The study of the influence of inhalation psychoactive substances (PAS) on the respiratory system is an important issue, given the speed and trend of the spread of various inhalation devices. Hookah is a device for smoking tobacco, the essence of which is the passage of tobacco smoke through a container with water or other liquids (milk, alcohol). The study was conducted among students of the Northern (Arctic) Federal University named after M.V. Lomonosov (SAFU), and the population permanently residing in the city of Arkhangelsk. The study was conducted from 2020 to 2022. The aim of this article is to compare the indicators of external respiration in individuals using PAS in different ways. Material and methods. External respiration was assessed by spirometry. Spirometry is a fairly simple, non-invasive and informative method for measuring airflows and volumes. The article presents an analysis of spirometry data from 155 people. Group I included individuals not using tobacco products, Group II included cigarette smokers only, and Group III included individuals using tobacco with a hookah. Results. Volume indicators (FVC, FEV1) in Group I were significantly higher than in representatives of Groups II and III (p > 0.01); Also, in Group I, speed indicators were significantly higher. A significant decrease in the FEV indicator was found in Group III compared to Group II (p > 0.01). Also, members of Groups II and III had a significant decrease in speed indicators compared to Group I.