DENNIS ODA / DODA@STARBULLETIN.COM Renee Hollison Betamour and husband Mohammad Betamour run a hookah service, which offers retail and out-call services to clubs wanting the water pipes.

Lung group warns against hookahs

An association says that water pipes are more dangerous than smoking cigarettes

The American Lung Association of Hawaii cautioned college students today against a growing campus fad of smoking with water pipes, called hookahs.

Association President Sterling Yee said in a news release that water pipe smoking potentially is more dangerous than cigarette smoking because users are exposed to larger amounts of nicotine, carbon monoxide and other toxins.

However, a couple who operates the only licensed hookah service in Hawaii says using a water pipe is not smoking, which they oppose, but is "vaporizing."

"When you light up a cigar or cigarette or any type of tobacco or nontobacco, you're causing combustion to occur," said Renee Hollison Betamour. No combustion is involved with smoking a hookah, she said. "It's closer to aromatic therapy."

Several sessions were devoted to hookah smoking at a recent World Tobacco Conference in Washington, D.C., said Bert Kobayashi, who attended with Debbie Odo as Hawaii Lung Association representatives.

He said Yee became concerned when his daughter, attending college on the mainland, was invited to a hookah party. The invitation said hookah smoking is harmless because the tobacco smoke is filtered through water, Kobayashi said.

He said the major selling point for young people in colleges and college town environments is that "it's smoking within a social, conversational, laid-back atmosphere with multiple smokers in one session."

But he said the lung association's message is, "If it involves tobacco and nicotine in your lungs, it is not safe."

One concern is that sucking hard on the pipe causes the smoke to go deep into the lungs, he said. Another is that hookah rooms usually are filled with smoke, Kobayashi said.

"Hookah is spreading rapidly among young people drawn to its allegedly glamorous and harmless nature, but smoking tobacco in all its forms is dangerous," Yee said.

But Renee and Mohammad Betamour say water pipe smokers are only inhaling steam. "It's closer to cooking than smoking," Renee said.

Tyson Suzuki, 21, who has been involved five years with Hawaii smoking cessation and anti-corporate marketing programs, also attended the world conference. He is working with the Washington, D.C.-based American Legacy Foundation, gathering data on hookah smoking for a college campaign.

"It's like a social event to smoke hookah in a large group," Suzuki said, acknowledging he tried it once. "There is no huge industry standard yet, but there is a market that taps into this. It's more trendy in America but it's on the rise.

"Apparently, college campuses do promote it as an alternative to smoking marijuana or other drugs," said Suzuki, one of 100 youths chosen globally to work on anti-smoking corporate marketing initiatives in their communities.

A hookah has four parts -- a base or smoke chamber partially filled with water, a bowl containing tobacco and the charcoal to heat it, a pipe connecting the bowl to the base that dips into the water, and a hose that opens into air in the base.

The Mayo Clinic said in an Internet article on hookah smoking that when a smoker inhales through the tube, a pressure difference forces air past the heating source and heats the tobacco. Smoke is pulled away from the tobacco, passes through the water and into the smoke chamber where the smoker inhales it.

Yee said constant puffing to keep charcoal hot in the pipe's burner produces much more smoke and exposes the user to high levels of arsenic, chromium and lead.

The Betamours counter that the smoke is filtered by the water so the user is just getting "aromatics and vapor out of the hose."

"It's safer than walking down the street at rush hour with carbon monoxides in the air," said Renee Betamour.

Water pipes have been used for hundreds of years in the Middle East and Asia, and are showing up increasingly in American coffee shops and cafes.

"American demand on the market has caused it to shoot up," Renee Betamour said.

The basic mixture is an "all-natural raw compound of tobacco leaves" with molasses added for flavor and honey as a preservative, Mohammad Betamour said.

They have a contract with the Pink Cadillac to provide hookahs for patrons.

The couple said they had hoped to establish a coffee shop with hookah smoking, but they did not count on the new state law going into effect Nov. 16 to prohibit smoking in most public places. "We'll see how that goes," Renee Betamour said.