Waterpipe Smoking

What is waterpipe smoking?

Waterpipe is a tobacco-smoking device that originated from India and the Middle East.

Waterpipe tobacco utilises charcoal or other heating substances to heat paste made from flavoured or non-flavoured tobacco to give off smoke. The smoke passes through a water bowl and is inhaled by the smoker through the hose.

Health effects of waterpipe smoking

Waterpipe smoke contains the addictive substance nicotine and causes dependence. Besides, the combustion of fuel, for instance charcoal, releases high concentrations of carbon monoxide, heavy metals, and other toxic compounds such as hydrocarbons even after the smoke has passed through water. Due to the mode of smoking - including higher frequency of puffing, deeper inhalation and longer smoking session - waterpipe smokers usually inhale more toxins than they would when smoking cigarettes. A typical one-hour waterpipe smoking session exposes the user to 100-200 times the volume of smoke inhaled from a single cigarette, and up to 9 times the carbon monoxide and 1.7 times the nicotine of a single cigarette.

Waterpipe smokers are at risk of the same kind of diseases as are caused by cigarette smoking, including oral cancer, lung cancer, stomach cancer, cancer of the oesophagus, reduced lung function, heart disease and decreased fertility. Secondhand smoke from waterpipes also poses a serious health hazard.

Waterpipe apparatus is commonly shared by waterpipe smokers. The parts and accessories of waterpipe (e.g. hose and water bowl) are difficult to be completely disinfected after each use. The design of the apparatus and the manner of use also promotes growth and transmission of microorganisms. Research already showed that sharing waterpipe apparatus increases the risk of infectious disease such as herpes, tuberculosis and hepatitis. Therefore, you are strongly advised not to smoke waterpipe and especially not to share the apparatus.

Prohibition of smoking in no smoking area

According to the Smoking (Public Health) Ordinance, no person shall smoke or carry a lighted cigarette, cigar or pipe in statutory no smoking areas. Offenders will be subject to a fixed penalty of HK$1,500. Anyone who smokes waterpipe in statutory no smoking areas will also be prosecuted.

Smoking Cessation Services

At present, there are a number of smoking cessation services provided by the Department of Health (DH), the Tung Wah Group of Hospitals, the United Christian Nethersole Community Health Service, the Pok Oi Hospital, the Hospital Authority and various organisations. Some family doctors and private hospitals also provide smoking cessation services. Members of the public can call the DH's Integrated Smoking Cessation Hotline at 1833 183 or click here for more information.

Smoking is the major preventable cause of death. For yourself and your family’s health, quit smoking now.

Information Sheets:
Waterpipe Smoking

Press release
CHP appeals to public to take precautionary measures against carbon monoxide poisoning

1. World Health Organization. Waterpipe Tobacco Smoking: Health, Effects Research Needs and Recommended Actions by Regulators. (accessed in Aug 2021)

2. USA. Centers for Disease Control and Prevention website (accessed in August 2021)

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7. Akl EA, Gaddam S, Gunukula SK, Honeine R, Jaoude PA, Irani J. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. International journal of epidemiology. 2010 Jun 1;39(3):834-57.

22 Feb 2022