Young adults who smoke using water pipes were shown to have increased exposure to nicotine and cancer-causing agents.

According to a new study, chronic water pipe-smoking caused young adults to have significant levels of nicotine, cotinine, carcinogens, and volatile organic compounds (VOCs) in their urine. Such elevated levels of these agents can increase the risk of developing cancer and other chronic health diseases.

Gideon St. Helen, Ph.D., postdoctoral fellow in the Division of Clinical Pharmacology and the Center for Tobacco Control Research and Education at the University of California, San Francisco, and study colleagues suggest the possibility of addictiveness of smoking with a water pipe, and the hazardous effects on the brains of developing children and youths who use them.

Researchers involved in the study analyzed 55 healthy young adults between the ages of 18 and 48 years who were experienced water pipe-smokers. After ceasing smoking for one week, the participants provided a urine sample, then resumed their water pipe smoking habits. Another urine sampled was provided, and a form was filled out which detailed their smoking session. Another urine sample was collected the following morning to identify how much of the tobacco and other agents left their systems.

The researchers discovered that levels of nicotine, cotinine, and NNA remained elevated in the urine samples collected the next day.

“Water pipe smoking is generally perceived to be a safe alternative to cigarette smoking, even for children and youths. Our study shows that water pipe use, particularly chronic use, is not risk-free,” said St. Helen in a statement.

The findings of the study are published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.