Waterpipe, shisha or hookah smoking is not safer than cigarette smoking. That is the important message presenting the clear scientific evidence in a new GASP 3D display called ‘Shisha or Hookah Smoking; NOT a Safe Alternative’. Countering the widely-held, but mistaken, belief that shisha or hookah smoking is safer than cigarette smoking is important as the use of waterpipes, particularly by the young in developed countries, has increased greatly over the past few years.
An ancient practice
Shisha, the origins of which are disputed (some say India, others Persia or Turkey) is a glass-bottomed water pipe in which fruit-flavoured tobacco is covered with foil and roasted with charcoal. The tobacco smoke passes through a water chamber and is inhaled deeply and slowly; the fruit-flavoured tobacco tastes smooth and smells sweet, enthusiasts say, making it an enjoyable and unrushed experience.
The practice of shisha smoking goes back about 500 years. It spread westward and within a century, the modern version of the shisha or hookah was in use throughout the Middle East. It was often used in groups and became a social activity.
Growth in shisha smoking
Currently, shisha/hookah smoking is popular in many countries around the world, and young people seem to be taking it up in increasing numbers. Studies indicate that about 10%-25% of them used waterpipes in the past few months.
Shisha cafes and bars have also appeared particularly in college towns and cities such as London, Manchester and Birmingham. There have been an increasing number of café owners in breach of the smokefree legislation who try to argue that shisha/hookah smoking is different than cigarette smoking, both in how it’s inhaled and how much secondhand smoke it produces.
However, shisha / hookah smoking is not very different than cigarette smoking. The fruity and sweet, flavourings that are used in shisha tobacco, as well its moistness due to being passed through water, and its use as a relaxing social activity, all go to hide the fact that what shisha users and those around them are inhaling is tobacco smoke, with all of the health dangers that accompany it.
Health risks of shisha / hookah
As shisha smoking has taken off across the world, there’s been more research into its health effects.
Shisha smoke, like cigarette smoke:
- contains significant amounts of cancer-causing ingredients, such as arsenic, cobalt, chromium and lead;
- generates heart-disease-causing carbon monoxide in amounts equal to, or greater than, cigarette smoke; and
- has the same addictive properties, which can lead a shisha user to begin using cigarettes, or becoming a user of hookah and cigarettes.
Shisha use has some uniquely harmful risks:
- Shisha users often inhale more smoke than cigarette smokers. Waterpipe sessions often last an hour or more, during which shisha smokers will inhale large quantities of tobacco smoke as well as the secondhand smoke of others.
- Shisha smoke may also contain combusted charcoal or wood which can increase the chemicals in the smoke that cause cancer and heart disease; and
- Sharing the shisha pipe can increase the risk of contracting a diseases, such as tuberculosis, hepatitis, or meningitis.
The devil in disguise
Shisha smoking offers no safe haven from the dangers of cigarette smoking. Despite the social setting in which shisha is used, its sweet flavourings, and its smoother taste, it is a devil in disguise and should be avoided.
Shisha facts and practice:
- Manchester council has collected £21,056.73 from ten prosecutions of shisha cafés in the past year. Smokefree legislation means the cafes are allowed to permit smoking outside but not indoors. But many owners are allowing shisha to be smoked indoors.
- Councils are considering bringing in licensing for shisha cafes, in an attempt to tackle the growing number of back-street premises. Officials fear that more water-pipe bars are moving into enclosed premises, in a bid to escape anti-smoking laws. Councils say licences may be needed because of the health and fire risks associated with shisha.
- Freedom of Information requests suggest a there has been a 210% increase in the number of such cafes since 2007. According to requests submitted to 133 UK councils, by the British Heart Foundation (BHF) for No Smoking Day, the number of shisha cafes nationwide has risen from 179 to 556.
- The World Health Organization advises that a 40-minute session on a waterpipe is the equivalent to the volume of smoke inhaled from at least 100 cigarettes. Yet 84% of those surveyed thought it was fewer than 10. About 44% of young adults, thought it was less harmful than cigarette smoking.
- The estimated findings show that, on average, a smoker will inhale half a litre of smoke per cigarette, while a shisha smoker can take in anything from just under a sixth of a litre to a litre of smoke per inhale.
- The survey suggests more than a quarter of 18-to-24 year olds had smoked shisha.
- Shisha smoking is no longer a pastime for certain ethnic groups, with 8% of people with white ethnicity saying they used it. The same number of non-smokers had also tried it.
- Leicester City Council, is concerned about a worrying trend with shisha establishments trying to avoid legal requirements. They’re locating in back streets, even old industrial units, hidden from view. Customers hear about them via Twitter or Facebook and gain entry by pressing a buzzer by the locked door or making a call from outside on their mobile phone. These places are enclosed, often with doors locked. Health and Safety commented, “They are deathtraps, not just because of the fire hazard, but with the potential for carbon monoxide poisoning from the charcoal-fuelled tobacco.”
- Environmental health officers across the UK are receiving reports of people collapsing through inhaling the smoke. Students are filling their lungs with the smoke, then passing out from the carbon monoxide level starving them of oxygen.
- Birmingham City Council reported that shisha bars are being hired for 18th birthday parties