The other day, a friend called to ask whether I would consider writing an article on shisha smoking.
She has been studying non-communicable and lifestyle-related diseases and is concerned that the many Kenyans smoking shisha are unaware of the harm associated with this pastime. As I mentioned recently, we as a nation tend to focus so much on infectious diseases or the traditional disease risk factors that we totally fail to notice new diseases and habits that subtly creep up on us and which are harmful.
Shisha smoking has become a craze of sorts in Nairobi and other cities. It looks cool, makes for good bonding or hangout, and even smells nice. It is not your typical cigarette, so it must be safe, right? Wrong. Unknown to many, smoking shisha may actually end up being more harmful than regular cigarettes.
We shall find out why.
There must be some asking, what is shisha?
Shisha smoking also goes by the terms hookah, narghile, qalyân, waterpipe, or hubble bubble smoking. This is a form of smoking tobacco through a bowl and tube or hose. The tobacco is usually mixed with fruit, herbs, or sugar from molasses. Often, the tube is shared and several people smoke around a table.
The smoke has a fruity, sweet, or scented aroma depending on what the tobacco is mixed with. It is because of this aroma that many people assume smoking shisha is safe; in fact, many assume it has no tobacco. Even I once had a puff, but thank God I decided not to take a second one!
In a shisha bowl/pipe, the tobacco is mixed with herbs, fruit or molasses sugar, which make it damp. The tobacco is then heated using wood, coal, or charcoal. The smoke passes over water before you inhale it. So, in addition to the nicotine, tar, and other harmful compounds in the tobacco, one is exposed to other toxins, including carbon monoxide from smoking the heating process.
In one puff of shisha, you have smoked the equivalent of one cigarette. In fact, the World Health Organisation and other experts estimate that in just one session of shisha, which lasts about an hour, one has inhaled the equivalent of 100 cigarettes.
How is it harmful?
Since shisha contains tobacco, one can expect to be exposed to similar illnesses like other cigarette smokers, including heart disease, cancers, and lung disease. Even in non-tobacco containing shisha, there is carbon monoxide and other toxins from burning coal and charcoal that you will be inhaling. Also, if you are in a shisha bar, even if you are not smoking, you passively inhale other smokers’ shisha, hence are also at risk.
Tobacco in shisha, just like in cigarettes, contains nicotine, hence it is addictive. You may start smoking just for fun or on weekends with friends and find yourself hooked. Also, as the pipe is usually shared, there is risk of contracting hepatitis, TB, and other diseases if your friends have them.
Where did it come from?
It is not clear exactly whether it came from India or Persia, but shisha smoking has been practised by many Middle Eastern and Asian communities for generations. It is now becoming trendy in Western countries as well as African countries like Kenya. Young people are getting drawn to it due to the ‘“cool” scented aromas and the coolness of hanging out in shisha bars. Favourite flavours include coconut, plum, and mango.
What to do if addicted?
If you find yourself addicted to shisha or cigarette smoking, there are places you can get help to quit. First, talk to your doctor. There are nicotine patches that can be used as well as other psychological support systems for those keen to quit.
The writer is a doctor and public health specialist. Send your questions to [email protected]