Air pollution was studied in 33 homes in the United Arab Emirates: 11 where only shisha was smoked, 12 where only cigarettes were smoked, and 10 where no smoking occurred.

All pollutants assessed in the study, including carbon monoxide (CO) and various airborne particulate matter, were found to be higher in shisha smoking homes compared to homes where cigarettes were smoked.

Specifically, CO levels in rooms where shisha was smoked were found to be five times higher than in rooms where cigarettes were smoked, while CO levels in rooms next to where shisha was smoked were nearly four times higher compared to rooms next to where cigarettes were smoked. Too much carbon monoxide in the bloodstream can cause severe damage to vital organs, and toxic chemicals from secondhand smoke can cause cancer, respiratory problems, and heart disease.

NYU Abu Dhabi Public Health Research Center Principal Investigator Dr. Scott Sherman said: “The study shows that the other rooms (where shisha wasn’t smoked) were not any safer. So, sending your children to play in the other room while you smoke is not a safe alternative. This is one of the first studies to show it’s a big deal in ways that we didn't necessarily expect.”

Previous research has shown that shisha is harmful to smokers but this is the first study to examine hazardous levels of home air pollution caused by shisha and the potential health effects for people in nearby rooms. Shisha is harmful because the tobacco used in it is flavored, and these flavors contain multiple toxic chemicals not found in cigarettes.

Lead researcher Dr. Michael Weitzman, professor in the departments of pediatrics and environmental medicine at the NYU School of Medicine, said the study shows that smoking shisha at home could put children and non-smokers at risk.

He hopes the research will influence policy makers to push for better control and awareness about the dangers of smoking shisha and indoor smoking more broadly, “and open up a conversation that will motivate the public to behave differently or to create regulations that could save many lives and improve the quality of life for countless people around the world.”

“It’s a very difficult and different challenge,” added Sherman, noting that “clean indoor air laws have made a big difference around the world in smoking rates. If people want to smoke at home then they have that choice so it’s really a question of education and making them realize what they're getting themselves and their families into.”

Dr. Weitzman is the lead author of the paper detailing the findings of this study, "Effects of hookah smoking on indoor air quality in homes", which has been published by Tobacco Control, one of the leading peer-reviewed journals on the subject, while Dr. Scott Sherman and Dr. Afzal Hussein Yusufali, a consultant cardiologist at Dubai Hospital, are co-authors.