Waterpipe smoking, also known as shisha, goza, narghile, ghalyoon, or hookah, is a popular method of tobacco consumption in many parts of the world, particularly in the Eastern Mediterranean Region. This traditional practice involves smoking tobacco through a water pipe, where the smoke is filtered through water before being inhaled by the user. However, contrary to popular belief, waterpipe smoking is not a safe alternative to cigarettes and poses significant health risks.
Understanding Waterpipe Smoking
A waterpipe consists of a small bowl with holes in the bottom, which is attached to a tube linked to a water container. The tobacco product is placed in the bowl and heated with hot charcoal, producing smoke that is drawn through the water and into the user's lungs by puffing on a hose connected to the water container. This process is believed to cool and purify the smoke, leading to the misconception that waterpipe smoking is less harmful than cigarette smoking.
The Health Risks of Waterpipe Smoking
Contrary to popular belief, the smoke produced by a waterpipe is not purified by passing through water. In fact, waterpipe tobacco use is damaging to health in similar ways to cigarette tobacco use. The smoke produced by waterpipe tobacco contains significantly higher nicotine content than cigarettes, with one head of unflavoured tobacco equivalent to 70 cigarettes. Additionally, waterpipe tobacco contains numerous toxins known to cause lung disease, cancer, heart diseases, and other illnesses.
Even after passing through water, the smoke produced by a waterpipe still contains high levels of toxins, including carbon monoxide, metals, and cancer-causing chemicals. A typical 1-hour long waterpipe smoking session involves inhaling 100–200 times the volume of smoke inhaled with a single cigarette. Furthermore, the fuels used to heat waterpipes, such as wood cinders and charcoal, produce toxins that contain high levels of carbon monoxide, metals, and cancer-causing chemicals.
Second-hand smoke from waterpipes is also a serious health risk, as it is a mixture of tobacco smoke and smoke from the fuel. This poses a significant danger to those inhaling it, especially children. Waterpipe use or exposure to second-hand smoke from a waterpipe can also have adverse effects during pregnancy and is linked to chronic bronchitis, respiratory disease, and the transmission of hepatitis and herpes viruses.
The Increasing Use of Waterpipe Tobacco
Waterpipe tobacco is highly addictive, and its use is rapidly increasing, especially among young people and women. In the Eastern Mediterranean Region, rates of waterpipe tobacco use among boys aged 13–15 are as high as 14%, compared to 7% cigarette use. Among girls aged 13–15, rates of waterpipe tobacco use are 9%, compared to only 2% cigarette use. These rates are even higher in some countries of the region.
One of the underlying factors contributing to the increasing use of waterpipe tobacco is the misperception that it is less harmful to health than smoking cigarettes. Waterpipe smoking is being marketed as a fashionable and sophisticated activity, appealing to people's sense of identity and heritage. Additionally, waterpipe tobacco is available in sweetened flavors that may particularly appeal to young people and women.
Unfortunately, waterpipe tobacco has not been subjected to the same level of regulation as cigarettes. In most countries, the tobacco mixtures sold for waterpipe use do not carry health warnings on their packaging, reinforcing the perception that waterpipe tobacco use is relatively safe. Some waterpipe tobacco mixtures even claim to contain no tar, a technically accurate but misleading statement as tar is produced during the combustion of tobacco.
Is Waterpipe Smoking Safe?
No, waterpipe smoking is not safe. Contrary to popular belief, passing smoke through water does not filter the toxic substances present in tobacco smoke. Waterpipe smokers inhale toxic substances emitted by burning tobacco and the coal used to heat the tobacco, as well as second-hand tobacco smoke. While waterpipe smokers may smoke less frequently than cigarette smokers, they tend to inhale the smoke deeply into their lungs due to the greater force needed to pull air through the water pathway. This increases the inhalation of carcinogens present in the smoke.
Waterpipe smoking is associated with several negative health effects, including respiratory symptoms, decreased pulmonary function, and increased risk for lung diseases such as chronic obstructive pulmonary disease (COPD). It is also linked to increased risk for arterial stiffness, ischemic heart disease, and various types of cancer, including lung cancer.
Despite its popularity and the misconceptions surrounding its perceived safety, waterpipe smoking is far from harmless. It poses significant health risks and is not a safe alternative to cigarette smoking. It is essential to raise awareness about the dangers of waterpipe tobacco use and implement regulations to protect public health. Understanding the reality of waterpipe smoking is crucial in promoting informed decision-making and reducing the prevalence of this deceptive trend.
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