Dangers of Water Pipe Smoking

Commonly known as ‘sheesha’ or ‘huqqah,’ water pipes and smokeless tobacco including both snuff as well as chewing tobacco, pose health dangers that are little understood by users. Contrary to popular belief, water pipes and smokeless tobacco are not a safe alternative to cigarettes, and there is no proof that any device or accessory can make water pipe smoking safer. It is often wrongly believed that the smoke is purified when passing through water in a water pipe. Using a water pipe to smoke tobacco may seriously damage the health of a smoker and of those exposed to the second-hand smoke emitted. According to the research carried out by the World Health Organisation, water pipe tobacco has significantly higher nicotine content than cigarettes. One head of unflavoured tobacco has nicotine equivalent to 70 cigarettes. Water pipe tobacco also contains numerous toxins known to cause lung cancer, heart diseases, and other illnesses. Even after it has been passed through water, the smoke produced by a water pipe contains high-level of toxins including carbon monoxide, metals and cancer-causing chemicals. A typical one-hour long water pipe smoking session involves inhaling 100-200 times the volume of smoke inhaled with a single cigarette. Secondly, the fuels used to heat water pipes, including wood cinders and charcoal, produce toxins that contain high levels of carbon monoxide, metals and cancer-causing chemicals. Second hand smoke from water pipes is a mixture of tobacco smoke and smoke from the fuel, and therefore, poses a serious risk for those inhaling it. Water pipe use or exposure to second-hand smoke from a water pipe can also have adverse effects during pregnancy. Thirdly, water pipe use is linked to chronic bronchitis and respiratory disease. It also facilitates the transmission of hepatitis and tuberculosis, being responsible for an estimated 17 per cent of the total TB cases in the Eastern Mediterranean Region of the World Health Organisation. Similarly, smokeless tobacco also contains cancer-causing toxins and its use increases the risk of cancers of the oral cavity (such as cancer of the mouth, tongue, lips and gums). The nicotine in smokeless tobacco is more easily absorbed than by smoking cigarettes. As more permissive attitudes gain ground, the use of water pipe and smokeless tobacco is increasing among women. Underlying this is the misperception that water pipe and smokeless tobacco use are less harmful to health than smoking cigarettes. In addition, smokeless tobacco is easier for young people to obtain than cigarettes and easier to use without drawing attention. Water pipe smoking is becoming part of a new lifestyle trend in many countries including Pakistan, as a popular way to spend time with friends socializing. It is being promoted as fashionable, sophisticated, and a sign of women’s freedom. It is sometimes portrayed a traditional activity, appealing to people’s sense of identity and heritage. Water pipe tobacco is available in sweetened flavours such as apple, strawberry, grape, cherry, mint and cappuccino, making it particularly appealing to young people and women.