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Smoke is Smoke

All smoke is harmful, whether it comes from tobacco, cannabis (marijuana) or from a hookah pipe (waterpipe). Smoke is smoke.

While it is well known that there is no safe level of second-hand smoke, many are not aware of the health risks associated with exposure to smoke from cannabis or a hookah pipe. Just like tobacco, both produce second-hand smoke.


A Hookah or waterpipe is a device used to smoke specially made tobacco and non-tobacco herbal products called shisha.1 Both tobacco and herbal shisha can produce toxic chemicals such as carbon monoxide, ultrafine particles and aldedhydes.1,2,3 However, not only does the shisha give off chemicals, but so does the burning charcoal. The charcoal used to heat the shisha produces very high levels of carbon monoxide, heavy metals and cancer causing chemicals.2,3

Smoke from cannabis (marijuana) has been shown to have many of the same toxic chemicals as tobacco such as fine particles, heavy metals and carbon monoxide.4 Cannabis smoke also contains THC (delta-9-tetrahydrocannabinol), the chemical responsible for the “high” experienced by users. Breathing in second-hand cannabis smoke could negatively affect the health of those exposed.5,6


Limit Exposure

Limiting exposure to all sources of smoke (tobacco, herbal shisha and cannabis) is the best way to protect yourself and others from the harmful effects.

  • Avoid places where you might be exposed to any kind of second-hand smoke.
  • Make your home and car smoke-free.
  • Avoid smoking tobacco, herbal shisha or cannabis around of children, pregnant women, older adults and those with health conditions such as asthma, lung and heart disease.
  • If you smoke, think about quitting.
Date of creation: September 25, 2017
Last modified on: January 22, 2018


1American Lung Association. (2007). An Emerging Deadly Trend: Waterpipe Tobacco Use. American Lung Association: Washington, D.C. Retrieved from
2Centers for Disease Control and Prevention. (2011). Smoking & Tobacco Use: Hookahs. Retrieved from
3World Health Organization. (2015). Waterpipe tobacco smoking: health effects, research needs, and recommended actions for regulators. (2nd Ed). Geneva, Switzerland: WHO Document Production Services.
4Smoking and Health Action Foundation. (2016). Secondhand Marijuana Smoke: Health effects of exposure. Retrieved from
5Centers for Disease Control and Prevention. (2017) Marijuana and Public Health. Retrieved from
6State of Colorado. (2017). Smoking and secondhand smoke. Retrieved from