A hookah (shisha or waterpipe) is a single-or multistemmed instrument that has been used for smoking various flavoured substances, such as cannabis, tobacco and opium, for centuries and is popular in the Indian subcontinent, the Arabian peninsula, Kenya, South Africa, Turkey, United States and Canada. Across the US, 2.6 million people smoke hookah, and the number of “hookah bars” has mushroomed, with 100 million hookah users globally. 2, 3 In Canada, its high prevalence, in particular among young adults, is a matter of growing concern. 4 Smoking has emerged as an independent risk not only for transmission but also for severity of coronavirus disease 2019 (COVID-19). 5 Similarly, hookahs are ideal for transmission and may exacerbate the risk for severe COVID-19 through shared use. They have difficult-to-clean long pipes and a cold water reservoir, ideal for transmission of SARS-CoV-2. Furthermore, hookah tobacco smoke contains several hazardous chemicals that injure the respiratory lining and predispose the smoker to viral infections, tuberculosis and other infectious diseases, and the coronavirus is no exception.