Waterpipe Tobacco: Is Shisha healthier than smoking cigarettes?

WHO has declared 31 May World No Tobacco Day.. While most of us are relatively well-informed about the dangers of smoking pipes and cigarettes, one form of tobacco is still the subject of great misunderstanding – waterpipe tobacco, often known as “shisha”. The School of Public Health of The University of Hong Kong was commissioned byHong Kong Council on Smoking and Health (COSH) to conduct a survey to understand the perception of waterpipe tobacco smoking among young adults. The survey found nearly 95% of respondents reporting awareness of waterpipe tobacco smoking. Around 30.4% and 13.4% of respondents had ever used waterpipe tobacco and were current waterpipe smokers respectively. Also, over one-fourth of never-using respondents were susceptible to waterpipe smoking.¹

In addition, the majority of respondents perceived traditional cigarettes were more harmful than waterpipe; and traditional cigarettes were more addictive than waterpipe. This reflected that young adults underestimated the adverse effects of waterpipe smoking on one’s health.¹

Contrary to popular belief, waterpipe tobacco does have well-documented adverse health effects. Don’t be fooled by its sweet, fruity taste – the health consequences are anything but sweet! Here are just a few myth-busting facts about waterpipe tobacco.¹

What is waterpipe tobacco?

Waterpipe is a tobacco-smoking device that originated from India and the Middle East. The main components of waterpipe are the tobacco bowl and water bowl. The tobacco is usually heated by charcoal to give off smoke which passes through the water bowl and is inhaled by the smoker through the hose of the waterpipe. ¹

What kinds of waterpipe tobacco are there?

The appearance of a waterpipe is usually fancy and attractive. The waterpipe tobacco also comes in different flavours. Mixing tobacco with honey, syrup, fresh leaves and various dried fruits, the flavours created can be fruity and sweet, such as strawberries, oranges, peaches, or even red wine or milk, eliminating the usual unpleasant smell of cigarettes. The appealing and aromatic smoking experience is one of the reasons it attracts youth and non-smokers.

Is smoking waterpipe tobacco healthier than smoking cigarettes?

Shisha smoke does contain carcinogenic substances associated with burning tobacco such as formaldehyde and benzene, and even heavy metals. And while many believe in the myth that the water “filters” out these harmful substances, science says different – studies of the blood and urine of shisha smokers reveals that they have similar levels of exposure to most of these toxins as cigarette smokers! A U.S. study pointed out that in an average session, waterpipe smokers inhale more than 125 times the volume of smoke, 25 times the volume of tar, 2.5 times the volume of nicotine and 10 times the volume of carbon monoxide compared to smoking one cigarette.2 Therefore, it is an absolute misunderstanding for thinking smoking waterpipe tobacco is healthier than smoking cigarettes.

Is waterpipe tobacco addictive?

Any form of tobacco contains nicotine, and nicotine is addictive. Waterpipe smokers exhibit behavioural symptoms of nicotine dependence after use. If you don’t want to be chained to an unhealthy habit, the safest course is to avoid shisha altogether.

Symptoms of nicotine withdrawal include³:

• Anxiety
• Depression
• Difficulty concentrating
• Restlessness
• Increased appetite
• Insomnia

Is second-hand shisha smoke harmful?

In fact, it can be even more harmful than second-hand cigarette smoke, because waterpipe second-hand smoke contains higher levels of carbon monoxide, polycyclic aromatic hydrocarbons and volatile aldehydes (all toxins associated with increased risk of heart and lung diseases, and elevated cancer risk) than cigarette smoke.

Extended Reading:

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Although establishments such as bars and party rooms are forced to close under government regulations in regards to the COVID-19 situation, some of the Shisha bars are still operating in secret.

WHO has announced that waterpipe smoking encourages the transmission of COVID-19 in social gatherings⁴. A doctor also pointed out that smoking waterpipe at a Shisha bar has a higher risk of being infected than having a meal at a restaurant. The waterpipe apparatus is usually not cleaned properly after each smoking session, plus the mouthpiece and hose are often shared between users, increasing the potential for the transmission of infectious diseases between users.⁵

Any kind of tobacco smoking is harmful to the cardiovascular and respiratory systems, making smokers more vulnerable to COVID-19 illness and increasing the risk of suffering from serious symptoms4. Scientific research shows that among COVID-19 patients, smokers are 1.4 to 2.4 times more likely to suffer from serious symptoms and death than non-smokers.⁶

So whether you use waterpipe tobacco regularly, or consider yourself a social shisha smoker, for the sake of reducing the risk of infection, for better health and the wellbeing of loved ones around you, 31 May presents the perfect opportunity to shun this habit for good.

Sources:

1. https://www.ucsfhealth.org/conditions/nicotine-dependence/symptoms
2. http://www.emro.who.int/tfi/know-the-truth/tobacco-and-waterpipe-users-are-at-increased-risk-of-covid-19-infection.html
3. https://hk.on.cc/hk/bkn/cnt/news/20200728/bkn-20200728050052010-0728_00822_001.html
4. https://www.fhb.gov.hk/blog/cn/2020/post_20200531.html