehpore that Hakim Aboul Futteh Ghilani, one of Akbar's physicians, is supposed to have invented the hookah, the pipe of India.}}</ref> [[Louis Rousselet]] writes that the physician of Akbar, Hakim Aboul Futteh Ghilani {{Langx|fa|حکیم ابوالفتح گیلانی}}, then invented the hookah in India.<ref name= Sivaramakrishnan4-5>{{cite book |title= Tobacco and Areca Nut |last= Sivaramakrishnan |first=V. M |year=2001 |publisher=Orient Blackswan |location= [[Hyderabad (India)|Hyderabad]] |isbn= 978-81-250-2013-4 | pages= 4–5|quote=The hookah is of historical interest. Portuguese merchants introduced tobacco leaves and European style pipes into Bijapur, the glittering capital of the Adil Shahi kingdom. From here, Asad Beg, the Moghul ambassador in Bijapur, took a large quantity of tobacco leaves and pipes to the Mughal court. He presented Emperor Akbar with some tobacco leaves and a jewel-encrusted European style pope. Out of courtesy and curiosity, Akbar took a few puffs, but his personal physician was worried that tobacco smoke, a hitherto totally unknown substance, might be dangerous. So, he suggested that the smoke be purified by passing it through water, before being inhaled. Thus, the hookah, or water pipe, came into being.}}</ref><ref name= Blechynden215>{{cite book |title= Calcutta, Past and Present |last= Blechynden |first= Kathleen |year= 1905 |publisher=University of California |location=Los Angeles | page= 215|quote=It is said that it was in the early years of their settlement at Hughly that the Portuguese introduced tobacco to the notice of the Emperor Akbar, and that the Indian pipe, the ''hookah'', was invented.}}</ref><ref name= RousseletLouis>{{cite book |title= India and Its Native Princes: Travels in Central India and in the Presidencies of Bombay and Bengal |url= https://archive.org/details/indiaitsnativepr00loui |last= Rousselet |first=Louis |year= 1875 |publisher=Chapman & Hall |location= London | page= [https://archive.org/details/indiaitsnativepr00loui/page/290 290]|isbn= 978-81-206-1887-9 |quote=According to tradition, it was here that he received the Jesuits of Goa, who brought him the leaves and seeds of tobacco; and it was at Futtehpore that Hakim Aboul Futteh Ghilani, one of Akbar's physicians, is supposed to have invented the hookah, the pipe of India.}}</ref>
However, a quatrain of [[Ahli Shirazi|Ahlī Shirazi]] (d. 1535), a Persian poet, refers to the use of the ḡalyān (Falsafī, II, p.&nbsp;277; Semsār, 1963, p.&nbsp;15), thus dating its use at least as early as the time of the Shah [[Tahmasp I|Ṭahmāsp I]]. It seems, therefore, that Abu'l-Fath Gilani should be credited with the introduction of the ḡalyān, already in use in Persia, into India.<ref name= "iranica">{{cite web | url= http://www.iranicaonline.org/articles/galyan- | title= ḠALYĀN | publisher= [[Encyclopedia Iranica]] | date= 15 December 2000 | access-date= 19 December 2012 | last= Razpush | first= Shahnaz | pages= 261–65 | archive-date= 27 January 2012 | archive-url= https://web.archive.org/web/20120127064634/http://www.iranicaonline.org/articles/galyan- | url-status= live }}</ref> There is, however, no evidence of the existence of the water pipe until the 1560s. Moreover, tobacco is believed to have arrived in India in the 17th century, until then [[Cannabis (drug)|cannabis]] was smoked in India, so that suggests another substance was probably smoked in Ahlī Shirazi's quatrain, perhaps through some other method.<ref>{{cite encyclopedia |url= http://www.iranicaonline.org/articles/tobacco |title= Tobacco |encyclopedia= Encyclopaedia Iranica |publisher= Iranica online |date= 2009-07-20 |access-date= 2013-09-03 |archive-date= 16 September 2013 |archive-url= https://web.archive.org/web/20130916004125/http://www.iranicaonline.org/articles/tobacco |url-status= live }}</ref>

Following the European introduction of [[tobacco]] to Persia and India, Hakim Abu'l-Fath Gilani, who came from [[Gilan Province|Gilan]], a province in the north of [[Persia]], migrated to Hamarastan. He later became a physician in the Mughal court and raised health concerns after smoking tobacco became popular among Indian noblemen.<ref>{{cite web|title= An Oriental Delight | work = What I learned today | date = 29 May 2013 |url= https://medium.com/what-i-learned-today/776b63cbb110 |publisher=Medium |access-date= 21 June 2013 |archive-url= https://web.archive.org/web/20140116123140/https://medium.com/what-i-learned-today/776b63cbb110 |archive-date= 16 January 2014}}</ref> He subsequently envisaged a system that allowed smoke to be passed through water in order to be 'purified'.<ref name= Sivaramakrishnan4-5/> Gilani introduced the ''ḡalyān'' after Asad Beg, the ambassador of [[Adil Shahi|Bijapur]], encouraged Akbar I to take up smoking.<ref name= Sivaramakrishnan4-5 /> Following popularity among noblemen, this new device for smoking soon became a status symbol for the Indian aristocracy and gentry.<ref name= Sivaramakrishnan4-5 /><ref name= RousseletLouis />

==Modern development==
Instead of [[copper]], [[brass]] and low-quality alloys, manufacturers increasingly use [[stainless steel]] and [[aluminium]]. [[Silicone rubber]] compounds are used for hookah hoses instead of [[leather]] and wire. New materials make modern hookahs more durable, eliminate odors while smoking and allow washing without risks of [[corrosion]] or [[bacterial decay]]. New technologies and modern design trends are changing the appearance of hookahs. Despite the obvious benefits of modern hookahs, because of high production cost and lack of modern equipment in traditional hookah manufacturing regions, most hookahs are still produced with older technologies.

==Culture==
===South Asia===

====India====
{{multiple image|total_width=300
| image1 = Big hookah.jpg|caption1=The intricate work on a Malabar hookah.
| image2 = Gaddi village men with hookah, on mountain path, 1980.jpg|caption2=[[Gaddi people|Gaddi]] village men with hookah, on mountain path near [[Dharamshala]], India.
}}
The concept of hookah is thought to have originated in [[medieval India]].<ref name= "RousseletLouis"/><ref name=Wealth/> Once the province of the wealthy, it was tremendously popular especially during [[Mughal Empire|Mughal]] rule. The hookah has since become less popular; however, it is once again garnering the attention of the masses, and cafés and restaurants that offer it as a consumable are popular. The use of hookahs from ancient times in India was not only a custom, but a matter of prestige. Rich and landed classes would smoke hookahs.

Tobacco is smoked in hookahs in many villages as per traditional customs.  Smoking tobacco-molasses is now becoming popular among the youth in India. There are several chain clubs, bars and coffee shops in India offering a wider variety of {{transliteration|ar|[[mu'assel]]s}}, including non-tobacco versions. In 2011, hookah was banned in [[Bangalore]]. However, it can be bought or rented for personal usage or organized parties.<ref>{{cite news| url=http://articles.timesofindia.indiatimes.com/2011-06-07/bangalore/29628694_1_hookah-bars-shisha-joints | archive-url=https://web.archive.org/web/20130511190209/http://articles.timesofindia.indiatimes.com/2011-06-07/bangalore/29628694_1_hookah-bars-shisha-joints | archive-date=11 May 2013 | work=[[The Times of India]] | title=Business at hookah-less cafes go up in smoke | date=7 June 2011}}</ref>

[[Koyilandy]], a small fishing town on the west coast of India, once made and exported hookahs extensively. These are known as [[Koyilandy#Koyilandy hookahs|Malabar Hookhas or Koyilandy Hookahs]]. Today these intricate hookahs are difficult to find outside Koyilandy and are becoming difficult even to find in Koyilandy itself.

As hookah resurges in India, there have been numerous raids and bans recently on hookah smoking, especially in [[Gujarat]].<ref name="Indian Express">{{cite news|url = http://www.indianexpress.com/news/-Ban-on-public-smoking-up-in-smoke-in-Gujarat-/465845/|title = Hookah|work = The Indian Express|access-date = 2008-06-08|archive-date = 8 July 2009|archive-url = https://web.archive.org/web/20090708141859/http://www.indianexpress.com/news/-Ban-on-public-smoking-up-in-smoke-in-Gujarat-/465845/|url-status = live}}</ref>

====Pakistan====
Although it has been traditionally prevalent in rural areas for generations,<ref>{{cite journal|title=Full text &#124; Hookah smoking and cancer: carcinoembryonic antigen (CEA) levels in exclusive/ever hookah smokers |journal=Harm Reduction Journal |volume=5 |page=19 |doi=10.1186/1477-7517-5-19 |pmid=18501010 |pmc=2438352 |year=2008 |last1=Sajid |first1=Khan |last2=Chaouachi |first2=Kamal |last3=Mahmood |first3=Rubaida |doi-access=free }}</ref> smoking hookahs has become very popular in the cosmopolitan cities of Pakistan. One can see many cafés in Pakistan offering hookah smoking to its guests. Many households even have hookahs for smoking or decoration purposes.

In Punjab, Pakhtunkhwa, and in northern Balochistan, the topmost part on which coals are placed is called ''chillum''.

In big cities like Karachi and Lahore, cafes and restaurants offered Hookah and charged per hour. In 2013, it was banned by the [[Supreme Court of Pakistan]]. The cafe owners started offering shisha to minors, which was the major reason for the ban.<ref>{{cite news |date=8 July 2013 |title=Sheesha ban smoked |url=http://www.pakistantoday.com.pk/2013/07/08/city/islamabad/sheesha-ban-smoked/ |url-status=dead |archive-url=https://web.archive.org/web/20150402112248/http://www.pakistantoday.com.pk/2013/07/08/city/islamabad/sheesha-ban-smoked |archive-date=2 April 2015 |access-date=7 March 2015 |work=[[The Pakistan Today]]}}</ref>

====Bangladesh====
{{multiple image|total_width=300
| image1 = I'tisam-ud-Din.png|caption1=[[I'tisam-ud-Din]], a [[Bengali Muslim]] from the 18th century, smoking hukka.
| image2 = Bamboo Hookah at khagrachori 03.jpg|caption2=[[Garo people|Garo]] woman smoking a traditional bamboo hookah.
}}

The hookah ({{langx|bn|হুক্কা|hukka}}) has been a traditional smoking instrument in [[Bangladesh]], particularly among the old [[Bengali Muslim]] [[zamindar]] gentry.<ref>{{cite journal|last1=Kaneta Choudhury|last2=S.M.A. Hanifi|last3=Abbas Bhuiya|last4=Shehrin Shaila Mahmood|title=Sociodemographic Characteristics of Tobacco Consumers in a Rural Area of Bangladesh|journal=Journal of Health, Population, and Nutrition|date=December 2007|volume=25|issue=4|pages=456–464|pmc=2754020|pmid=18402189}}</ref> However, flavoured shisha was introduced in the early 2000s. Hookah lounges spread quite quickly between 2008 and 2011 in urban areas and became popular among young people as well as middle-aged people as a relaxation method. There have been allegations of a government crack-down on hookah bars to prevent illicit drug usage.<ref>{{cite news|last1=Ahmed Shatil Alam|title=Killer in disguise|url=http://newagebd.net/84643/killer-in-disguise/#sthash.LnBdhDzn.dpbs|access-date=7 March 2015|work=[[The New Age]]|archive-date=2 April 2015|archive-url=https://web.archive.org/web/20150402104114/http://newagebd.net/84643/killer-in-disguise/#sthash.LnBdhDzn.dpbs|url-status=live}}</ref> The hookah is also an [[electoral symbol]] for a candidate used first in the [[1973 Bangladeshi general election]].<ref>{{cite book|publisher=Embassy of Bangladesh|date=26 January 1973|volume=3|issue=2|title=Bangladesh: a fortnightly news bulletin|chapter-url=https://books.google.com/books?id=TWEwAQAAIAAJ&q=hookah&pg=PA8-IA134|page=4|chapter=Elections symbols prescribed}}</ref> In the biography of [[Mountstuart Elphinstone]], it is mentioned that [[James Achilles Kirkpatrick]] had a ''hookah-bardar'' (hookah servant/preparer) during his time in the [[Indian subcontinent]]. Kirkpatrick's hookah servant is said to have robbed and cheated Kirkpatrick, making his way to England and stylising himself as the ''Prince of Sylhet''. The man was waited upon by the [[prime minister of Great Britain]] [[William Pitt the Younger]], and then dined with the [[Duke of York]] before presenting himself in front of [[George III]].<ref>{{cite book|title=Life of the Honourable Mountstuart Elphinstone|first=Thomas Edward|last=Colebrooke|pages=34–35|year=1884|author-link=Sir Edward Colebrooke, 4th Baronet|chapter=First Start in Diplomacy|publisher=Cambridge University Press|isbn=978-1-108-09722-2|chapter-url=https://books.google.com/books?id=tSoMEJ-_Nx0C&q=hookah&pg=PA34|access-date=26 October 2020|archive-date=1 June 2024|archive-url=https://web.archive.org/web/20240601132443/https://books.google.com/books?id=tSoMEJ-_Nx0C&q=hookah&pg=PA34#v=snippet&q=hookah&f=false|url-status=live}}</ref>

====Nepal====
{{multiple image|total_width=300
| image1 = Hukkah nepal.jpg|caption1=A hookah at a restaurant in Nepal.
| image2 = Tobacco smoking4.jpg|caption2=A man smoking tobacco in hookah (or ''hukka'') in [[Darchula]], [[Nepal]].
}}
''Hookahs'' (हुक़्क़ा), especially wooden ones, are popular in [[Nepal]]. Use of hookahs has been usually considered to symbolize an elite family status in Nepali history.<ref>{{Cite book|url=https://books.google.com/books?id=iorHBAAAQBAJ&q=hookah+elite+family+status+nepal&pg=PA360|title=North-East India: Land, People and Economy|last1=Dikshit|first1=K. R.|last2=Dikshit|first2=Jutta K.|date=2013-10-21|publisher=Springer Science & Business Media|isbn=978-94-007-7055-3|access-date=26 October 2020|archive-date=1 June 2024|archive-url=https://web.archive.org/web/20240601132444/https://books.google.com/books?id=iorHBAAAQBAJ&q=hookah+elite+family+status+nepal&pg=PA360#v=snippet&q=hookah%20elite%20family%20status%20nepal&f=false|url-status=live}}</ref> 
[[File:Huble Buble sign Kathmandu. 1993.jpg|thumb|Huble Buble sign in Kathmandu. 1993]]
Nowadays, the cities of Kathmandu, Pokhara and Dharan have special hookah bars. Although hookahs have started becoming popular among younger people and tourists, the overall number of hookah smokers is likely dwindling owing to the widespread availability of cheaper cigarettes.<ref>{{cite web|last=Nepal |first=ECS |title=Smoke on The Water: Hubby-bubbly .Hookah |url=http://www.ecs.com.np/feature_detail.php?f_id=176 |publisher=ECS Nepal |access-date=28 February 2011 |archive-url=https://web.archive.org/web/20110724190114/http://www.ecs.com.np/feature_detail.php?f_id=176 |archive-date=24 July 2011}}</ref>

===Middle East===
[[File:Hookah 2.jpg|right|thumb|An [[Egypt]]ian hookah (shisha).]]
[[File:View of Constantinople by Jean Pascal Sébah (1905).png|thumbnail|A café in [[Istanbul]], 1905]]

In the [[Arab world]] and the [[Middle East]], people smoke waterpipes as part of their culture and traditions. Local names of waterpipe in the Middle East are, argila, čelam/čelīm, ḡalyān or ghalyan, ḥoqqa, nafas, nargile, and shisha.<ref name="iranica"/>

Social smoking is done with a single or double [[Hose (tubing)|hose]] hookah, and sometimes even triple or quadruple hose hookahs are used at parties or small get-togethers. When the smoker is finished, they either place the hose back on the table, signifying that it is available, or hand it from one user to the next, folded back on itself so that the [[Smoking pipe (tobacco)|mouthpiece]] is not pointing at the recipient.

Most [[café]]s in the Middle East offer shishas.<ref>{{cite book|title=Frommer's Dubai|author=Shane Christensen|publisher=John Wiley & Sons|date=25 January 2011|page=141|url=https://books.google.com/books?id=Uee71cyblkwC&q=shisha+in+middle+east&pg=PA141|isbn=978-1-119-99427-5|access-date=26 October 2020|archive-date=1 June 2024|archive-url=https://web.archive.org/web/20240601132444/https://books.google.com/books?id=Uee71cyblkwC&q=shisha+in+middle+east&pg=PA141|url-status=live}}</ref> Cafés are widespread and are among the chief social gathering places in the Arab world (akin to [[public house]]s in Britain).<ref>{{cite book|title=Coffee – Philosophy for Everyone: Grounds for Debate|author=Fritz Allhoff|publisher=John Wiley & Sons|date=23 February 2011|page=10|url=https://books.google.com/books?id=e0Lri7eoIoUC&q=coffee+houses+in+arab+world&pg=PA10|isbn=978-1-4443-9336-1|access-date=26 October 2020|archive-date=1 June 2024|archive-url=https://web.archive.org/web/20240601132445/https://books.google.com/books?id=e0Lri7eoIoUC&q=coffee+houses+in+arab+world&pg=PA10|url-status=live}}</ref>

====Gaza====
[[File:Hookah in a Palestinian shop (DSC03515).jpg|thumb|150px|Flower-ornamented hookah in a Palestinian shop]]
In 2010 the [[Hamas]]-led [[Islamist]] government of [[Gaza Strip|Gaza]] imposed a ban on women smoking hookahs in public. A spokesman for the Interior Ministry explained that "It is inappropriate for a woman to sit cross-legged and smoke in public. It harms the image of our people."<ref name=Reuter>[https://www.independent.co.uk/news/world/middle-east/gaza-ban-on-women-smoking-pipes-2029782.html Gaza ban on women smoking pipes] {{Webarchive|url=https://web.archive.org/web/20201111215815/https://www.independent.co.uk/news/world/middle-east/gaza-ban-on-women-smoking-pipes-2029782.html |date=11 November 2020 }}, Reuters, 19 July 2010, The Independent.</ref> The ban was soon lifted later that year and women returned to smoking in popular venues like the cafe of Gaza's [[Crazy Water Park]].<ref name=Koutsoukis>[http://www.smh.com.au/world/edict-lifted-for-female-smokers-20100728-10w2c.html "Edict lifted for female smokers"] {{Webarchive|url=https://web.archive.org/web/20220606032648/https://www.smh.com.au/world/edict-lifted-for-female-smokers-20100728-10w2c.html |date=6 June 2022 }} Jason Koutsoukis, 29 July 2010, The Sunday Morning Herald.</ref>

====Iran====
[[File:Naser al-Din Shah Qajar with qalyan.jpg|thumb|[[Naser al-Din Shah Qajar]] smoking qalyan]]
[[File:Qalyoon.jpg|thumbnail|Persian woman with hookah (qalyan), 1900, Iran]]
The earliest known literary evidence of the hookah, anywhere, comes in a quatrain by Ahlī Shirazi (d. 1535), a Persian poet, referring to the use of the ḡalyān,<ref>Falsafī, II, p.&nbsp;277; Semsār, 1963, p.&nbsp;15</ref> thus dating its use at least as early as the time of the Shah [[Tahmasp I|Ṭahmāsp I]]. This suggests, the hookah was already in use in ancient Persia, and it made its way into India soon afterward.{{citation needed|date=February 2016}}

Although the [[Safavid]] [[Abbas I of Persia|Shah ʿAbbās I]] strongly condemned tobacco use, towards the end of his reign smoking ḡalyān and [[Chibouk|čopoq]] had become common on every level of the society, women included. In schools, both teachers and students had ḡalyāns while lessons continued.<ref>Falsafī, II, pp.&nbsp;278–80</ref> Shah [[Safi of Persia]] (r. 1629–42) declared a complete ban on tobacco, but the income received from its use persuaded him to soon revoke the ban.<ref>{{cite book|title=The pursuit of pleasure: drugs and stimulants in Iranian history, 1500-1900|author=Rudolph P. Matthee|publisher=Princeton University Press|year=2005|page=139|url=https://books.google.com/books?id=Kf0XfDMLndsC&q=safi+ban+of+tobacco&pg=PA139|isbn=978-0-691-11855-0|access-date=26 October 2020|archive-date=1 June 2024|archive-url=https://web.archive.org/web/20240601132445/https://books.google.com/books?id=Kf0XfDMLndsC&q=safi+ban+of+tobacco&pg=PA139#v=snippet&q=safi%20ban%20of%20tobacco&f=false|url-status=live}}</ref> The use of ḡalyāns became so widespread that a group of poor people became professional tinkers of crystal water pipes. During the time of [[Abbas II of Persia]] (r. 1642–1666), use of the water pipe had become a national addiction.<ref>Chardin, tr., II, p.&nbsp;899</ref> The shah (king) had his own private ḡalyān servants. Evidently the position of water pipe tender (ḡalyāndār) dates from this time. Also at this time, reservoirs were made of glass, pottery, or a type of gourd. Because of the unsatisfactory quality of indigenous glass, glass reservoirs were sometimes imported from [[Venetian glass|Venice]].<ref>Chardin, tr., II, p.&nbsp;892</ref> In the time of [[Suleiman I of Persia]] (r. 1694–1722), ḡalyāns became more elaborately embellished as their use increased. The wealthy owned gold and silver pipes. The masses spent more on ḡalyāns than they did on the necessities of life.<ref>Tavernier apud Semsār, 1963, p.&nbsp;16</ref>

An emissary of [[Sultan Husayn]] (r. 1722–32) to the court of [[Louis XV]] of France, on his way to the royal audience at [[Versailles]], had in his retinue an officer holding his ḡalyān, which he used while his carriage was in motion.<ref>Herbette, tr. p.&nbsp;7; Kasrawī, pp.&nbsp;211–12; Semsār, 1963, pp.&nbsp;18–19</ref> We have no record indicating the use of ḡalyān at the court of [[Nader Shah]], although its use seems to have continued uninterrupted. There are portraits of [[Karim Khan]] of the [[Zand dynasty]] of Iran and [[Fat′h-Ali Shah Qajar]] that depict them smoking the ḡalyān.<ref>{{cite encyclopedia |url=http://www.iranicaonline.org/articles/galyan- |title=Encyclopædia Iranica &#124; Articles |encyclopedia=Encyclopaedia Iranica |publisher=Iranica.com |access-date=2010-08-22 |archive-date=27 January 2012 |archive-url=https://web.archive.org/web/20120127064634/http://www.iranicaonline.org/articles/galyan- |url-status=live }}</ref>
[[Iran]]ians have a special tobacco called ''Khansar'' (خانسار, presumably name of the origin city, [[Khvansar]]). The charcoals would be put on the Khansar without foil.{{Citation needed|date=July 2023}}

The Iranian [[Shia]] [[marja']] [[Mirza Shirazi]] issued his historical [[fatwa]]: "In the name of God, the Merciful, the Beneficent. Today the use of both varieties of tobacco, in whatever fashion is reckoned war against the [[Imam of the Age]] – may God hasten his advent." The fatwa sparked a huge movement to the extent that even in the private quarters of [[Naser al-Din Shah Qajar]] (r. 1848–1896), hookahs were broken.<ref>{{cite web | author1=Arooj | url=https://shiawaves.com/english/uncategorized/98385-jumadi-al-awal-1st-marks-anniversary-of-mirza-shirazis-historic-fatwa-to-ban-tobacco-during-qajar-era/ | title=Jumadi al-Awal 1st marks anniversary of Mirza Shirazi's historic fatwa to ban tobacco during Qajar era | work=Shia Waves | date=16 November 2023 }}</ref>

====Saudi Arabia====
In 2014, [[Saudi Arabia]] was in the process of implementing general smoking bans in public places. This included shishas.<ref>{{cite news|title=Saudi Arabia bans smoking in public places|url=http://www.thenational.ae/news/world/middle-east/saudi-arabia-bans-smoking-in-public-places|access-date=31 October 2014|work=The National (Abu Dhabi)|date=31 July 2012|archive-date=31 October 2014|archive-url=https://web.archive.org/web/20141031120439/http://www.thenational.ae/news/world/middle-east/saudi-arabia-bans-smoking-in-public-places|url-status=live}}</ref><ref>{{cite news|title=Saudi Arabia Bans Smoking in Most Public Places|url=http://www.huffingtonpost.com/2012/07/30/saudi-arabia-smoking-ban_n_1718619.html|access-date=31 October 2014|work=Huffington Post|archive-date=2 August 2012|archive-url=https://web.archive.org/web/20120802224526/http://www.huffingtonpost.com/2012/07/30/saudi-arabia-smoking-ban_n_1718619.html|url-status=live}}</ref> Currently, hookah remains legal in the country, with some restaurants charging customers extra fees.<ref>{{Cite web |date=2019-10-15 |title=New Saudi rules on hookah leave businesses, consumers confused |url=https://www.arabnews.com/node/1569011/saudi-arabia |access-date=2023-02-04 |website=Arab News|archive-date=1 June 2024 |archive-url=https://web.archive.org/web/20240601132456/https://www.arabnews.com/node/1569011/saudi-arabia |url-status=live }}</ref>

====Syria====
[[File:Syriancafe.jpg|thumb|[[Bedouin]] smoking a hookah, locally called ''nargileh'', in a [[coffeehouse]] in [[Deir ez-Zor]], on the [[Euphrates]], 1920s.]]

Although perceived to be an important cultural feature of Syria (see [[Smoking in Syria]]), narghile had declined in popularity during most of the twentieth century and was used mostly by older men. Similar to other Middle Eastern countries, its use increased dramatically during the 1990s, particularly among youth and young adults.<ref name=Rastram04>{{cite journal |last1=Rastram|first1=S|last2=Ward|first2=KD|last3=Eissenberg|first3=T|last4=Maziak|first4=W|title=Estimating the beginning of the waterpipe epidemic in Syria|journal=BMC Public Health|date=2004|volume=4|issue=32|page=32|pmid=15294023|doi=10.1186/1471-2458-4-32|pmc=514554|doi-access=free}}</ref><ref name=Ward06>{{cite journal|last1=Ward|first1=KD|last2=Hammal|first2=F|last3=Vander Weg|first3=MW|last4=Maziak|first4=W|last5=Eissenberg|first5=T|title=The tobacco epidemic in Syria|journal=Tobacco Control|date=2006|volume=15|issue=Supplement 1|pages=i24–9|pmid=16723671|doi=10.1136/tc.2005.014860|pmc=2563543}}</ref> As of 2004, prior to the [[Syrian civil war]], 17% of 18- to 29-year-olds, 10% of 30- to 45-year-olds, and 6% of 46- to 65-year-olds reported using narghile, and use was higher in men than women.<ref name=Ward06 /> More recent data is not available.

====Turkey and the Balkans====
''Nargile'' became part of Turkish and Balkan culture from the 17th century. Back then, it became prominent in society and was used as a status symbol. ''Nargile'' was such an important Turkish custom that it even sparked a diplomatic crisis between France and the Ottoman Empire.<ref>{{cite news |url=https://www.nytimes.com/1997/06/10/world/inhale-the-pleasure-of-an-unhurried-ottoman-past.html |title=Inhale the Pleasure of an Unhurried Ottoman Past |newspaper=The New York Times |date=1997-06-10 |access-date=2013-09-03 |first=Stephen |last=Kinzer |archive-date=13 May 2017 |archive-url=https://web.archive.org/web/20170513180658/http://www.nytimes.com/1997/06/10/world/inhale-the-pleasure-of-an-unhurried-ottoman-past.html |url-status=live }}</ref> Western Turkey is noted for its traditional pottery production where potters make earthenware objects, including ''nargile'' bowls.<ref>{{cite journal|last=Crane|first=Howard|title=Traditional Pottery Making in the Sardis Region of Western Turkey|journal=Muqarnas|year=1988|volume=5|page=12}}</ref>

===Southeast Asia===
In [[Southeast Asia]], the hookah, where it is predominantly called shisha, was particularly used within the [[Arab]] and Indian communities.<ref>Ramachandra SS, Yaldrum A. Shisha smoking: An emerging trend in Southeast Asian nations. J Public Health Policy. 2015 Aug;36(3):304-17.</ref>{{Citation needed|date=November 2012}}

Hookah was virtually unknown in Southeast Asia before the latter 20th century, yet the popularity among contemporary younger people is now vastly growing.<ref>{{Cite web|author1=Gamiecocharm |title=Đánh giá về tác hại của shisha|url=https://gamiecocharm.vn/danh-gia-ve-tac-hai-cua-shisha/|website=Gamiecocharm.vn|date=24 August 2020|language=vi|access-date=3 July 2021|archive-date=9 July 2021|archive-url=https://web.archive.org/web/20210709181835/https://gamiecocharm.vn/danh-gia-ve-tac-hai-cua-shisha/|url-status=live}}</ref> Southeast Asia's most cosmopolitan cities, [[Makati]], [[Bangkok]], [[Singapore]] (now banned),<ref>{{Cite web |url=https://www.channelnewsasia.com/news/singapore/e-cigarettes-shisha-illegal-banned-tobacco-feb-1-9898420 |title=E-cigarettes, shisha to be illegal from Feb 1 under amended Tobacco Act – CNA |work=CNA |access-date=7 August 2018 |archive-date=4 July 2019 |archive-url=https://web.archive.org/web/20190704045700/https://www.channelnewsasia.com/news/singapore/e-cigarettes-shisha-illegal-banned-tobacco-feb-1-9898420 }}</ref> [[Phnom Penh]], [[Siem Reap]], [[Hanoi]] and [[Ho Chi Minh City]], now have various bars and clubs that offer hookahs to patrons.{{Citation needed|date=July 2023}}

Although hookah use has been common for hundreds of years and enjoyed by people of all ages, it has recently started to become a youth pastime in Asia.<ref>Gundavarapu KC, Dicksit DD, Ramachandra SS. Characteristics of shisha smoking venues in a satellite township near Kuala Lumpur, Malaysia: an observational study. Tobacco Prevention & Cessation. 2016;2(August):70. doi:10.18332/tpc/64807.
</ref> Hookahs are most popular with college students, and [[Youth|young adults]], who may be underage and thus unable to purchase [[cigarette]]s.<ref>{{cite web |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5520a2.htm |title=Use of Cigarettes and Other Tobacco Products Among Students Aged 13-15 Years – Worldwide, 1999-2005 |publisher=CDC |access-date=2010-08-22 |archive-date=12 September 2017 |archive-url=https://web.archive.org/web/20170912113042/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5520a2.htm |url-status=live }}</ref>

===Kenya===
The hookah is called shisha in Kenya. They are officially banned in the country. Despite this, many clubs still continue to defy the law and hookah smoking goes on in urban areas.<ref>{{Cite web |url=https://www.nation.co.ke/news/Nairobians-smoking-shisha-despite-ban/1056-5226836-qejagh/index.html |title=Nairobians smoking shisha despite ban |access-date=7 January 2020 |archive-date=30 January 2020 |archive-url=https://web.archive.org/web/20200130191808/https://www.nation.co.ke/news/Nairobians-smoking-shisha-despite-ban/1056-5226836-qejagh/index.html |url-status=live }}</ref><ref>{{Cite web|url=https://www.the-star.co.ke/sasa/word-is/2018-12-10-has-the-ban-on-shisha-really-worked/|title=Has the ban on shisha really worked?|website=The Star|access-date=7 January 2020|archive-date=4 August 2020|archive-url=https://web.archive.org/web/20200804090354/https://www.the-star.co.ke/sasa/word-is/2018-12-10-has-the-ban-on-shisha-really-worked/|url-status=live}}</ref>

===South Africa===
In South Africa, hookah, colloquially known as a ''hubbly bubbly'' or an ''okka pipe'', is popular among the [[Cape Malay]] and [[Indian South Africans|Indian]] populations, wherein it is smoked as a social pastime.<ref>{{cite news |newspaper=Independent Online |url=http://www.iol.co.za/index.php?set_id=1&click_id=29&art_id=qw103460508099B241 |title=Hubble-bubble as cafes go up in smoke |date=14 October 2002 |access-date=2010-08-22 |archive-url=https://web.archive.org/web/20121023201706/http://www.iol.co.za/news/back-page/hubble-bubble-as-cafes-go-up-in-smoke-1.95976#.V0XSz-SDpnU |archive-date=23 October 2012}}</ref>{{failed verification|date=May 2016|reason=Article is about Egypt, not South Africa, and doesn't support anything here.}} However, hookah is seeing increasing popularity with South Africans, especially the youth.<ref>{{cite journal | last1 = van der Merwe | first1 = N. | display-authors = etal | year = 2013 | title = Hookah pipe smoking among health sciences students | journal = South African Medical Journal | volume = 103 | issue = 11 | pages = 847–849 | doi = 10.7196/SAMJ.7448 | doi-broken-date = 12 July 2025 | pmid = 24148170 | url = http://samj.org.za/index.php/samj/article/download/7448/5485 | doi-access = free | hdl = 11427/34902 | hdl-access = free | access-date = 5 September 2019 | archive-date = 1 June 2024 | archive-url = https://web.archive.org/web/20240601132447/http://samj.org.za/index.php/samj/article/download/7448/5485 | url-status = live }}</ref> Bars that additionally provide hookahs are becoming more prominent, although smoking is normally done at home or in public spaces such as beaches and picnic sites.{{Citation needed|date=February 2012}}

In South Africa, the terminology of the various hookah components also differ from other countries. The clay "head/bowl" is known as a "clay pot". The hoses are called "pipes" and the air release valve is known as a "clutch".{{Citation needed|date=February 2012}}

The windcover (which is considered optional for outside use{{Citation needed|date=February 2012}}) is known as an "As-jas", which directly translates from [[Afrikaans]] to English as an "ash-jacket". Also, making/preparing the "clay pot" is commonly referred to as "racking the hubbly".{{Citation needed|date=February 2012}}

Some scientists point to the [[marijuana pipe]] as an African origin of hookah.<ref>"The Mysterious Origins of the Hookah (Narghile)" [http://www.sacrednarghile.com/en/mystery.html The Sacred Narghile] {{Webarchive|url=https://web.archive.org/web/20161220081816/http://www.sacrednarghile.com/en/mystery.html |date=20 December 2016 }}</ref>

===United States and Canada===
{{see also|Hookah lounge}}
[[File:Syrian restaurant LCCN2014698960.jpg|thumb|270px|Men smoking shisha and playing cards in a Syrian restaurant, [[Little Syria]] (Manhattan), 1910.]]
[[File:HarvardSquareHookah.jpg|thumb|upright|A hookah and a variety of tobacco products are on display in a [[Harvard Square]] store window in [[Cambridge, Massachusetts]], United States.]]

During the 1960s and 1970s, hookahs were a popular tool for the consumption of various derivations of tobacco, among other things.<ref>{{cite news |author=Jillian Krotki|title= Hookah lounge brings '60s pastime back to the present |newspaper=Seminole Chronicle |date=29 October 2008|url= http://www.seminolechronicle.com/vnews/display.v/ART/2008/10/29/4908dae9de4c4|access-date=2013-09-03|archive-url=https://archive.today/20120919133210/http://www.seminolechronicle.com/vnews/display.v/ART/2008/10/29/4908dae9de4c4|archive-date=19 September 2012}}</ref> At parties or small gatherings the hookah hose was passed around with users partaking as they saw fit. Typically, though, open flames were used instead of burning coals.

Today, hookahs are readily available for sale at smoke shops and some gas stations across the United States, along with a variety of tobacco brands and accessories. In addition to private hookah smoking, hookah lounges or bars have opened in cities across the country.

Recently, certain cities, counties, and states have implemented indoor [[smoking ban]]s. In some jurisdictions, hookah businesses can be exempted from the policies through special permits. Some permits, however, have requirements such as the business earning a certain minimum percentage of their revenue from alcohol or tobacco.

In cities with indoor smoking bans, hookah bars have been forced to close or switch to tobacco-free mixtures. In many cities, though, hookah lounges have been growing in popularity.<ref>{{cite news|author=Harben, Victoria|title=Beyond the Smoke, There is a Solidarity Among Cultures|publisher=Cgnews.org|date=2 May 2006|url=http://www.cgnews.org/article.php?id=1692&lan=en&sp=0|archive-url=https://web.archive.org/web/20131017095642/http://www.cgnews.org/article.php?id=1692&lan=en&sp=0|archive-date=17 October 2013|access-date=2013-09-03}}</ref> From the year 2000 to 2004, over 200 new hookah cafés opened for business, most of them targeted at young adults<ref>Lyon, Lindsay "The Hazard in Hookah Smoke". (28 January 2008)</ref> and located near [[college campus]]es or cities with large Middle-Eastern communities. This activity continues to gain popularity within the post-secondary student demographic.<ref>{{cite news|author=Quenqua, Douglas |title=Putting a Crimp in the Hookah|newspaper=[[The New York Times]]|date=30 May 2011|url=https://www.nytimes.com/2011/05/31/health/31hookah.html|access-date=2013-09-03}}</ref> Hookah use among high school students declined from 9.4% to 3.4% from 2014 to 2019 while cigarette smoking decreased from 9.2% to 5.8% during this same time period, according to the US CDC.<ref>{{cite web |url=https://www.cdc.gov/tobacco/infographics/youth/pdfs/tobacco-use-teens-2019-p.pdf |title=Tobacco Product Use Among High School Students |date=2019 |website=Centers for Disease Control and Prevention |access-date=8 July 2020 |archive-date=8 July 2020 |archive-url=https://web.archive.org/web/20200708091350/https://www.cdc.gov/tobacco/infographics/youth/pdfs/tobacco-use-teens-2019-p.pdf |url-status=live }}</ref><ref>{{cite journal|last1=Arrazola, RA|title=Tobacco use among middle and high school students--United States, 2011-2014|journal=Mortality and Morbidity Weekly Report|date=17 April 2015|volume=64|issue=14|pages=381–385|display-authors=etal}}</ref><ref>{{cite journal|last1=Wang, TW|last2=Gentzke, AS| last3=Creamer, MR|title=Tobacco product and associated factors among middle and high school students--United States, 2019|journal=Mortality and Morbidity Weekly Report|date=6 December 2019|volume=68|issue=12|pages=1–22|display-authors=etal}}</ref> According to a 2018 study, 1.1% of students with some college but no degree, an associate degree or an undergraduate degree reported waterpipe or pipe tobacco product use either every day or some days.<ref>{{cite journal|last1=Creamer, MR|last2=Wang, TW| last3=Babb, S|title= Tobacco Product Use and Cessation Indicators Among Adults – United States, 2018|journal= MMWR. Morbidity and Mortality Weekly Report|date=15 November 2019|volume=68|issue=45|pages=1013–1019|doi=10.15585/mmwr.mm6845a2|pmid=31725711|pmc=6855510|display-authors=etal}}</ref> As of November 2017, at least 2,082 college or university campuses in the U.S. have adopted 100% smokefree campus policies that attempt to eliminate smoking in indoor and outdoor areas across the entire campus, including residences.<ref>{{cite journal|last1=Wang, TW|last2=Tynan, MA| last3=Hallett, C|title= Smoke-Free and Tobacco-Free Policies in Colleges and Universities ― United States and Territories, 2017|journal= MMWR. Morbidity and Mortality Weekly Report|date=22 June 2018|volume=67|issue=24|pages=686–689|doi=10.15585/mmwr.mm6724a4|pmid=29927904|pmc=6013086|display-authors=etal}}</ref>

In the United States, the prevalence of hookah use has been noted in a 2019 article to be increasing, particularly among certain states with larger populations of Arab Americans. The use of hookah is more common in urban areas compared to rural areas, and this trend is influenced by factors like availability in public spaces such as cafés and restaurants, as well as cultural and social influences.<ref>{{Cite journal |last1=Qasim |first1=Hanan |last2=Alarabi |first2=Ahmed B. |last3=Alzoubi |first3=Karem H. |last4=Karim |first4=Zubair A. |last5=Alshbool |first5=Fatima Z. |last6=Khasawneh |first6=Fadi T. |date=2019-09-14 |title=The effects of hookah/waterpipe smoking on general health and the cardiovascular system |journal=Environmental Health and Preventive Medicine |volume=24 |issue=1 |page=58 |doi=10.1186/s12199-019-0811-y |doi-access=free |issn=1347-4715 |pmc=6745078 |pmid=31521105|bibcode=2019EHPM...24...58Q }}</ref>

==Operation==
[[File:Hookah-lookthrough.svg|thumb|upright|Hookah cross-section view]]
[[File:Small Argileh.jpg|right|thumb|upright|A small hookah]]
The jar at the bottom of the hookah is filled with water sufficient to submerge a few centimeters (an inch or two) of the body tube, which is sealed tightly to it. Deeper water will only increase the inhalation force needed to use it. Tobacco or tobacco-free molasses are placed inside the bowl at the top of the hookah. Often the bowl is covered with perforated tin foil or a metal screen and coal placed on top. The foil or screen separates the coal and the tobacco, with the foil and the tobacco reaching maximum temperatures of 450 and 130 degrees Celsius (850&nbsp;°F and 270&nbsp;°F) respectively.<ref name =shihadehreport2002>{{cite journal |last1=Shihadeh, A |title=Investigation of mainstream smoke aerosol of the argileh water pipe |journal=Food and Chemical Toxicology  |date=21 July 2002 |volume=41 |issue=1 |pages=75–82 |doi=10.1016/j.pbb.2004.06.005 |pmid=15388286 |s2cid=29182130 }}</ref> These temperatures are too low to sustain combustion and considerably lower than the 900 degrees Celsius (1700&nbsp;°F) found in cigarettes.<ref>{{cite book |last= Wakeham, H |title= The Chemistry of Tobacco and Tobacco Smoke|date= 1972|chapter= Recent Trends in Tobacco and Tobacco Smoke Research|pages= 1–20|location= Boston, MA |publisher= Springer |doi= 10.1007/978-1-4757-0462-4_1|isbn= 978-1-4757-0462-4}}</ref> A larger fraction of the smoke condensates of the hookah are produced by simple distillation rather than by pyrolysis and combustion, and as a result, would tend to carry considerably less of the pyrosynthesized compounds found in cigarette smoke.<ref name=shihadehreport2002/>

As a result of suction through the hose, a vacuum is created in the headspace of the water bowl sufficient to overcome the small static head of the water above the inlet pipe, causing the smoke to bubble into the bowl. At the same time, air is drawn over and heated by the coals. It then passes through the tobacco mixture where due to hot air convection and thermal conduction from the coal, the mainstream aerosol is produced.<ref name="ShihadehStudyJounBio">{{cite journal |last1=Shihadeh |first1=Alan |last2=Azar |first2=Sima |last3=Antonios |first3=Charbel |last4=Haddad |first4=Antoine |title=Towards a Topographical Model of Narghile Water-Pipe café Smoking: A Pilot Study in a High Socioeconomic Status Neighborhood of Beirut, Lebanon |journal=Pharmacology Biochemistry and Behavior |date=September 2004 |volume=79 |issue=1 |pages=75–82 |doi=10.1016/j.pbb.2004.06.005|pmid=15388286 |s2cid=29182130 |display-authors=etal  }}</ref> The vapor is passed down through the body tube that extends into the water in the jar. It bubbles up through the water, losing heat, and fills the top part of the jar, to which the hose is attached. When a user inhales from the hose, smoke passes into the lungs, and the change in pressure in the jar pulls more air through the charcoal, continuing the process.
Vapour that has collected in the bowl above the waterline may be exhausted through a purge valve, if present. This one-way valve is opened by the positive pressure created from gently blowing into the hose.

==Health effects==
{{Further|Health effects of tobacco|Mu'assel#Health effects}}

=== Exposure to toxic chemicals ===
Tobacco smoke contains toxic chemicals, including carcinogens (chemicals that cause cancer).<ref name="Akl10">{{cite journal|last1=Akl|first1=EA|last2=Gaddam|first2=S|last3=Gunukula|first3=SK|last4=Honeine|first4=R|last5=Jaoude|first5=PA|last6=Irani|first6=J|date=2010|title=The effects of waterpipe tobacco smoking on health outcomes: a systematic review|journal=International Journal of Epidemiology|volume=39|issue=3|pages=834–57|doi=10.1093/ije/dyq002|pmid=20207606|doi-access=free}}<!--|access-date=13 June 2015--></ref> Water does not filter out many of these chemicals.<ref name="Akl10" /> The toxic chemicals come from the burning of the charcoal, tobacco, and flavorings. These chemicals can lead to cancer, heart disease, lung disease, and other health problems.<ref name="Shihadeh15">{{cite journal|last1=Shihadeh|first1=A|last2=Schubert|first2=J|last3=Klaiany|first3=J|last4=El Sabban|first4=M|last5=Luch|first5=A|last6=Saliba|first6=NA|date=2015|title=Toxicant content, physical properties and biological activity of waterpipe tobacco smoke and its tobacco-free alternatives|journal=Tobacco Control|volume=24|issue=Supplement 1|pages=i22–i30|doi=10.1136/tobaccocontrol-2014-051907|pmc=4345918|pmid=25666550}}<!--|access-date=13 June 2015--></ref><ref>{{cite journal|last1=Grillo|first1=R|last2=Khemiss|first2=M|last3=Slusarenko da Silva|first3=Y|date=2023|title=Cytotoxic and genotoxic effects of waterpipe on oral health status: A systematic review and meta-analysis|journal=Sultan Qaboos University Medical Journal|volume=23|issue=1|pages=5–12|doi=10.18295/SQUMJ.6.2022.043|pmid=36865434|pmc=9974039}}</ref> 
The toxic chemicals include tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons (PAHs; e.g., benzo[a]pyrene and anthracene), volatile aldehydes (e.g. [[formaldehyde]], acetaldehyde, [[acrolein]]), benzene, nitric oxide, heavy metals (arsenic, chromium, lead), and carbon monoxide (CO).<ref name="Shihadeh15" /> Hookah smoking also increases the amount of carbon monoxide (CO) in a person's body to eight times their normal level.<ref name="Martinasek14">{{cite journal|last1=Martinasek|first1=MP|last2=Ward|first2=KD|last3=Calvanese|first3=AV|date=2014|title=Change in carbon monoxide exposure among waterpipe bar patrons|journal=Nicotine & Tobacco Research|volume=16|issue=7|pages=1014–9|doi=10.1093/ntr/ntu041|pmid=24642592}}<!--|access-date=13 June 2015--></ref> Compared to smoking one cigarette, a single hookah session exposes users to more carbon monoxide and PAHs, similar levels of nicotine, and lower levels of tobacco-specific nitrosamines.<ref name="WHO15" /><ref name="Shihadeh15" /> By inhaling these chemicals, hookah smokers are at increased risk of many of the same health problems as cigarette smokers.<ref name="ElZaatari15" /><ref name="Akl10" /> During an average hookah smoking session, smokers inhale 100–200 times more smoke than from smoking a single cigarette.<ref>{{Cite web |last=CDCTobaccoFree |date=2023-10-20 |title=Hookahs |url=https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm |access-date=2024-01-30 |website=Centers for Disease Control and Prevention|archive-date=1 June 2024 |archive-url=https://web.archive.org/web/20240601132951/https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm |url-status=live }}</ref>

=== Exposure to pathogens that cause infectious diseases ===
When people share a hookah, there is a risk of spreading infectious diseases such as [[oral herpes]], [[tuberculosis]], [[hepatitis]], [[influenza]], and ''[[Helicobacter pylori|H. pylori]]''.<ref name="ALAgrowingThreat">{{cite web |publisher=American Lung Association |url=http://www.lung.org/assets/documents/tobacco/hookah-policy-brief-updated.pdf |title=Hookah Smoking – A Growing Threat to Public Health |access-date=27 June 2018 |archive-date=18 September 2017 |archive-url=https://web.archive.org/web/20170918162317/http://www.lung.org/assets/documents/tobacco/hookah-policy-brief-updated.pdf }}</ref> Using personal disposable mouthpieces may reduce this risk, but does not eliminate it.<ref>{{cite web |title=Waterpipe and Hookah Smoking – A Dangerous New Trend |date=30 October 2015 |publisher=Simcoe Muskoka District Health Unit |url=http://www.simcoemuskokahealth.org/Topics/Tobacco/TobaccoUsePrevention/HookahsAndWaterpipes.aspx |access-date=13 June 2015 |archive-url=https://web.archive.org/web/20160625062356/http://www.simcoemuskokahealth.org/Topics/Tobacco/TobaccoUsePrevention/HookahsAndWaterpipes.aspx |archive-date=25 June 2016 }}</ref>

=== Addiction to and dependence on hookah ===
Hookah smokers inhale [[nicotine]], which is an addictive chemical. A typical hookah smoking session delivers 1.7 times the nicotine dose of one cigarette<ref name="Eissenberg09">{{cite journal|last1=Eissenberg|first1=T|last2=Shihadeh|first2=A|date=December 2009|title=Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure|journal=American Journal of Preventive Medicine|volume=37|issue=6|pages=518–23|doi=10.1016/j.amepre.2009.07.014|pmc=2805076|pmid=19944918}}<!--|access-date=13 June 2015--></ref> and the nicotine absorption rate in daily waterpipe users is equivalent to smoking 10 cigarettes per day.<ref name="Neergaard07">{{cite journal|last1=Neergaard|first1=J|last2=Singh|first2=P|last3=Job|first3=J|last4=Montgomery|first4=S|date=October 2007|title=Waterpipe smoking and nicotine exposure: a review of the current evidence|journal=Nicotine & Tobacco Research|volume=9|issue=10|pages=987–94|doi=10.1080/14622200701591591|pmc=3276363|pmid=17943617}}<!--|access-date=13 June 2015--></ref> Many hookah smokers, especially frequent users, have urges to smoke and show other [[Drug withdrawal|withdrawal]] symptoms after not smoking for some time, and it can be difficult to quit.<ref name="Aboaziza15">{{cite journal|last1=Aboaziza|first1=E|last2=Eissenberg|first2=T|date=March 2015|title=Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence?|journal=Tobacco Control|volume=24|issue=Suppl 1|pages=i44–i53|doi=10.1136/tobaccocontrol-2014-051910|pmc=4345797|pmid=25492935}}<!--|access-date=13 June 2015--></ref><ref name="Asfar14">{{cite journal|last1=Asfar|first1=T|last2=Al Ali|first2=R|last3=Rastam|first3=S|last4=Maziak|first4=W|last5=Ward|first5=KD|date=June 2014|title=Behavioral cessation treatment of waterpipe smoking: The first pilot randomized controlled trial|journal=Addictive Behaviors|volume=39|issue=6|pages=1066–74|doi=10.1016/j.addbeh.2014.02.012|pmc=4141480|pmid=24629480}}<!--|access-date=13 June 2015--></ref><ref name="Rastam2011">{{cite journal|last1=Rastam|first1=S|last2=Eissenberg|first2=T|last3=Ibrahim|first3=I|last4=Ward|first4=KD|last5=Khalil|first5=R|last6=Maziak|first6=W|date=May 2011|title=Comparative analysis of waterpipe and cigarette suppression of abstinence and craving symptoms|journal=Addictive Behaviors|volume=36|issue=5|pages=555–9|doi=10.1016/j.addbeh.2011.01.021|pmc=3061840|pmid=21316156}}<!--|access-date=13 June 2015--></ref><ref name="Ward05">{{cite journal|last1=Ward|first1=KD|last2=Hammal|first2=F|last3=VanderWeg|first3=MW|last4=Eissenberg|first4=T|last5=Asfar|first5=T|last6=Rastam|first6=S|last7=Maziak|first7=W|date=February 2005|title=Are waterpipe users interested in quitting?|journal=Nicotine & Tobacco Research|volume=7|issue=1|pages=149–56|citeseerx=10.1.1.625.4651|doi=10.1080/14622200412331328402|pmid=15804687}}<!--|access-date=13 June 2015--></ref> People who become addicted to hookah may be more likely to smoke alone.<ref name="Maziak05">{{cite journal|last1=Maziak|first1=W|last2=Eissenberg|first2=T|last3=Ward|first3=KD|date=January 2005|title=Patterns of waterpipe use and dependence: implications for intervention development|journal=Pharmacology Biochemistry and Behavior|volume=80|issue=1|pages=173–9|doi=10.1016/j.pbb.2004.10.026|pmid=15652393|s2cid=22556876}}<!--|access-date=13 June 2015--></ref> Hookah smokers who are addicted may find it easier to quit if they have help from a quit-smoking counseling program.<ref name=Asfar14 /><ref name="Dogar14">{{cite journal|last1=Dogar|first1=O|last2=Jawad|first2=M|last3=Shah|first3=SK|last4=Newell|first4=JN|last5=Kanaan|first5=M|last6=Khan|first6=MA|last7=Siddiqi|first7=K|date=June 2014|title=Effect of cessation interventions on hookah smoking: post-hoc analysis of a cluster-randomized controlled trial|journal=Nicotine & Tobacco Research|volume=16|issue=6|pages=682–8|doi=10.1093/ntr/ntt211|pmid=24376277}}<!--|access-date=13 June 2015--></ref><ref>{{Cite journal|last1=Maziak|first1=Wasim|last2=Jawad|first2=Mohammed|last3=Jawad|first3=Sena|last4=Ward|first4=Kenneth D.|last5=Eissenberg|first5=Thomas|last6=Asfar|first6=Taghrid|date=2015-07-31|title=Interventions for waterpipe smoking cessation|journal=The Cochrane Database of Systematic Reviews|volume=2015 |issue=7|article-number=CD005549|doi=10.1002/14651858.CD005549.pub3|issn=1469-493X|pmc=4838024|pmid=26228266}}</ref>

=== Short-term health effects ===
[[Carbon monoxide]] (CO) in hookah smoke binds to hemoglobin in the blood to form [[carboxyhemoglobin]], which reduces the amount of oxygen that can be transported to organs including the brain. There are several case reports in the medical literature of hookah smokers needing treatment in hospital emergency rooms for symptoms of CO poisoning including [[headache]], [[nausea]], [[lethargy]], and [[fainting]].<ref name="Cavus10">{{cite journal |last1=Cavus |first1=UY |last2=Rehber |first2=ZH |last3=Ozeke |first3=O |last4=Ilkay |first4=E |title=Carbon monoxide poisoning associated with narghile use |journal=Emergency Medicine Journal |date=2010 |volume=27 |issue=5 |page=406 |doi=10.1136/emj.2009.077214 |pmid=20442182 |s2cid=2332261 }}<!--|access-date=13 June 2015--></ref><ref name="LaFauci12">{{cite journal |last1=La Fauci |first1=G |last2=Weiser |first2=G |last3=Steiner |first3=IP |last4=Shavit |first4=I |title=Carbon monoxide poisoning in narghile (water pipe) tobacco smokers |journal=Canadian Journal of Emergency Medicine |date=2012 |volume=14 |issue=1 |pages=57–59 |pmid=22417961 |doi=10.2310/8000.2011.110431 |doi-access=free }}<!--|access-date=13 June 2015--></ref><ref name="Lim09">{{cite journal |last1=Lim |first1=BL |last2=Lim |first2=GH |last3=Seow |first3=E |title=Case of carbon monoxide poisoning after smoking shisha |journal=International Journal of Emergency Medicine |date=2009 |volume=2 |issue=2 |pages=121–122 |doi=10.1007/s12245-009-0097-8|pmid=20157455 |pmc=2700232 }}<!--|access-date=13 June 2015 --></ref><ref name="Turkmen11">{{cite journal |last1=Türkmen |first1=S |last2=Eryigit |first2=U |last3=Sahin |first3=A |last4=Yeniocak |first4=S |last5=Turedi |first5=S |title=Carbon monoxide poisoning associated with water pipe smoking |journal=Clinical Toxicology |date=2011 |volume=49 |issue=7 |pages=697–698 |doi=10.3109/15563650.2011.598160 |pmid=21819288|s2cid=43906064 }}</ref> This is sometimes called "hookah sickness".<ref name="Pearl15">{{cite news |last1=Pearl |first1=Mike |title=Is hookah sickness just carbon monoxide poisoning |url=http://influxnews.com/is-hookah-sickness-just-carbon-monoxide-poisoning/ |access-date=13 June 2015 |archive-url=https://web.archive.org/web/20150615061103/http://influxnews.com/is-hookah-sickness-just-carbon-monoxide-poisoning/ |archive-date=15 June 2015}}</ref> Hookah smoking can damage the [[cardiovascular system]] in several ways.<ref name="WHO15" /><ref name="ElZaatari15" /> Its use elevates [[heart rate]] and [[blood pressure]].<ref name="Alomari14">{{cite journal |last1=Alomari |first1=MA |last2=Khabour |first2=OF |last3=Alzoubi |first3=KH |last4=Shqair |first4=DM |last5=Eissenberg |first5=T |title=Central and peripheral cardiovascular changes immediately after waterpipe smoking |date=2014 |volume=26 |issue=10 |pages=579–587 |doi=10.3109/08958378.2014.936572 |pmid=25144473 |journal=Inhal Toxicol |bibcode=2014InhTx..26..579A |s2cid=30687980 |url=https://figshare.com/articles/dataset/Central_and_peripheral_cardiovascular_changes_immediately_after_waterpipe_smoking/1577598 |access-date=2 December 2021 |archive-date=26 March 2024 |archive-url=https://web.archive.org/web/20240326080125/https://figshare.com/articles/dataset/Central_and_peripheral_cardiovascular_changes_immediately_after_waterpipe_smoking/1577598 |url-status=live |url-access=subscription }}<!--|access-date=13 June 2015 --></ref> It also impairs [[baroreflex]] control (which helps to control blood pressure)<ref name="AlKubati06">{{cite journal |last1=Al-Kubati |first1=M |last2=Al-Kubati |first2=AS |last3=al'Absi |first3=M |last4=Fiser |first4=B. |title=The short-term effect of water-pipe smoking on the baroreflex control of heart rate in normotensives |journal=Autonomic Neuroscience |date=2006 |volume=126–127 |pages=146–9 |pmid=16716761 |doi=10.1016/j.autneu.2006.03.007|s2cid=31388586 }}<!--|access-date=13 June 2015 --></ref> and cardiac autonomic functioning (which has many purposes, including control of heart rate)<ref name="WHO15" /><ref name="Cobb12">{{cite journal |last1=Cobb |first1=CO |last2=Sahmarani |first2=K |last3=Eissenberg |first3=T |last4=Shihadeh |first4=A |title=Acute toxicant exposure and cardiac autonomic dysfunction from smoking a single narghile waterpipe with tobacco and with a "healthy" tobacco-free alternative |journal=Toxicology Letters |date=2012 |volume=215 |issue=1 |pages=70–75 |doi=10.1016/j.toxlet.2012.09.026 |pmid=23059956 |pmc=3641895 |bibcode=2012ToxL..215...70C }}<!--|access-date=2012--></ref><ref name="StHelen14">{{cite journal |last1=St Helen |first1=G |last2=Benowitz |first2=NL |last3=Dains |first3=KM |last4=Havel |first4=C |last5=Peng |first5=M |last6=Jacob |first6=P |title=Nicotine and carcinogen exposure after water pipe smoking in hookah bars |journal=Cancer Epidemiol Biomarkers Prev |date=2014 |volume=23 |issue=6 |pages=1055–66 |doi=10.1158/1055-9965.EPI-13-0939 |pmid=24836469 |pmc=4047652}}<!--|access-date=13 June 2015--></ref> Hookah use also acutely harms vascular functioning,<ref name="Alomari14" /> increases [[inflammation]],<ref name="Hakim11">{{cite journal |last1=Hakim |first1=F |last2=Hellou |first2=E |last3=Goldbart |first3=A |last4=Katz |first4=R |last5=Bentur |first5=Y |last6=Bentur |first6=L |title=The acute effects of water-pipe smoking on the cardiorespiratory system |journal=Chest |date=April 2011 |volume=139 |issue=4 |pages=775–81 |pmid=21030492 |doi=10.1378/chest.10-1833 |doi-broken-date=18 November 2025 }}<!--|access-date=13 June 2015 --></ref> and harms lung function and reduces the ability to exercise.<ref name="Hawari13">{{cite journal |last1=Hawari |first1=FI |last2=Obeidat |first2=NA |last3=Ayub |first3=H |last4=Ghonimat |first4=I |last5=Eissenberg |first5=T |last6=Dawahrah |first6=S |last7=Beano |first7=H |title=The acute effects of waterpipe smoking on lung function and exercise capacity in a pilot study of healthy participants |journal=Inhalation Toxicology |date=August 2013 |volume=25 |issue=9 |pages=492–7 |pmid=23905967 |doi=10.3109/08958378.2013.806613|doi-broken-date=18 November 2025 |bibcode=2013InhTx..25..492H |s2cid=22728685 }}<!--|access-date=13 June 2015 --></ref>

=== Long-term health effects ===
Current evidence indicates hookah causes numerous health problems.<ref name="WHO15" /><ref name="ElZaatari15" /><ref name="Akl10" /><ref>{{Cite web|last=CDCTobaccoFree|date=2021-04-23|title=Hookahs|url=https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm|access-date=2021-10-13|website=Centers for Disease Control and Prevention|archive-date=7 October 2021|archive-url=https://web.archive.org/web/20211007015136/https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm|url-status=live}}</ref> Hookah smoking is associated with increased risk of several cancers (lung, esophageal, and gastric), pulmonary diseases (impaired pulmonary function, chronic bronchitis, and [[emphysema]]), [[coronary artery disease]], [[periodontal disease]], obstetrical and perinatal problems (low birth weight and pulmonary problems at birth), larynx and voice changes, and [[osteoporosis]]. Many of the studies to date have methodological limitations, such as not measuring hookah use in a standardized way.<ref name="ElZaatari15" /> Larger, longitudinal studies are needed to learn more about the long-term health effects of hookah use and of exposure to hookah smoke.<ref name="ElZaatari15" /> Oral health is also affected, notably dental and periodontal status.<ref>{{cite journal|last1=Grillo|first1=R|last2=Khemiss|first2=M|last3=Bibars|first3=A|last4=Slusarenko da Silva|first4=Y|date=2023|title=Impact of waterpipe smoking on oral health of users: a systematic review and meta-analysis|journal=Prosthodontics|volume=72|issue=4|pages=322–332|doi=10.5114/PS/157370|s2cid=254625804|doi-access=free}}</ref>

=== Effects of secondhand exposure to hookah smoke ===
[[Secondhand smoke]] from hookahs contains significant amounts of carbon monoxide, [[Aldehyde|aldehydes]], [[PAHs]], [[Ultrafine particle|ultrafine particles]], and respirable particulate matter (particles small enough to enter the lungs).<ref name="WHO15" /> Studies have found that concentrations of particulate matter in the air of hookah bars were in the unhealthy to hazardous range according to [[United States Environmental Protection Agency|the U.S. Environmental Protection Agency]] standards.<ref name="Kumar15">{{cite journal|last1=Kumar|first1=SR|last2=Davies|first2=S|last3=Weitzman|first3=M|last4=Sherman|first4=S|title=A review of air quality, biological indicators and health effects of second-hand waterpipe smoke exposure |journal=Tobacco Control|date=March 2015|volume=24|issue=Suppl 1 |pages=i54–i59|pmid=25480544|doi=10.1136/tobaccocontrol-2014-052038|pmc=4345792}}<!--|access-date=13 June 2015--></ref> The air in hookah bars also contains significant amounts of toxic chemicals, including aromatic hydrocarbons, carbon monoxide, nicotine, and trace metals. The concentrations in the air of all these toxic substances are greater than for cigarettes (for the same number of smokers per hour).<ref name="Daher15">{{cite journal|last1=Daher|first1=N|last2=Saleh|first2=R|last3=Jaroudi|first3=E|last4=Sheheitli|first4=H|last5=Badr|first5=T|last6=Sepetdjian|first6=E|last7=Al Rashidi|first7=M|last8=Saliba|first8=N|last9=Shihadeh|first9=A|title=Comparison of carcinogen, carbon monoxide, and ultrafine particle emissions from narghile waterpipe and cigarette smoking: Sidestream smoke measurements and assessment of second-hand smoke emission factors |journal=Atmospheric Environment|date=1 January 2010|volume=44|issue=1|pages=8–14|pmid=20161525|doi=10.1016/j.atmosenv.2009.10.004|pmc=2801144|bibcode=2010AtmEn..44....8D}}<!--|access-date=13 June 2015--></ref> During a typical one-hour hookah session, a user expels into the air 2-10 times the amount of cancer-causing chemicals and other harmful chemicals compared to a cigarette smoker.<ref name="Daher15" /> No studies have examined the long-term health effects of exposure to secondhand hookah smoke, but short term effects may include experience respiratory symptoms such as wheezing, nasal congestion, and chronic cough.<ref name="Tamin03">{{cite journal|last1=Tamim|first1=H|last2=Musharrafieh|first2=U|last3=El Roueiheb|first3=Z|last4=Yunis|first4=K|last5=Almawi|first5=WY|title=Exposure of children to environmental tobacco smoke (ETS) and its association with respiratory ailments |journal=The Journal of Asthma|date=2003|volume=40|issue=5|pages=571–6|pmid=14529107|doi=10.1081/jas-120019029|doi-broken-date=18 November 2025|s2cid=35129626}}<!--|access-date=13 June 2015--></ref><ref name="Zeidan14">{{cite journal|last1=Zeidan|first1=RK|last2=Rachidi|first2=S|last3=Awada|first3=S|last4=El Hajje|first4=A|last5=El Bawab|first5=W|last6=Salamé|first6=J|last7=Bejjany|first7=R|last8=Salameh|first8=P|title=Carbon monoxide and respiratory symptoms in young adult passive smokers: a pilot study comparing waterpipe to cigarette |journal=International Journal of Occupational Medicine and Environmental Health|date=August 2014|volume=27|issue=4|pages=571–82|pmid=25012596|doi=10.2478/s13382-014-0246-z|doi-access=free}}<!--|access-date=13 June 2015--></ref>

=== Comparison to cigarettes ===

==== Aerosol composition comparison ====
The composition of aerosol produced by traditional shisha differs significantly from that of cigarette smoke. While cigarette smoke consists of approximately 76% harmful substances such as tar, nicotine, and carbon monoxide, the aerosol generated during a typical shisha session is composed primarily (about 84%) of water, [[glycerol]], and [[propylene glycol]].<ref name=":0">{{Cite journal |last1=Wilkinson |first1=Peter J. |last2=Clarke |first2=Anna |last3=Fearon |first3=Ian M. |last4=Barry |first4=Ronan |date=2025-04-30 |title=Emissions from conventional and electronic waterpipes relative to cigarettes and a heated tobacco product |journal=Scientific Reports |language=en |volume=15 |issue=1 |page=14176 |doi=10.1038/s41598-025-90721-w |pmid=40307321 |issn=2045-2322|pmc=12044023 |bibcode=2025NatSR..1514176W }}</ref>

==== Toxicant levels per milliliter ====
Studies analyzing shisha aerosol generated using heat management devices and coconut shell charcoal have shown that, per milliliter of aerosol, levels of tobacco-related harmful substances are between 94% and 100% lower compared to those found in cigarette smoke.<ref name=":0" />

==See also==
* [[Bong]]
* [[Chillum (pipe)]]
* [[Electronic hookah]]
* [[Health effects of tobacco]]
* [[Incense]]
* [[One-hitter (smoking)]]
* [[Pipe smoking]]
* [[Thuoc lao]]

{{clear}}

==References==
{{Reflist}}

==External links==
{{EB1911 poster|Hookah}}
{{wiktionary}}
*{{Commons category-inline}}
* [https://web.archive.org/web/20060307092937/http://www.who.int/tobacco/global_interaction/tobreg/Waterpipe%20recommendation_Final.pdf WHO Report on water pipe (hookah)], by WHO Study Group on Tobacco Product Regulation.
* {{cite journal |doi=10.1186/1477-5751-5-17|pmid=17112380|pmc=1664583|title=A critique of the WHO Tob ''Reg''<nowiki/>'s "Advisory Note" report entitled: "Waterpipe tobacco smoking: Health effects, research needs and recommended actions by regulators"|journal=Journal of Negative Results in Biomedicine|volume=5|page=17|year=2006|last1=Chaouachi|first1=Kamal |doi-broken-date=18 November 2025 |doi-access=free }}
* [http://www.cesar.umd.edu/cesar/cesarfax/vol17/17-23.pdf Scientific Evidence of the Health Risks of Hookah Smoking] {{Webarchive|url=https://web.archive.org/web/20080710161756/http://www.cesar.umd.edu/cesar/cesarfax/vol17/17-23.pdf |date=10 July 2008 }} (University of Maryland, College Park: 9 June 2008, vol 17, issue 23)

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