Many hookah users believe it is a healthier option to other forms of tobacco use and love socialising arond it. Traditional and flavoured hookahs, shisha, and pipe smoking have struck a friendly chord with many in Kerala for the past few years. Cafes or bars providing the service observe users associate a 'relaxing vibe' with it.

Karnataka recently banned the sale and consumption of hookah products, citing that it's not healthy. Kerala, Gujarat, Maharashtra and Punjab have already banned it. The Karnataka government order even highlighted a study that said 45 minutes of hookah smoking is equal to 100 cigarettes! Here are a few other reasons that make hookah smoking unhealthy:

Respiratory issues
Hookah produces smoke that passes through water, after being heated with charcoal. These high temperatures can irritate the mouth, throat, and lungs even causing burns at times. The tobacco burned in hookah also produces smoke containing many toxins like carbon monoxide, heavy metals, and carcinogens. They can damage the lungs and make users susceptible to lung cancer, heart disease, and many other respiratory issues. Even non-smokers exposed to secondhand hookah smoke can face health risks and cardiovascular disease.

Nicotine addiction
Hookah can be a potential gateway for cigarette smoking for even those who are not addicted to nicotine. Even the hookah preparation part - selecting the flavour, putting the ingredients together, and creating the social setting for the same, can become an addictive experience for certain users. Moreover, regular use will lead to tolerance of the substance, forcing users to increase the amount of nicotine in hookah to get the desired effect. 

Transmitting infectious diseases
As the smoking practice involves sharing a common hose among many users, it can also transmit infectious diseases like COVID-19 or tuberculosis. You can't be sure whether the smoking establishments are adhering to hygiene standards and how sanitary their mouthpieces are. The possible saliva exchange is also a risky element while using hookah. 

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