Effect of Hookah Smoking on Serum Liver Enzymes and Serum Zinc Levels

Background and Objective: Hookah smoking (waterpipe) has become a widespread social habit, often misperceived as less harmful than cigarette smoking. However, it delivers high levels of toxic compounds that may impair liver function. This study aimed to evaluate the effects of hookah smoking on liver enzyme activities (AST, ALT, and ALP) and serum zinc concentration among young adult males. Materials and Methods: A cross-sectional study was conducted at the University of Babylon, Iraq. Forty healthy male participants were enrolled 30 hookah smokers and 10 non-smokers. Blood samples were collected to determine serum levels of Aspartate Transaminase (AST), Alanine Transaminase (ALT), Alkaline Phosphatase (ALP), and zinc, using spectrophotometric assays. Data were analyzed using Student’s t-test in SPSS v26, with p<0.05 considered statistically significant. Results: Hookah smokers exhibited significantly higher mean enzyme activities compared with non-smokers: AST (24.9±10.7 vs. 13.3±2.3 IU/L; p<0.001), ALT (28.1±11.9 vs. 15.3±6.4 IU/L; p<0.01), and ALP (96.3±12.2 vs. 71.8±4.66 IU/L; p<0.01). Serum zinc levels were also significantly elevated in smokers (37.22±6.99 μg/dL) compared to non-smokers (16.52±3.25 μg/dL; p<0.05). Conclusion: Hookah smoking significantly alters liver function biomarkers and zinc concentration, suggesting potential hepatocellular stress and oxidative imbalance. These findings highlight the misconception that hookah smoking is safer than cigarette use.