The popularity of hookah, also known as shisha and narghile, runs against the anti-tobacco trend, partly because it appeals to teens and young adults. Water pipes also are exempted from some smoke-free laws and enjoy a mystique of being a more cultural and safer alternative to cigarettes. But the truth is every risk of cigarette smoking is also associated with water pipes. There are three terms are highly relevant: narghile, hookah and shisha.
Hookahs are commonly used in Arabic communities for smoking herbal fruits after meals, but it is becoming increasingly popular among young adults in Western Europe for smoking tobacco, massel (aromatic tobacco), cannabis and bango, an intoxicating plant leaf. It is believed about 100 million people use a hookah daily worldwide. Now they are in every college head shop and Middle Eastern market across the entire U.S... It is also growing in popularity in Japan.
The University of Oklahoma newspaper ran an article describing the tensions between campus hookah smokers and campus security. Even off-campus, many hookah cafes run afoul of a new generation of smoking bans that have created skirmishes for hookah bars in many cities.
The tobacco used in shisha smoking is a 1:2 mixture of shredded tobacco leaves and sweeteners like honey, molasses, or semi-dried fruit. In recent years, glycerin, artificial flavorings, and natural extracts have been added to the tobacco recipe to produce a variety of flavors (apple, cappuccino, strawberry, coconut, mango, cola, and mint). The most popular flavor is apple, others include strawberry, pineapple, apricot, grape, rose, mint, and even cappuccino! (There is even an exclusive cola flavor). The trend was initiated in Egypt, during the mid-80s, when Egyptian companies started marketing their tobacco products to women. So this whole flavor business is really nothing more than making the smoking experience a bit more pleasant and soothing to the throat.
"Most people misleadingly believe shisha does not contain tobacco and that when they smoke they inhale herbal products. It is the added flavors that make them feel they are smoking herbs, while they are actually taking in tobacco and are highly likely to become addicted to nicotine. Shisha smokers should realise that it is far more dangerous than cigarette smoking because the amount of nicotine in shisha can not be measured due to packing differences," a doctor in the government sector warned.
Some hookahs can be smoked with a no-tobacco herbal blend. But even then, water pipe smokers still inhale smoke from the charcoal that heats the pipe, said Shelly Kiser, director of advocacy with the American Lung Association of Ohio who helped spearhead the anti-smoking measure.
"Any time you burn anything and inhale it, it's going to damage your lungs," said Kiser said. A shisha is a multi-stemmed waterpipe for smoking substances such as herbal fruits and tobacco. Just like smoking herbal or “natural” cigarettes, herbal shisha exposes the smoker to tar and carcinogens.
It is marketed as being a safe alternative to cigarettes because the percentage of tobacco in the product smoked is low. This claim for safety is false. The water does not filter out many of the toxins. In fact, hookah smoke contains more toxins such as nicotine, carbon monoxide, tar, and other hazardous substances than cigarette smoke. Moreover; infectious diseases can be spread by sharing the pipe or through the way the tobacco.
Thomas Eissenberg, a psychology professor at Virginia Commonwealth University and co-author of a hookah study suggested that a hookah, which is smoked for about 45 minutes, delivers 36 times more tar than a cigarette, 15 times more carbon monoxide and 70% more nicotine.
Dr. Lutz Forkert, associate professor in the School of Medicine, said the volume of smoke is what makes shisha harmful. This is because while cigarette smokers usually spend about five minutes smoking, shisha smokers will take anywhere between 20 to 80 minutes. And although the water filters out some of the nicotine, tar and other chemicals, the sheer volume of smoke being consumed makes up for the small percentage of bad ingredients that are filtered out. “The volume of smoke in a bowl is much higher than a cigarette. … Therefore, it must be that the effects are worse,” he said.
A study in the Journal of Periodontology found that water pipes smokers were five times more likely than non-smokers to show signs of gum disease. The fact that the waterpipe was the trigger of relapse for some cigarette quitters. Thus, initiation of waterpipe use can be a significant unintended consequence of cigarette smoking cessation
In a June 2004 study, Jane Henley, an epidemiologist at the American Cancer Society, found that men who smoked water pipes had five times the risk of lung cancer as non-smokers.
Research suggests that the waterpipes have three additional lethal risks over the risks of smoking cigarettes: flavored tobacco is smoked over coals and fumes from these fuels add new toxins to the already dangerous smoke. According to a recent World Health Organization (WHO) advisory, a typical one-hour session of hookah smoking exposes the user to 100 to 200 times the volume of smoke inhaled from a single cigarette. Even after passing through the water, the tobacco smoke produced still contains high levels of toxic compounds, including carbon monoxide, heavy metals and cancer-causing chemicals (carcinogens). Hookah smoking also delivers significant levels of nicotine — the very addictive substance in tobacco.
Some may wonder why there is no restriction or ban on shisha-smoking as the government has spent a huge amount on the anti-smoking campaign. And why the health authorities are keeping mum on shisha-smoking as it also promotes the use of tobacco?
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