Man hospitalised for two weeks following complications caused by smoking hubbly

The study revealed that people tend to smoke hookah for longer periods compared to cigarettes, leading to exposure to greater amounts of smoke. 2Picture: Pexels/ Joseph Ruwa

The study revealed that people tend to smoke hookah for longer periods compared to cigarettes, leading to exposure to greater amounts of smoke. 2Picture: Pexels/ Joseph Ruwa

Published Jan 11, 2024


A concerning incident has unfolded in Mahikeng, North West, where Bakang Rankokwa, 30, was left fighting for his life in the ICU for two weeks after suffering a stroke linked to smoking hubbly.

"An X-ray revealed that one of his lungs had a hole and was filled with water and blood," reported SABC News, indicating the severe impact of the incident on Rankokwa's health.

"The nurses told me I was very lucky to have survived this," Rankokwa said.

This cautionary tale has rapidly spread through social media apps like WhatsApp, with concerned parents using the news clip as a warning to their children about the risks of engaging in smoking hubbly.

The stark reality of Rankokwa's condition has fuelled an intense online discussion on the hazards associated with smoking vapes and hubbly bubbly, especially among younger users.

The news clip has become a viral sensation, prompting a much-needed debate on the topic.

"If your parents didn’t send you this clip, you are a saint," joked some netizens, underscoring the widespread concern stirred by this serious health scare.

Sharing the pipe also exposes users to diseases like herpes simplex, hepatitis and TB. Picture: Pexels/Deepak Ramesha

While the clouds of smoke from a hubbly, also known as hookah or shisha, and the sleek design of vape pens might seem inviting, scientists warn that these trendy alternatives to traditional smoking are not free from health risks.

What happens to your body when you smoke shisha?

Despite the social allure, smoking hookah has been linked with many of the same dangers as cigarette smoking. The Centers for Disease Control and Prevention (CDC) points out that hookah smokers actually might get more toxins than typical cigarette smokers.

This is because a hookah session can last much longer than smoking a cigarette and thereby involve more inhalations.

When you light up a hookah, you're inhaling more than just flavoured tobacco. You're also sucking in carbon monoxide, metals, and other carcinogens — substances that are known to increase the risk of cancer.

Long-term, the Mayo Clinic suggests that hookah smoking can contribute to lung cancer, respiratory illness, low birth weight and periodontal disease.

A research team from the School of Public Health and Family Medicine at the University of Cape Town, composed of fourth-year medical students, conducted a study in 2013 titled "Hubbly Bubbly: Masquerading the Dangers".

The study revealed that people tend to smoke hookah for longer periods compared to cigarettes, leading to exposure to greater amounts of smoke.

"Studies investigating the acute and long-term effects of hookah pipe smoking show that there is a risk factor for lung cancer, periodontal diseases, cardiovascular disease, and adverse pregnancy outcomes," the paper said.

Sharing the pipe also exposes users to diseases like herpes simplex, hepatitis and TB.

"Thus, while hookah pipes are commonly perceived to be safer than cigarettes, they may be even more harmful."

The group also found that peer influence is a significant factor in initiating users.

The South African Tobacco Control policy may prohibit smoking in public places but hookah pipes have eluded its reach.

A study done at another local university showed a large proportion of students smoked on campus.

However, it's thought that UCT's strict tobacco-usage policies have deterred the use of hookahs here.


The modern world of e-cigarettes or vapes, is fraught with controversy. While often marketed as a safer alternative to cigarettes, researchers warn against taking that claim at face value.

The American Lung Association has emphatically stated that e-cigarettes are not safe and can cause harm to the lungs.

One ingredient in many e-liquids, nicotine, is highly addictive and can negatively affect adolescent brain development, which continues into the early to mid-20s.

But beyond nicotine, there's alarm over other substances lurking in the aerosol, like diacetyl, a flavouring chemical linked to a serious lung disease called bronchiolitis obliterans or "popcorn lung."

In 2019, the outbreak of EVALI (e-cigarette or vaping product use-associated lung injury) brought the potential dangers of vaping to the forefront.

The CDC has indicated that vitamin E acetate, typically used as a thickening agent in vaping products, was strongly linked to the EVALI outbreak.

The slow burn of damage

The real kicker with both hookah and vaping is the cumulative effect over time. While the damage isn’t always immediate, consistent use can lead to chronic health issues.

The World Health Organization (WHO) warns that cardiovascular diseases, cancers and a range of respiratory conditions can emerge down the line due to these smoking habits.

Especially for the youth, where vaping has seen a dramatic uptick, the future health implications are concerning. Many experts have warned that nicotine exposure during adolescence can disrupt the formation of brain circuits that control attention, learning, and susceptibility to addiction.

Recent troubling incidents have highlighted the severe health risks associated with smoking hookah, commonly known as shisha.

In a concerning case reported by PEOPLE magazine, a gathering revolving around a five-hour-long hookah session resulted in a frightening trip to the hospital for Rachel Micheaux and her friends in November 2023.

Micheaux revealed that her carbon monoxide levels reached a hazardous 17%, indicating severe poisoning. According to information from the National Institutes of Health, levels surpassing 20-25% are associated with severe poisoning, with abnormal readings considered at 3-4% for nonsmokers and 10% for smokers.

The women required five hours of oxygen therapy to aid their breathing. Thankfully no one died.

Despite common misconceptions, the perceived harmlessness of hookah is misleading. It contains a cocktail of hazardous substances, with elevated levels of carbon monoxide compared to cigarette smoke, along with compounds such as tar, heavy metals, lead, and nickel.

These toxic ingredients, particularly the cancer-causing agents, known as carcinogens, pose significant health threats, including cancer and various other serious health issues.

The dangers of smoking hookah extend to long-term health problems, including a heightened risk of cancer, diminished lung function, decreased fertility and an increased likelihood of heart disease.

Rankokwa’s alarming case serves as a stark reminder of the severe dangers posed by the use of hookah, dispelling illusions of its safety over traditional tobacco products and emphasizing the urgent need for awareness of its potential health hazards.