THE other day I was at a five-star hotel in Karachi and was shocked to see many young people smoking shisha. Unfortunately shisha culture is on the increase in Pakistan. I recently attended a conference held in the UAE in which world experts on shisha raised their concern on this rising global epidemic. Shisha is a form of smoking in which tobacco is served, mixed with various fruity flavous.

According to a research done early this year in 71 educational institutions, covering six major cities of Pakistan, prevalence of regular shisha smoking was found to be 20 per cent. There is a common misconception amongst the users that smoking shisha is not as harmful as smoking cigarettes because fumes are filtered out when it passes through water.

Scientific studies regarding the adverse health consequences of smoking shisha point to dangers that are worse than those associated with smoking cigarettes. Lung cancer, cancers of the esophagus, chronic obstructive lung disease, emphysema, low birth weight, precipitation of asthma attacks and pneumonia are some of the health hazards linked with shisha smoking. Children are particularly vulnerable to the harmful effects of shisha use According to WHO, an average pipe smoking session of shisha may be as bad as smoking up to 200 cigarettes.

The smoke from shisha, besides other toxic elements, contains hundreds of potentially dangerous heavy metals like arsenic, cobalt, chromium and lead. . According to a study conducted on the tobacco smoke pollution in the Pakistani restaurants, it was noted that the mean PM2.5 (a sensitive marker of tobacco smoke) value was 101 ìg/m3 for non-smoking venues, 689 ìg/m3 for cigarette smoking venues and 1,745 ìg/m3 for shisha smoking venues. Such high-level of environmental tobacco smoke in shisha cafes has serious consequences on the health of those who get exposed to it.

There is an urgent need to educate the public against the dangers of shisha use. Our health professionals, electronic and print media people, religious scholars need to come forward and educate the public against shisha use. The government must take measures to implement the current anti-smoking laws which strictly prohibit serving shisha inside any public place, including hotels, cafés and restaurants.

JAVAID A. KHAN
Chair, National Alliance for Tobacco Control & Professor of Medicine,
The Aga Khan University
Karachi