Updated

Here's even more proof that smoking—in any capacity—isn't good for you: A single evening of smoking hookah can significantly increase your exposure to carcinogens (substances that cause cancer), according to a recent study published in the journal Cancer Epidemiology, Biomarkers & Prevention.

The Centers for Disease Control and Prevention have reported that smoking hookah is at least as toxic as smoking cigarettes, but researchers from the University of California at San Francisco wanted to see just how much exposure to harmful chemicals one night of smoking hookah would result in.

The team collected baseline urine samples from 55 healthy individuals—all of whom had varying levels of hookah exposure prior to the experiment. Study subjects were then asked to refrain from smoking anything (hookah or cigarettes) for at least a week. After that, they were told to go to a hookah bar of their choosing and keep track of their smoking habits for one night.

On average, the study subjects said they spent an average of 74 minutes actually smoking. They also reported puffing about 0.6 bowls (nearly the same amount of tobacco found in one cigarette) each. In addition, 12 of the 55 people who participated reported inhaling secondhand smoke (for an average duration of about nine minutes). Another urine sample was taken from each study subject the morning afterward—and nicotine levels were 73 times higher, on average, than in the original samples.

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Typically, people smoke hookah less often than cigarettes—but a single hookah session results in much more exposure to carcinogens than smoking a single cigarette, says Tom Glynn, the director of cancer science and trends at the American Cancer Society. Hookah devices vary, but they usually deliver a purer (and potentially more harmful) form of nicotine and other cancer-related substances to smokers. (Worth noting: The CDC says the research on nicotine—and whether it's a carcinogen—is still unclear. But since some evidence suggests it may contribute to your likelihood of getting cancer, it's best to play it safe.)

What's more, you likely spend more time inhaling toxic substances in one hookah night than you would on one smoke break: A study published in the Journal of Nicotine and Tobacco Research found that people who used hookahs were exposed to 56 times more smoke than cigarettes users.

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If this isn't eye-opening enough, let's reinforce a common misconception: Hookah is not a healthier alternative to cigarettes. Whether or not you'll get cancer from smoking depends on various factors, but two biggies include: the amount you smoke (as in, the number of cigarettes a day) and the length of time (in years) you spend as a smoker.

In other words, the more you smoke—however you do it—the greater your risk of cancer, says Glynn. Cancer isn't the only health risk, either. Even if you're just an occasional smoker, the carbon monoxide from smoke can compromise your heart health, says Glynn. So keep this in mind the next time you're tempted to hit up a hookah bar.

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