Tobacco Products

Hookah Tobacco (Shisha or Waterpipe Tobacco)

Hookah tobacco (also known as waterpipe tobacco, maassel, shisha, narghile, or argileh) is a type of combustible tobacco that is smoked with a hookah (waterpipe).

Hookah (waterpipe) smoke exposes people to the addictive chemical nicotine and contains many of the same toxic chemicals that are in cigarette smoke.1, 2, 3, 4 In fact, research shows that waterpipe smokers may absorb even more of the harmful chemicals found in cigarette smoke because smoking sessions are typically longer. A typical one-hour hookah session involves inhaling 100–200 times the volume of smoke from a single cigarette.5

Waterpipe smokers are at risk for the same kind of diseases caused by cigarette smoking.6, 7, 8, 9 and may absorb even more toxic chemicals like carbon monoxide than cigarette smokers. 10 

Share comments, data, research results, or other information about flavors in tobacco products

On March 20, 2018, FDA issued an advance notice of proposed rulemaking to help determine how best to regulate flavors in tobacco products, including menthol. This action creates an opportunity for public comment as first announced in FDA's comprehensive plan for tobacco and nicotine regulation on the role of flavors in tobacco product use and use patterns.


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Statistics about Hookah (Waterpipe) Use

  • Nationwide, an estimated 700,000 high school students and 230,000 middle school students currently smoke waterpipe.11
  • According to a 2013-2014 survey, 79 percent of youth aged 12-17 who smoked hookah said that they used hookah products because “they come in flavors I like."12,13

Image of a Hookah

FDA Regulation of Hookah (Waterpipe) Tobacco

In 2016, FDA finalized a rule extending our regulatory authority to cover all tobacco products, including hookah tobacco. FDA regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of hookah tobacco. This includes components and parts of tobacco products regulated by the 2016 rule, but excludes accessories such as lighters, tongs, or external burners. 

“Components” or “parts” include, among other things, software or an assembly of materials intended or reasonably expected to alter or affect the tobacco product’s performance, composition, constituents, or characteristics; or to be used with or for the human consumption of a tobacco product. For more information about components, parts, and accessories, please read Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act. Examples of components and parts that are regulated include, but are not limited to:

  • Hookah (waterpipe)
  • Flavor enhancers
  • Hose cooling attachments
  • Water filtration base additives (including those that are flavored)
  • Charcoal made from wood, coconut shell or other materials, as well as electric heating systems
  • Bowls, valves, hoses, and heads

Manufacturing Hookah (Waterpipe) Tobacco

If you make, modify, mix, manufacture, fabricate, assemble, process, label, repack, relabel, or import hookah (waterpipe) tobacco, you must comply with the requirements for manufacturers.

CTP’s Office of Small Business Assistance can answer specific questions about requirements of small businesses and how to comply with the law. This office also provides online educational resources to help regulated industry understand FDA regulations and policies.


Required Nicotine Addictiveness Warning on Packages and Advertisements

Beginning on August 10, 2018, all "covered" tobacco products* must bear the required nicotine addictiveness warning statement on product packages and advertisements. *Note: Cigars, which are also “covered” tobacco products, have additional required warning statements.  


Retail Sales of Hookah (Waterpipe) Tobacco

Federal Rules for Hookah and Pipe Tobacco Sales Flyer  

Retail Rules for Hookah and Pipe Tobacco Sales flyer thumbnail.  Click to Access.

Order Print Copies

If you sell hookah tobacco, please read this summary of federal rules that retailers must follow.

You may also order flyers with rules for hookah tobacco sales, or download a PDF to print yourself.

You can find a list of retailer responsibilities for hookah (waterpipe) tobacco in the final rule Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act. In addition, our website offers more information on regulations, guidance, and webinars for retailers.


Importing Hookah (Waterpipe) Tobacco

Tobacco products imported or offered for import into the United States must comply with all the applicable requirements under the Federal Food, Drug, and Cosmetic Act (FD&C Act). You can find more information on the Importing and Exporting webpage.

You can also learn more about the importation process in the FDA Regulatory Procedures Manual, Chapter 9, Import Operations and Actions.

If you have questions about importing a specific tobacco product, please contact the FDA district into which your product will be imported (PDF - 406 KB).


Reporting Adverse Experiences and Product Violations

If you experience an unexpected health or safety issue with a specific tobacco product, you can report your adverse experience to FDA. Knowledge about adverse experiences can help FDA identify health or safety issues beyond those normally associated with product use.

If you believe these products are being sold to minors, or you see another potential violation of the FD&C Act or FDA's tobacco regulations, report the potential violation.


1. Centers for Disease Control and Prevention (CDC). Smoking & Tobacco Use: Hookahs (Fact Sheet). http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/. Updated December 17, 2013. Accessed August 18, 2014.
2. Cobb CO, Ward KD, Maziak W, Shihadeh AL, Eissenberg T. Waterpipe tobacco smoking: An emerging health crisis in the United States. American Journal of Health Behavior. 2010; 34(3):275–85.
3. Shihadeh A, Schubert J, Klaiany J, Sabban ME, Luch A, Saliba NA. Toxicant content, physical properties and biological activity of waterpipe tobacco smoke and its tobacco-free alternatives. Tobacco Control. 2015; 24:i22-i30.
4. Monzer B, Sepetdjian E, Saliba N, Shihadeh A. Charcoal combustion as a source of CO and carcinogenic PAH in mainstream narghile waterpipe smoke. Food and Chemical Toxicology. 2008; 46(9):2991-2995.
5. Centers for Disease Control and Prevention (CDC). Smoking & Tobacco Use: Hookahs (Fact Sheet). http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/. Updated December 17, 2013. Accessed August 18, 2014.
6. Centers for Disease Control and Prevention (CDC). Smoking & Tobacco Use: Hookahs (Fact Sheet). http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/. Updated December 17, 2013. Accessed August 18, 2014.
7. Cobb CO, Ward KD, Maziak W, Shihadeh AL, Eissenberg T. Waterpipe tobacco smoking: An emerging health crisis in the United States. American Journal of Health Behavior. 2010; 34(3):275–85.
8. Shihadeh A, Schubert J, Klaiany J, Sabban ME, Luch A, Saliba NA. Toxicant content, physical properties and biological activity of waterpipe tobacco smoke and its tobacco-free alternatives. Tobacco Control. 2015; 24:i22-i30.
9. Monzer B, Sepetdjian E, Saliba N, Shihadeh A. Charcoal combustion as a source of CO and carcinogenic PAH in mainstream narghile waterpipe smoke. Food and Chemical Toxicology. 2008; 46(9):2991-2995.
10. Centers for Disease Control and Prevention (CDC). Smoking & Tobacco Use: Hookahs (Fact Sheet). http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/. Updated December 17, 2013. Accessed August 18, 2014.
11. Centers for Disease Control and Prevention (CDC). Tobacco use among middle and high school students – United States, 2011-2016. Morbidity and Mortality Weekly Report. 2017; 66(23):597-603.
12. Corey CG, Ambrose BK, Apelberg BJ, King BA. Flavored tobacco product use among middle and high school students--United States, 2014. Morbidity and Mortality Weekly Report. 2015; 64(38):1066-1070.
13. Ambrose BK, Day HR, Rostron B, et al. Flavored tobacco product use among US youth aged 12-17 years, 2013-2014. Journal of the American Medical Association. 2015; 314(17):1871-1873.


 

Page Last Updated: 05/07/2018
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