Shisha is a glass-bottomed water pipe in which flavoured tobacco is covered with foil and roasted with charcoal. The tobacco smoke then passes through the water chamber and is inhaled deeply and slowly.

“Most shisha smokers are unaware of the health risks involved,” observes Associate Professor Loo Chian Min, Senior Consultant and Head, Department of Respiratory & Critical Care Medicine, Singapore General Hospital (SGH), a member of the SingHealth group. “Some youths don’t even realize that there’s tobacco involved and so they don’t regard shisha as smoking.”

Smoking shisha has become a trendy pursuit among young people today. Many young adults gather in shisha cafes and share the pipe between friends. They see smoking shisha as a pleasant and relaxing experience and according to a recent study as many as 44% of them believe smoking shisha is less harmful than smoking cigarettes.  But here’s the shocking truth research shows that smoking shisha tobacco is actually more dangerous than smoking cigarettes.

Why do young people think smoking shisha is safer?

Many people wrongly believe that bubbling tobacco smoke through water makes it safe. This false belief first originated in the 15th century when a physician called Hakim Abu Faith wanted to make smoking shisha safer. He believed that if the tobacco smoke passed through a filter it would be safer, so he devised a small receptacle of water that smoke could pass through. However, modern research states that filtering tobacco smoke through cold water does not make it safer.

The ancient belief of a 15th century physician combined with exotic looking waterpipes and a combination of sweet smelling tobaccos, honey molasses and dried fruit, along with deceptive advertising and a lack of information to educate people about the dangers of smoking shisha, has duped young people into believing that smoking shisha is harmless. While, on the other hand, there is widespread awareness about the dangers of smoking cigarettes. It’s no wonder that young people have been conned into believing that smoking shisha is a safer alternative to smoking cigarettes.

Shisha use has some extra harmful risks

Shisha smokers often inhale more smoke than cigarette smokers because of the length of time a shisha session lasts. One session can last up to an hour during which shisha smokers will inhale a large amount of tobacco smoke as well as the second-hand smoke of others. A report from The World Health Organization (WHO) noted that the smoke inhaled in a typical one-hour hookah session can equal 100 cigarettes or more. The WHO report also claims that even after it has been passed through water, shisha tobacco smoke still contains high levels of cancer-causing chemicals. Shisha smoke may also contain combusted charcoal or wood which can increase the chemicals in the smoke that cause cancer and heart disease.

Shisha tobacco smoke can contain:

- up to 36 times more carcinogenic tar than cigarette smoke

- up to 15 times more carbon monoxide

- higher levels of lead, nickel and arsenic

- hydrogen cyanide and a whole bunch of potent carcinogens

- nicotine, a chemical that causes an addictive effect

Also, shisha contains tobacco; therefore, it is linked to the same serious and life-threatening illnesses as cigarettes, such as cancers, heart disease, lung disease and many more.

And, that’s not all! If the shisha pipe is not properly cleaned, sharing it with others can increase the risk of contracting diseases, such as tuberculosis, hepatitis, meningitis and other infectious diseases.

Since smoking shisha involves smoking for a longer period of time, inhaling higher levels of toxins deeper into the lungs and also sharing the waterpipe, there can be little doubt that smoking shisha is not just as dangerous as smoking cigarettes -  but even worse.

Addressing the misconceptions about shisha smoking

Unlike cigarette smoking, which is always portrayed negatively in the media, the harmful effects of shisha smoking are not as well known. “Cigarette boxes sold in Nigeria carry mandatory health warnings but you don’t see similar warnings at shisha joints”.

For a start, shisha is often smoked in a social gathering, in the intimate ambience of a comfortable cafe. It has none of the negativity associated with cigarette smoking. 

Also, shisha boasts natural fruit flavours such as apple, lemon, orange and melon. So those who are not in the know tend to associate shisha with being fruity and healthy. Some may even see it as a safer alternative to cigarettes.

How harmful is it?

But shisha smoking is far from benign.

Shisha smoke is often laced with carcinogens or cancer causing substances. Regular smoking of shisha may lead to cancer of the lungs, mouth, stomach and oesophagus. This is on top of health conditions like impaired pulmonary function, heart disease and reduced fertility.

According to recent research by the World Health Organization (WHO), it is estimated that a smoker inhales half a liter of smoke per cigarette, while a shisha smoke can take in anything from just under a sixth of a liter to as much as a liter of smoke per inhalation.

Meanwhile, experts at the London-based Department of Health and the Tobacco Control Collaborating Centre have found that one session of smoking shisha resulted in carbon monoxide levels spiking to at least four times more than the amount produced by one cigarette.

Sharing a shisha pipe might also expose you to infections such as herpes and tuberculosis. “That’s because the water pipe may be a breeding ground for bacteria”.

However, while many health experts agree on the harmful effects of shisha smoking, there are those who say that its long-term effects have not been properly researched. Also, they claim that shisha smoke is actually 30 times less concentrated in certain chemicals than cigarette smoke.

“Despite these contradictory viewpoints, shisha smokers should keep in mind that it is not as harmless an activity as it seems,”

The perils of second-hand smoke

Even if you’re not smoking shisha, just sitting with your friends at the same table exposes you to dangerous second-hand smoke.

Breathing in this less-than-desirable smoke means that you face an increased risk of health conditions like:

Rhino sinusitis, an inflammation of the nose or sinuses

- Asthma

- Coughing and sore throat

- Cancer

- Heart disease

So if you don’t smoke shisha, it will be better if you didn’t hang around a shisha lounge. And if you do smoke shisha, I think it's time to quit.

By Frank Oluwafemi