July 28, 2007

Shisha, traditionally known as hookah was considered to be an integral part of rural south Asia. One can still picture a shaded spot under a tree in rural Pakistan where three or four elderly folks will sit on a charpai and take turns in sucking tobacco from the contraption which is known as a water pipe. Even a decade ago, one could not have imagined that this rural derelict will become a fashionable pastime of the rich and idle in all our big cities. Though shisha smoking emulated from the west, its strong cultural background played a central role in its social acceptance. So, now hookah or shisha, as it is known commonly, has cemented its place within our younger society as a means to shoot the breeze.

As already mentioned hookah was considered to be a way of consuming tobacco in rural Pakistan. Suddenly at the turn of the century we saw a fast bloom of hangouts in posh localities which started keeping hookahs or shishas for our younger generation to come, relax and take a swig of tobacco with their favourite flavour while at the same time chatting idly about their lives and most importantly what is happening in other people’s life. This sudden sprouting of these joints selling nicotine instead of caffeine was instigated by a rise in popularity of shisha in the west. Numerous hangouts of middle-eastern origin in large cities like Houston, New York, Chicago and London started keeping the water pipe for tobacco users. This new trend also became popular with the western locals. So, like any other western vice, this new fad soon caught-up in our own up-market backyards.

Shisha smoking is associated with a lot of misconceptions spread by the café owners. Some of them are:

• Shisha smoking is less dangerous than cigarette smoking because the nicotine content is lower.

• Tobacco toxins are filtered out by the water in the pipe.

• Shisha smoking is less irritating and therefore less toxic to the respiratory tract.

• Fruit flavours added to the tobacco makes shisha smoking a healthy choice.

In reality the hazards associated with water-pipe smoking are manifold and these range from nicotine addiction to diseases associated with tobacco smoking and last but not least infections from pipe sharing. Water pipe tobacco smoking delivers nicotine, and, as is common with other tobacco products, frequent use is associated with addiction. Indeed, a water pipe smoking session may expose the smoker to more smoke over a longer period of time than when smoking a cigarette. According to the World Health Organisation (WHO), a water pipe smoker may typically inhale as much smoke during one session as a cigarette smoker would inhale by smoking 100 or more cigarettes.

Furthermore, even after it has been passed through water, the smoke from a water pipe contains high levels of toxic compounds including carbon monoxide, heavy metals, and cancer-causing chemicals. Therefore the perception that this form of tobacco is less detrimental to health is a total sham. A single inhalation from a water-pipe contains two to four per cent of nicotine as compared to one to three per cent from a cigarette. While cigarettes contain about 0.4 per cent carbon monoxide, another deadly toxin, water-pipe can have up to 1.4 per cent of it in one single inhalation. Another problem with water-pipe smoking is that it exposes the user to more smoke per minute as compared to a cigarette.

Apart from becoming addicted to nicotine and exposed to slow poisoning from carbon monoxide, shisha also helps in spreading infectious diseases. Sharing the mouth piece can lead to hepatitis and tuberculosis. This is in addition to all the ailments associated with tobacco smoking.

In a nutshell, shisha or water-pipe smoking is as bad for health as other forms of smoking and may invite some additional health risks which are not present in cigarette smoking.