Smoking tobacco-based products is common. The United States Surgeon General requires cigarette manufacturers to include warning labels on packaging. Warning labels on cigarette packages and other smokable forms of tobacco alert the public to risks related to the use of tobacco-based products. One of the required labels states “Cigarette Smoke Contains Carbon Monoxide." 
Hookah is used to smoke flavored tobacco by use of a water pipe where smoke is inhaled through a mouthpiece. Ninety-one hookah lounges or bars currently operate in Michigan. Most of these establishments operate in the metropolitan Detroit area. Those who use hookah should be aware of the risk of carbon monoxide exposure associated with this method of use.
A study released in 2021 states the estimated increase in carbon monoxide exposure increased nearly 12-fold after an hour-long hookah session involving 200 hookah lounge patrons.
In addition to smoke from tobacco, smoke from the charcoal used to heat the hookah increases ambient carbon monoxide concentrations. Exposure to hookah smoke for one hour exposes users to 100 to 200 times the smoke from one tobacco cigarette. Hookah products are not regulated and may not come with warning labels.
Carbon monoxide is the most common gas responsible for death from poisoning. It is colorless and odorless. Signs and symptoms from carbon monoxide exposure include:
- Headache
- Weakness
- Dizziness
- Nausea
- Vomiting
- Shortness of breath
- Confusion
- Blurred vision
- Fatigue
- Loss of consciousness
It is vital to seek medical care in a hospital emergency room for symptoms that may be related to carbon monoxide exposure.
People may develop chronic symptoms such as:
- Memory loss
- Difficulty with body movement
- Personality changes
The Michigan Poison & Drug Information Center stresses the importance of avoiding smoking or exposure to smoke. If you do not use tobacco or nicotine-containing products, do not start.
To avoid use or for help with quitting, many resources are available on our website at https://www.poison.med.wayne.edu/smokingecigarettesvaping.
Homeowners should ensure that working carbon monoxide detectors are installed properly on each floor of the home. Consider replacing carbon monoxide detectors if they have been in use for 10 years or longer.
- If a carbon monoxide detector sounds off or if you suspect symptoms related to carbon monoxide go outdoors and call 911 for emergency assistance.
- To learn more about installation and household carbon monoxide prevention visit our Household Safety page at https://www.poison.med.wayne.edu/household-product-safety.
Seek medical care immediately at your closest hospital emergency room if you suspect carbon monoxide poisoning regardless of its source. For more questions about carbon monoxide poisoning and prevention call the Michigan Poison & Drug Information Center Poison Helpline at 1-800-222-1222. Free, professional, and expert advice is available 24/7/365.