Contrary to what many people think, smoking the Sheesha is more injurious to health than smoking cigarettes
It is difficult to point out a single source responsible for introducing the Sheesha to the public of Pakistan. Nevertheless, it can be safely said that the Sheesha (also known as water-pipe, or hubble bubble) has gained popularity among the younger lot of the country.
Smoking the Sheesha is a relatively new trend in Pakistan but has been there in the Middle East for well over a decade now. Many people rightly link it to the age-old use of the Hookah to smoke tobacco. The traditional Hookah had lost popularity and was replaced by the cigarette in the early 20th century mainly due to the convenience it offered in smoking tobacco. However, the Hookah now makes a comeback in the form of the Sheesha and it is imperative that the reasons behind this transition are understood to predict the outcome of this development.
Anything new that hits the market creates a wave of fascination which produces a counter-wave of discovery. It is probably the single most contributing factor resulting in scores of young and old Pakistanis having a crack at smoking the Sheesha with the majority of them continuing to do so as a habit.
Shehzad, a 22-year-old, admits smoking the Sheesha publicly with his friends at least once a week in order to relax and unwind. He says that the first three sessions were mainly ‘try-out’ sessions to discover his favourite flavour and boastfully admits that he finally settled for Apple. When asked why would he choose the Sheesha over cigarettes, he said: “It’s more acceptable. In fact, it’s trendy and ‘cool’. My parents won’t complain, as it is not harmful at all and I don’t have to carry it with me all the time as it is not addictive.”
Shehzad’s remarks bring to light a major area of concern, which constitutes a host of misconceptions and lenient assumptions made by Sheesha-smokers and the public in general regarding their health. It should never be forgotten that smoking the Sheesha (similar to smoking cigarettes) involves smoking tobacco, regardless of the flavour that gets into the mouth. A time bomb in a gift-wrap is nevertheless a time bomb and is designed to explode. In the same way, smoking tobacco is bound to be injurious to health (as the country’s Health Ministry insists), irrespective of what it tastes or smells.
“But the water in the Sheesha filters all the harmful ingredients,” said Ali, a 19-year-old student, defending the notion that smoking the Sheesha is harmless. False. Water in the Sheesha may filter some of the harmful ingredients, especially those in solid form. However, the harmful ingredients in the gaseous form escape the liquid as part of the ‘sweet-tasting’ smoke that is inhaled.
It is a well-established fact that tobacco smoke contains a range of harmful ingredients such as carbon monoxide (CO), carcinogens like tobacco specific nitrosamines, and the notorious drug nicotine that is responsible for causing addiction to smokers. A research carried out at the Atomic Energy Medical Centre in Multan and published in Journal Pakistan Medical Association in 1993 indicates that the amount of carbon monoxide in smoke from the Sheesha varies from the type of the Sheesha and can be as high as 1.40 per cent compared to 0.40 per cent in cigarettes. Even the least harmful of the Sheesha, it was found, contained a minimum of 0.38 per cent carbon monoxide. The results indicate that at best the Sheesha smoker is exposed to the same amount of CO as any cigarette smoker and most often he/she is exposed to significantly higher levels of CO.
Further research into the constituents of Sheesha smoke has been carried out in Egypt and Lebanon over the past 30 years. One of these researches was performed at the American University of Beirut and was published in 2003 in Food and Chemical Toxicology Journal. The study involved simulating the smoke produced by the Sheesha by a specialized machine and proved that the smoke contains significant amount of nicotine (the addiction agent) along with other toxic heavy metals such as arsenic, cobalt, chromium and lead. As for tar, the research stated that under normal conditions, smoke produced by a single Sheesha contains approximately the same amount of tar (dry particulate matter) as 20 cigarettes.
Different methods of research to counter-check the above facts have been adopted. An interesting procedure involved checking for carboxyhaemoglobin (COBHb) levels in cigarette and Sheesha smokers after they had been exposed to the respective type of smoke. This study was performed at the Department of Medicine, King Abdul Aziz University in Saudi Arabia and published in the journal, Tropical and Geographical Medicine. Haemoglobin is the oxygen-carrier of blood and delivers this vital gas to different parts of the body. Interestingly, it has a natural inclination towards carbon monoxide. Therefore, any CO inhaled by the smoker is passed on to the blood and the rest of the body. They study showed that COHb concentration in cigarette smokers was 6.47 per cent while in Sheesha smokers was found to be 10.06 per cent (almost 60 per cent more) after being exposed to this type of smoke. The research conclude: “Sheesha smoking as well as cigarette smoking will produce similar harmful effects on the function of ventilatory capacity of both male and female subjects and increase the risk of developing obstructive airway disease, with Sheesha smokers being at a greater risk.”
Other short-term health hazards including the spread of infectious diseases by mouth (if the same Sheesha is used by multiple smokers), and the potential for receiving higher doses of psychomotor stimulant, which can result in physical dependence at some time in the smoker’s life. Even though no major withdrawal symptoms are known, experts believe that the insistence to use the Sheesha even with known health hazards, financial cost, and reported reluctance to quit smoking are more subtle, but definite signs of dependence. It is not rare to find a Sheesha smoker who has been smoking for some time socially now chooses to do so even in solitude, a trend well-known to cigarette smokers.
Like short-term health risks, long-term health hazards have also been predicted by various studies and are similar to those which exist for cigarette smokers. These include the risk of lung and oral cancers, the decrease in pulmonary function, and a high occurrence of cardiovascular diseases among smokers. Smoking mothers face much higher possibilities of giving birth to babies with low birth weight, low Apgar scores and respiratory distress.
Recently, smoking tobacco was banned in public places in New York and a similar action is about to be taken in London. These measures have been introduced to act as a protective shield not for smokers, but for non-smokers. Environmental Tobacco Smoke (ETS) is injurious to health, irrespective of gender and age of the individual which is subjected to it. In Lebanon, an increase in the incidence of respiratory diseases among young children has been linked to their exposure to ETS. Other health hazards in children are similar to those resulting from cigarette smoke, such as upper respiratory function, asthma, and the sudden infant death syndrome. n
It is difficult to point out a single source responsible for introducing the Sheesha to the public of Pakistan. Nevertheless, it can be safely said that the Sheesha (also known as water-pipe, or hubble bubble) has gained popularity among the younger lot of the country.
It is a well-established fact that tobacco smoke contains a range of harmful ingredients such as carbon monoxide (CO), carcinogens like tobacco specific nitrosamines, and the notorious drug nicotine that is responsible for causing addiction to smokers. A research carried out at the Atomic Energy Medical Centre in Multan and published in Journal Pakistan Medical Association in 1993 indicates that the amount of carbon monoxide in smoke from the Sheesha varies from the type of the Sheesha and can be as high as 1.40 per cent compared to 0.40 per cent in cigarettes. Even the least harmful of the Sheesha, it was found, contained a minimum of 0.38 per cent carbon monoxide. The results indicate that at best the Sheesha smoker is exposed to the same amount of CO as any cigarette smoker and most often he/she is exposed to significantly higher levels of CO.
