Hookah use is on the rise, especially among young adults, but few consumers are aware of its potentially lethal effects

Carbon monoxide is often referred to as a “silent killer” for good reason: It is a gas that you cannot see, smell or taste.

One of life’s basic, commonsense rules is that you should never burn charcoal in a poorly ventilated area. The carbon monoxide fumes could kill you.

The rising popularity of smoking tobacco with hookahs – water pipes heated by burning charcoal – creates significant health and safety concerns, warns Diane Calello, executive and medical director at the New Jersey Poison Control Center at Rutgers New Jersey Medical School’s Department of Emergency Medicine.

According to recent medical literature, approximately 100 cases of carbon monoxide poisoning from hookah smoking have been reported both nationally and internationally, and that number continues to grow.

Calello discusses how to mitigate the risks of carbon monoxide poisoning when using hookah pipes.

How can carbon monoxide poisoning result from hookah use?
Hookah pipes use charcoal. The resulting carbon monoxide gas is inhaled along with the tobacco smoke, creating a very real risk of severe and potentially deadly carbon monoxide poisoning. The risk of carbon monoxide poisoning increases depending on the size of the space you are smoking in, the number of people smoking in that space and how well ventilated the space is.

Is it possible for people who smoke hookahs to lessen their risk?
Carbon monoxide is often referred to as a “silent killer” for good reason: It is a gas that you cannot see, smell or taste. Prevention and early detection are crucial in avoiding injury and death from carbon monoxide. Any type of tobacco use – and especially any type associated with a risk of carbon monoxide poisoning – is not recommended. But if someone chooses to use a hookah pipe it should only be done in large, well-ventilated areas. If you visit a hookah bar, inquire about carbon monoxide detectors. In your residence, make sure you have battery-operated carbon monoxide detectors on every level and near every sleeping area. Remember to check the batteries of both fire and carbon monoxide detectors when you change the clocks twice a year. Also, replace your detectors every five to seven years because the sensors can degrade.

What are the symptoms and health implications of carbon monoxide poisoning?
Common symptoms of low-level poisoning include headaches, sleepiness, fatigue, confusion and irritability. At higher levels, poisoning can result in nausea, vomiting, irregular heartbeat, impaired vision and coordination, brain damage and death. Unfortunately, symptoms of carbon monoxide poisoning can easily be confused with symptoms of viral illnesses like the common cold or seasonal flu.

Carbon monoxide poisoning is serious and should be handled as a medical emergency. Get help immediately if you suspect someone was exposed to carbon monoxide. If the person is unconscious, not breathing, hard to wake up or seizing, call 9-1-1. Otherwise, contact the Poison Control Center (800-222-1222).