Hookah Disinfection: Myths and Reality. What the Experts Say

BET YOU DIDN’T KNOW THIS?

Pack the bowl, we’re in for a long talk. Today we’re discussing hookah microbiology and hygiene, which you definitely don’t know about. Hookahs are breeding grounds for a huge number of infections—this is a scientifically proven fact. MSGU conducted the world’s first scientific study of hookah microflora, examining numerous devices from establishments and after home smoking sessions for pathogenic microflora harmful to humans. These hookahs were usually washed with various agents and treated with a steam generator. Trust me, the results will definitely surprise you.

GO AHEAD, SURPRISE ME AND WHAT DID THEY FIND THERE?

Everything you can imagine. From various microbial colonies (staphylococci, E. coli group, mycobacteria, tuberculosis, salmonella), viruses (herpes, flu, hepatitis, corona, adenoviruses) to pathogenic fungi (candida, trichophyton, molds, etc.). What surprised scientists more wasn’t the qualitative composition of the microflora, but the quantitative one, exceeding permissible levels for clean dishes by over 2000 times. Can you imagine?!

NO WAY! WHERE DID THEY COME FROM?

There are three ways they get in. The first, simplest one—from the environment and direct hand contact. Second—from the smoking raw material, since tobacco, cigar, or tea leaves are highly infected substances with diverse microflora from all corners of the planet, which is quite varied. Results from another scientific study of hookah tobacco from Russian producers showed that all compositions contain various phytoanthropic and soil bacteria. Some of which we don’t even have immunity to, as they’re not endemic to our region. The third, main way, is from the human respiratory tract during hookah blowing. The oral cavity, as you know, is the most infected place in the human body. With each new puff, less microbiota is introduced into the hookah.

HOW DO THEY LIVE THERE? WHY DON’T THEY DIE, AND WHY ARE THEY DANGEROUS?

Hookahs provide an ideal environment for their colonization, meeting all requirements for any living organism’s life. First, it’s a semi-liquid system: shaft, hose, flask, and especially the shaft base, where the most moisture accumulates. Second, this environment combines three key criteria for their growth: comfortable temperature, water, and a nutrient medium in the form of sugar from molasses. Unlike us, hookahs have no immunity. Anything introduced, even in small amounts, multiplies over time in warm, humid, nutrient-rich conditions to critically dangerous levels for us. That’s why a home hookah, typically used by just one or two regular smokers, is as infected as those in establishments. It’s an ideal incubator for any pathogen, like a Petri dish, but bigger

OK, THERE ARE LOTS OF BACTERIA AND VIRUSES AROUND US—WHY ARE THEY SO DANGEROUS SPECIFICALLY IN HOOKAHS?

First, my friend, we need to understand infection mechanisms. Your contact with the environment isn’t as intimate—you don’t lick handrails in public transport or eat off the floor. Even if you did, bacteria would face a long path and obstacles to enter your bloodstream: saliva lysozyme, your tonsils in the throat, acidic stomach environment, alkaline intestines, and your own digestive microflora—all natural barriers posing danger to pathogenic microflora entering your GI tract this way. It’s very hard for microbes to survive and cause widespread generalized disease. Unlike hookah smoking, where all pathogenic microflora from the device easily enters the lung alveoli via smoke through the respiratory tract without barriers, then straight into the bloodstream. Then you just hope your immune system can handle it, which it can’t always.

YEAH, BUT I’VE SMOKED HOOKAH FOR YEARS AND NEVER GOT SICK—SO HOW IS IT REALLY DANGEROUS FOR ME

Well, first, that’s a highly debatable and unprovable claim. Hookahs without disinfection carry significant infection risks, and smoking weakens immune and respiratory functions over time. The immune system can’t always suppress all pathogenic microflora. Even if it handles the most dangerous ones like tuberculosis, flu, or herpes, it might not suffice for something like E. coli or fecal bacilli. After that, infections can manifest as cough, phlegm, high fever, etc., via airborne or device operator transmission. And it won’t just be a regular flu. But you’ll never link it to the hookah. Try proving it’s easier to get sick from a public transport germ than from a hookah shared by hundreds before you, if not properly disinfected. In short, hookah isn’t a harmless dessert—it’s a real microbial hotspot on your balcony.

And secondly, even if your immune system copes, you can at least be a carrier of these infections and transmit them to your loved ones through direct contact. And if they do get sick, tracing the chain of infection from the hookah to them will be an absolutely fantastic task for you. Just think about it, how many times has this happened before?!

OK, I AGREE. BUT I PERIODICALLY WASH MY HOOKAH WITH DETERGENTS, AND I’VE SEEN HOOKAH BAR’S USING STEAM GENERATORS. ISN’T THAT ENOUGH?

— As research has shown, no. A steam generator, which is essentially an autoclave, doesn’t work at all. The temperature and pressure it produces aren’t enough to kill them; in fact, it actually promotes their proliferation. These parameters are much higher in an autoclave, and the processing time there starts at an hour, compared to 10 seconds with a steam generator. And conventional detergents currently on the market aren’t effective at disinfecting. The main difference between detergents and disinfectants is their mechanism of action. Detergents do clean, removing dirt, grease, and molasses from the surface. But they don’t have a detrimental effect on the microflora; they can only have a “disinfecting effect” by washing away some of it, at best. Washing away the biofilm in hard-to-reach areas of the hookah is essentially physically impossible, and anything that remains will easily re-spread across the wet and warm walls of the hookah. Don’t confuse “effect” with “property.” Marketing is powerful, of course, but you wouldn’t disinfect a wound with Tide or wash a T-shirt with hydrogen peroxide, would you? Each product has its own limited properties. A disinfectant doesn’t just remove microflora; it kills it! Its mechanism of action is aimed specifically at disrupting cell function by destroying its membrane. Detergents don’t have these properties, despite what manufacturers might tell you in their advertising slogans. Please don’t confuse them!

— SO IT TAKES PLACE THAT THE HOOKAH NEEDS TO BE DISINFECTING, THEN THE RISK IS REDUCED TO ZERO?

“Absolutely right. Moreover, in addition to smoking safely, you’ll also experience a cleaner flavor from the filling. After all, hookah devices, as you probably know, smell disgusting after repeated use. The lion’s share of the foul odor, as in everything that smells bad, comes from the waste products of infectious agents. Hookah hygiene is just as important as personal hygiene in everyday life. There’s no point in fussing over mixes or smoking expensive, non-stick tobacco when you won’t understand the joys of a dirty device. Once you smoke a clean hookah, you won’t be able to return to a dirty one. This will be your step toward mindful smoking and self-respect. And for hookah establishments, disinfection isn’t just a necessity, it’s a duty.” Guests trust the hookah master as an expert and are confident that they won’t allow an infected device to be brought to them. Reputational risks are still a concern. Furthermore, the risk of infection, both for the hookah master, who is always unavailable for replacement, and for the regular guest who handles the cash register, are not ideal for any establishment and will negatively impact social distancing.

“OK, you’ve convinced me, but what’s the proper way to disinfect a hookah now? Should I use alcohol or some kind of pharmacy antiseptic?”

“You can, but it’s not the best solution. Laboratory studies have shown that alcohol concentrations below 70% are ineffective against the qualitative and quantitative composition of infections. And high concentrations can damage the appearance and internal components of the device over time. Chlorine-containing cleaners should absolutely not be used, as they also require a high concentration of solution to be effective, and it’s impossible to completely wash it away. If even a small amount remains on the walls of the hookah, the chlorine molecules will convert to toxic volatile compounds when heated and enter the body during smoking. This will have an extremely negative impact on your health, especially your nervous system. The same applies to plumbing cleaners like Shumanit/Azelit and window cleaners; their use for cleaning hookahs is strictly prohibited, especially in establishments (SanPiN, hello). The dangers of using them go without saying.” All this not only fails to disinfect the hookah, but turns it into a dangerous toxic weapon. It’s safer not to clean it with anything. Each product must be used according to the approved instructions and strictly for its intended purpose. There’s no point in reinventing the wheel; the same old story will happen, you know.

— SO WHAT SHOULD I USE THEN?

“All the work, my friend, has already been done for you by scientists and specialized agencies. Google the website “EAC Unified Register of State Registration Certificates (Russian entity)” and carefully study which products are currently registered specifically as hookah disinfectants, not just cleaning products, by searching for “hookah.” You’d be surprised how many aren’t listed there at all. Any disinfectant entering the market must undergo extensive testing by various research institutes, have a state registration certificate (as a hookah disinfectant), a declaration of conformity, and, most importantly, instructions for use approved by a specialized federal agency. The disinfectant must be effective against all hookah-related infections and be safe to use, both for humans and for the hookah apparatus. Cleaning products don’t require such complex criteria. As of 2025, there’s only one sanitizer on the hookah market that has passed all the necessary tests and has all the necessary documentation, approved by Rospotrebnadzor: Spell Hookah Clean. Don’t trust manufacturers’ advertising, or even me. Always check all the information in government registers, read the studies and ingredients, and request all the documentation from the manufacturers whose products you use. Research the topic, take care of your health, and take proper hygiene seriously. When you’ve finished smoking this bowl, wash your hookah properly—now you know how and why.

“YOU’RE RIGHT, I DIDN’T KNOW THAT. IF HOOKAH SMOKING CAN BE MADE SAFER AND TASTIER, WHY NOT?!”