Hookah myths & facts Part 4
“I switched to vaping, it's the same thing, just easier.” Anyone who has sat at a table with a hookah has heard this line. Vapes are everywhere now: in pockets, in cars, at bus stops. So let's see whether it really is the same thing and which of the two is better. A fair fight, round by round, with numbers from real measurements. Where the vape wins, we'll say so.
What a vape is and what a hookah is
A vape, or e-cigarette, is a battery with a heating coil and a tank of liquid. The liquid is a mix of propylene glycol, vegetable glycerin, flavoring and, usually, nicotine. The coil heats it into an aerosol that you inhale. Nothing burns. A disposable vape is the same thing in a sealed shell: once the liquid runs out or the battery dies, the whole device goes in the bin. In Serbia, under amendments to the Tobacco Act, since 1 January 2025 the liquid can contain at most 20 mg of nicotine per milliliter, and a disposable vape can hold at most 2 ml.
A hookah works differently. The bowl holds moist tobacco with molasses, glycerin and flavoring, and tobacco makes up only about a third of the mix. Charcoal on top of the bowl heats the tobacco, the smoke passes through the water in the base and reaches you through the hose. If you're not sure what goes where, check out the hookah in 3D. What exactly is in the pack, we covered in part three, is hookah a drug.
They don't have much in common. In both cases most of the cloud comes from glycerin, and both contain nicotine. That's where the comparison starts.
Round 1: the experience
You vape on the go. Two or three puffs at the bus stop, between two emails or in the elevator, and it's back in your pocket. The whole “event” lasts about ten seconds and nobody notices. Often not even you.
With hookah it's the other way around. You sit down, pick a flavor, the hookah master packs the bowl and lights the coals, and then you have an hour or an hour and a half at the same table. The hose goes around, the conversation flows, the phone stays on the side. Researchers from the US Food and Drug Administration (FDA) looked at almost four thousand hookah smokers and picked out exactly this as the key difference: unlike other tobacco products, hookah is usually smoked together with others and over a long stretch of time.
Nobody goes out for a vape. People go out for a hookah, and that's the whole point. Point to hookah.
Round 2: what you inhale
We won't pretend here. A vape doesn't burn, so there's no carbon monoxide, the gas that comes from combustion. It shows up in breath tests too. In one 2023 study, cigarette smokers exhaled 6.9 ppm of carbon monoxide on average, and vapers 1.6, about four times less.
A hookah has charcoal, and the charcoal burns for the whole hour. After 45 minutes of hookah, the blood holds about three times as much carbon monoxide as after one cigarette. That's where the headache and dizziness after a long session come from. The water doesn't help, because carbon monoxide passes right through it, as we showed in part two, does the water in a hookah filter the smoke.
That doesn't make vaping harmless. The aerosol carries nicotine, flavorings and fine droplets, and the long-term effects are still being studied, since vapes have only been on the market for about twenty years. But going by what you take in with a single puff, this round is the vape's. Point to vape.
Round 3: how often
This is where things turn. A vape sits in your pocket all day, always charged and always at hand. So how many times do people actually puff on it? In a 2015 study, 21 experienced vapers carried a device that logged every puff for 24 hours. The average was 225 puffs a day, in about fifteen sessions. The range was huge: one person took 24 puffs, another over a thousand.
The sample is small, so this isn't “the average vaper”. But the picture is clear: a vape gets used a little at a time, all the time. On top of that, many of today's liquids use nicotine salts. That's a form of nicotine that is easier on the throat, so the liquid can carry more of it, and it reaches the blood fast. In one study, admittedly funded by a manufacturer, nicotine from such liquids was absorbed as fast as from a cigarette.
You don't carry a hookah in your pocket. You need charcoal, water, an hour and, most of the time, a lounge. That's why people smoke it less often. In the large US PATH study, of 3,947 adults who had smoked hookah in the past year, only 10.7 percent smoked it daily or weekly. 13.7 percent smoked it monthly, 42.1 percent every couple of months and 33.5 percent about once a year.
To be fair: whoever smokes hookah every day loses this point. The nicotine is the same and hookah dependence is real. But hookah the way most people know it, on Friday with friends, and a vape hanging around your neck from morning till night are not the same habit. Point to hookah.
Round 4: what's left afterwards
A disposable vape has a lithium battery, a plastic shell and leftover liquid with nicotine. Once it's empty, the whole thing goes in the bin. In the UK, the organization Material Focus estimated that in the year before the ban, about five million disposable vapes a week were thrown away or dropped on the street.
That's why three European countries banned them, all in 2025: Belgium from 1 January, France from late February and the UK from 1 June. The reasons were the same everywhere: battery waste, and cheap, colorful disposables becoming a favorite with kids. In Serbia they aren't banned, but since 2025 they're limited to 2 ml of liquid.
A good hookah lasts for years. After the evening you're left with charcoal ash and spent tobacco, while the base, the stem and the hose wait for next time. Point to hookah.
Final score: 3:1 to hookah
An hour at the table with friends against ten seconds at the bus stop.
A vape doesn't burn and has no carbon monoxide. A hookah has charcoal.
Vape: 225 puffs a day in one measurement. Most people smoke hookah less than once a week.
A disposable vape goes in the bin, battery and all. A hookah lasts for years.
What this comparison doesn't say
It doesn't say hookah is healthy. One hookah session brings in more smoke and carbon monoxide than a cigarette, let alone a single puff on a vape. It doesn't say vaping is harmless either. The healthiest option is neither, and we know that too, even though we run a directory of hookah bars.
If you're quitting cigarettes and thinking of vaping as a way to do it, that's a separate topic, best discussed with your doctor. This post compares two ways to enjoy yourself, not ways to quit.
But if the question is how to enjoy the flavor and the cloud with people you like, without it turning into something you do 200 times a day without thinking, the answer is hookah. Now and then, at a good lounge, with friends.
If you pick hookah, pick it wisely
- Not every day. Hookah is a night out. Once it becomes a daily thing, it loses round three.
- Shorter sessions. One hour instead of two. Carbon monoxide builds up with every minute.
- Natural charcoal and a well-ventilated lounge. Quick-light coals give off about twice as much carbon monoxide as natural coconut charcoal. More on that in part one, how many cigarettes one hookah really is.
- Don't stack them. If you vape all day and then sit down for a hookah in the evening, you get nicotine from both.
- Find a good place. The map has hookah bars all over Serbia, with guest reviews. If it's your first time, read the beginner's guide first.
FAQ
Which is better, vape or hookah?
It depends on what you measure. On carbon monoxide the vape wins, because nothing burns. On the experience, on how often people use it and on waste, the hookah wins. As an occasional treat with friends, hookah takes it 3:1.
Is vaping healthier than hookah?
Puff for puff, a vape delivers fewer harmful substances, because there's no combustion and no carbon monoxide. But people vape all day long, 225 puffs a day in one measurement, and the long-term effects are still being studied. Neither is healthy, and the healthiest choice is not to smoke or vape at all.
How many puffs a day does a vaper take?
In a 2015 study where 21 vapers carried a device that logged every puff, the average was 225 puffs a day, spread over about 15 sessions. The range went from 24 to over a thousand puffs.
Why are disposable vapes banned in some countries?
Belgium, France and the UK banned them in 2025, because of the waste from their lithium batteries and because they became popular with kids. In Serbia they are not banned, but since 2025 they can hold at most 2 ml of liquid with 20 mg of nicotine per milliliter.
Does hookah produce carbon monoxide and vaping doesn't?
Yes. Carbon monoxide comes from burning, and in a hookah the charcoal burns. After 45 minutes of hookah there's about three times as much of it in the blood as after one cigarette. A vape only heats the liquid, so there's no carbon monoxide from combustion.
This is not medical advice. Sources: Robinson et al., vaping topography in everyday life (PLoS One, 2015), Robinson et al., FDA, hookah in the PATH study (Nicotine & Tobacco Research, 2018), a study of exhaled carbon monoxide in smokers and vapers (Narra J, 2023), Eissenberg and Shihadeh (American Journal of Preventive Medicine, 2009), O'Connell et al. on nicotine salts (Internal and Emergency Medicine, 2019), Material Focus, the Belgian, French and UK laws on disposable vapes, amendments to the Tobacco Act of the Republic of Serbia (2023).
This is the fourth post in the Hookah myths & facts series. The earlier ones ask how many cigarettes one hookah really is, whether the water filters the smoke and whether hookah is a drug. Find tonight's place on the map or browse all posts.
