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J Res Med Sci 2021,  26:97

How hookah increases the risk of corona virus in younger people?

1 Department of Physiology, Applied Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Internal Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Submission30-Aug-2020
Date of Decision08-Sep-2020
Date of Acceptance21-Sep-2020
Date of Web Publication18-Oct-2021

Correspondence Address:
Dr. Arash Toghyani
Department of Internal Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jrms.JRMS_1032_20

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How to cite this article:
Javanmard SH, Toghyani A. How hookah increases the risk of corona virus in younger people?. J Res Med Sci 2021;26:97

How to cite this URL:
Javanmard SH, Toghyani A. How hookah increases the risk of corona virus in younger people?. J Res Med Sci [serial online] 2021 [cited 2022 Oct 3];26:97. Available from: https://www.jmsjournal.net/text.asp?2021/26/1/97/328496

Dear Editor,

Case combination of COVID-19 patients is moving to younger people. The fact may reflect increased exposures as a result of reduced social distancing and a lack of knowledge and sensitization of COVID-19 related risk factors in this age group.

Water pipe or hookah smoking also commonly known as “hubble bubble,” is becoming widely used, especially among the younger people, and is often largely unrecognized as a health risk.

Hookah puffing is more variable such as the number of puffs, total puffing time, and total smoke inhaled. Regarding total puffing time, hookah use takes significantly longer periods (30–90 min/session) in comparison to cigarette smoking (average 5–6 min).[1] a common 1-hour-long hookah smoking session is comparable to 100–200 cigarette smoking and involves 200 puffs, which is about 90,000 ml smoke inhaled.[2] toxicant yields during 1–2 h hookah smoking damage the respiratory lining and predispose the smoker to respiratory infectious diseases, and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is no exception.

In addition to the hazardous effects of tobacco smoke on body organs, the risk of transmission of infectious agents through shared water pipe use are of serious concern during the COVID-19 outbreak. It is difficult to clean long pipes and the water reservoir of hookah.

In addition, recent studies have shown that SARS-CoV-2 RNA can be detected in people 1–3 days before beginning their symptoms; so, SARS-CoV-2 infected asymptomatic persons can also infect other people.[3] Shared hookah smoking, which is usual in hookah bars and gatherings, can be mentioned as a serious risk for transmission of COVID-19.

Several countries, including Iran, have already banned hookah smoking in public places, assumed the public health risks of COVID-19 transmission.[4] Regardless of the ban on use in public places, hookah use in private parties and friends/family gathering has persisted.

Sensitizing people to situations infected persons transmit the virus is important to take steps to prevent the virus from spreading.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Qasim H, Alarabi AB, Alzoubi KH, Karim ZA, Alshbool FZ, Khasawneh FT. The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environ Health Prev Med 2019;24:58.  Back to cited text no. 1
Yadav S, Rawal G. Waterpipe tobacco smoking: A mini-review. J Transl Int Med 2018;6:173-5.  Back to cited text no. 2
World Health Organization. (2020). Transmission of SARS-CoV-2: implications for infection prevention precautions: scientific brief, 09 July 2020. World Health Organization. https://apps.who.int/iris/handle/10665/333114. License: CC BY-NC-SA 3.0 IGO.  Back to cited text no. 3
Raoofi A, Takian A, Akbari Sari A, Olyaeemanesh A, Haghighi H, Aarabi M. COVID-19 pandemic and comparative health policy learning in Iran. Arch Iran Med 2020;23:220-34.  Back to cited text no. 4


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