Shisha - A Delicious Killer
Wednesday, December 8, 2010
By Dr. Syed Fahim Ahmed
Shisha also known as Hookah or Water Pipe is known to man kind for over 300 years. Shisha offers a mixture of crude types of tobacco fermented with molasses and fruits and the sweet odour of fruits conceals the natural smell of tobacco’s tar and nicotine. It has been claimed that more than 100 million people worldwide smoke Shisha daily. It is a common practice in the Middle East, Turkey, India, Pakistan, Bangladesh, and some Parts of China. Shisha tobacco is available in a variety of flavors, such as apple, mint, cherry, chocolate, coconut, licorice, cappuccino and watermelon. Shisha smoking is typically practiced in groups, with the same mouthpiece passed from person to person.
In Pakistan tobacco sale is prohibited by law to anybody under the age of 18. Smoking is also prohibited at all public places, including hotels and restaurants. It is indeed sad that by allowing cigarette and shisha smoking in these closed premises, the anti-smoking laws of the country are being openly violated by almost all hotels and restaurants in the country.
Unaware of the fact that shisha, or water-pipe smoking, is just as harmful as cigarette smoking, the city’s youth, particularly university-level students, are getting hooked to these shisha’s and that too with parental approval .
A large number of school and college students of both genders belonging to under-18 age group can be seen using shisha at most restaurants and hotels of the country. In fact, every day new shisha cafes are opening up in the country because of its increasing demand by the younger generation.
MYTH ABOUT WATER-PIPE SMOKING
A widespread myth about water-pipe smoking or shisha is that the passage of smoke through the steaming water in water-pipes ‘purifies’ the smoke of all harmful elements.
It has now been established, however, that exposure to carbon monoxide and nicotine after water-pipe smoking is at almost the same levels as those associated with cigarette smoking.
It has also been proven that long-term habitual use of water-pipes, as with regular cigarette smoking, is associated with lung, gastrointestinal and bladder problems as well as pulmonary, cardiovascular and hematological disease. Other dangers include infections such as tuberculosis, hepatitis C, pulmonary aspergillosis and Helicobacter pylori infection.
HEALTH HAZARDS OF SHISHA
The turn of the 21st century saw many transformations in the health sector. The move from curative to preventive and promotive health care is strengthening and the emphasis is now on improving the quality of life. Against all the positive advancement in health care, the 21st century also witnessed an unprecedented rise in elements bent upon destroying life; among them tobacco remains the number one factor adversely affecting the health of mankind. Though the developed world has controlled its usage, to some extent through strong legislation, yet no such laws are properly enforced in developing countries.
Several Scientific studies done to see the adverse health consequences of shisha smoking point to dangers that are similar to those associated with cigarette smoking. The research conducted on Shisha use has clearly shown that it has particularly serious health consequences on 2 vital organs of body namely the lungs and heart. Lung Cancer, Cancers of the Food Pipe, Chronic Obstructive Lung Disease, Emphysema, low birth weight, precipitation of Asthma attacks and pneumonia are some of the health hazards associated with shisha smoking.
Additional dangers not encountered with cigarette smoking are infectious diseases resulting from pipe sharing and the frequent addition of alcohol or psychoactive drugs to the tobacco. Another worrying aspect of shisha epidemic is that previously it was used in countries like Pakistan and India, mainly by the elderly people living in the villages but in the past few years its use has markedly increased in the urban areas of this subcontinent. Many restaurants in urban areas are now offering Shisha to their customers.
Smoke from Shisha besides others contains hundreds of potentially dangerous heavy metals like, Arsenic, Cobalt, Chromium and Lead. Under normal Shisha use the smoke produced from a single pipe use contain approximately the same amount of Nicotine and Tar equivalent to 20 Cigarettes. Research has also shown that after 45 minutes of Shisha use expired air, carbon monoxide, plasma nicotine and heart rate are significantly elevated. Nicotine dependence may also result from repeated inhalation of tobacco smoke from Shisha. Besides Lung Cancer Shisha use is also linked with increased risk of, Mouth and Urinary Bladder Cancer.
According to recent studies the pipe could act as a good medium for conveying bacteria causing infectious diseases like Hepatitis A that can be easily transmitted when shisha pipe is used by multiple smokers.
Research showed that people who regularly smoke shisha can suffer from dangerous levels of carbon monoxide (CO) similar to that of inhaling a car exhaust.
According to the research, one session of shisha smoking can result in CO level at least five times higher than the amount inhaled by one cigarette. This high level of CO not only can cause brain damage but may also result in death.
HOOKAH SMOKE AND CANCER
The charcoal used to heat tobacco in the shisha increases the health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals.
Even after it has passed through water, the smoke produced by a shisha contains high levels of toxic compounds, including carbon monoxide, heavy metals, and cancer-causing chemicals.
Shisha tobacco and smoke contain numerous toxic substances known to cause lung, bladder, and oral cancers.
Irritation from exposure to tobacco juices increases the risk of developing oral cancers. The irritation by tobacco juice products is likely to be greater among shisha smokers than among pipe or cigar smokers because shisha smoking is typically practiced (with or without inhalation) more often and for longer periods of time.
The prevalence of periodontal (gum tissue) diseases in the study conducted by Dr. Kenneth A. Krebs, president of the American Academy of Pediatrics, was 30 percent among shisha smokers, 24 percent in cigarette smokers and eight percent in non-smokers. Research from this study shows that the relative risk for periodontal disease increased five-fold in water pipe and 3.8-fold in cigarette smokers, compared to non-smokers.
HAZARD OF SHISHA DURING PREGNANCY
Since a mother and her fetus have connected blood systems; cancer-causing chemicals such as tobacco can pass through the placenta, the tissue and blood vessels which nourish the baby. As a result, it can then travel through the umbilical cord and into the body of a developing baby. Hence when you smoke during pregnancy:
· You could have a miscarriage or stillbirth.
· Your baby could be born too small or too soon.
· Babies born too small may have breathing and other health problems.
· Your baby could have learning and behavior problems later in childhood.
· Your baby is at an increased risk of death from a condition known as "sudden infant death syndrome". This illness causes a baby who seems healthy to die without any warning.
Studies have also shown that when a non-smoking pregnant woman breathes in passive smoke, it will also affect the unborn child. Hence, it is important for both the pregnant woman and her significant others, e.g. spouse, to quit smoking so as to reduce the risk of their baby being affected. Both parents should seek to create a smoke-free environment for the new born baby to ensure that he/she does not suffer from many short and long-term health problems pass through the placenta, the tissue and blood vessels which nourish the baby
SHISHA AND FERTILITY
Smoking has always been a health hazard that is totally preventable. Staying healthy will help increase a couple's chances of conceiving. A study conducted by the Institute of Health Sciences, University of Oxford, shows that women continue to smoke close to the time of conception take significantly longer to become pregnant than women who have never smoked or have stopped smoking a year before the time during which they attempt to conceive.
It is also important to note that the time taken for the body to recover from the ill effects of smoking varies for every individual, depending on a person's eating habits, lifestyle, stress level, age and genetic attributes, etc. However, there are also many other reasons which may affect a couple's fertility rate and it would be better for you and your husband to consult a gynecologist for professional advice.
SHISHA AND PASSIVE SMOKER
A passive smoker is anyone who breathes in smoke from another person's cigarette. It has been shown that passive smokers suffer the same health risks as smokers.
Passive smokers may suffer from irritation to the eyes, runny nose, sore throat and headache. If they continue to breathe in other people's smoke, they have a higher chance of developing lung cancer, heart attack and lung infection. Passive smoking can also make the lungs work less efficiently.
Passive smoking can bring on a severe attack in people with:
· asthma
· bronchitis
· heart disease
· colds and allergies
The smoke breathed in by the passive smoker may contain up to:
· 3 times more tar
· 5 times more carbon monoxide
· 3 times more nicotine
· 50 times more cancer-causing chemicals than the smoke inhaled by the smoker through the cigarette filter tip
But that doesn't mean smoking is less dangerous for the smoker. The smoker inhales far more smoke from each cigarette than the people around him
WORLD HEALTH ORGANIZATION (WHO) REPORT ON THE HEALTH CONSEQUENCES OF SHISHA
The use of “shisha” also known as hookah or water pipe is rapidly increasing in the major cities. Unfortunately most people who use shisha are not aware of its harmful effects. Most restaurant owners tell their customers that it is merely flavored smoke and that there is no tobacco in it.
Recently, however, the World Health Organization (WHO) released a report on the health consequences of shisha use and it has proved to be an eye-opener. A commonly held belief is that shisha is harmless because the smoke first passes through water before it is inhaled. The shisha smoker may inhale as much smoke during one session as a cigarette smoker would inhale consuming 100 or more cigarettes. Even after it has passed through water, the smoke produced by a shisha contains a high level of toxins, including carbon monoxide, heavy metals and other carcinogens.
A similar hazard is posed to other people who are not directly using shisha by means of passive smoking. It is indeed sad that in spite of an ordinance in place, which bans smoking in public places many restaurants; offer shisha to their customers. Tobacco used in these water pipes is often sweetened and flavored, making it very appealing to children and teenagers. A survey done on youngsters of school-going age in Karachi recently showed that almost 70 per cent had tried shisha in the past six months, and this included children as young as seven.
Many of the commercially available packets, which are used for shisha smoking, have misleading labels such as 0.5 per cent nicotine and zero tar. WHO in its report has strongly recommended that healthcare professionals educate the public about the potential dangers of shisha use. Moreover, the sharing of shisha between people poses an additional risk of TB, herpes, flu, meningitis and hepatitis transmission
W.H.O RESEARCHERS STRESSED.
“Water pipes should be subjected to the same regulations as cigarettes and other tobacco products. Water pipes and water pipe tobacco should contain health warnings. Claims of harm reduction and safety should be prohibited.”
W.H.O REGULATION ON TOBACCO PRODUCT
1. Shisha should be subjected to the same regulations as cigarettes and other tobacco products.
2. Shisha should contain health warnings.
3. The restaurants should inform their clients of the actual contents of Shisha.
4. Media should be involved in creating awareness against the hazards of Shisha smoking.
5. Awareness sessions against the hazards of Shisha smoking and other substance abuses should be made a regular feature in all educational institutions.
6. Surveys should be conducted to assess the extent of the problem and its prevalence in our society.
7. Longitudinal studies should be conducted to assess the health implications of Shisha smoking.
WHO Report on Pakistan’s Population
According to the World Health Organization (WHO), Pakistan’s population of 160 million includes 22-25 million tobacco smokers; 36 percent of adult males and 9 percent of adult females smoke. About 60,000 people die annually from tobacco-related diseases in the country.
Pakistan Medical Association Recommendation
A 2007 article in the Journal of the Pakistan Medical Association recommended a number of steps should be taken, including:
- Shisha should be subjected to the same regulations as cigarettes and other tobacco products.
- It should contain health warnings.
- Restaurants should inform their clients of the actual contents of `shisha’.
- Media should be involved in creating awareness against the hazards of `shisha’ smoking
- Social acceptability
Another factor adding to shisha popularity is its social acceptability as compared to cigarettes and its portrayal is a symbol of modernization of our cultural heritage. The extent to which water pipe smoking has penetrated our society is difficult to establish since very little work has been done on it. A recent survey conducted in high socio-economic schools of Karachi reported that Shisha is gaining popularity among the young generation and it is easily available in the restaurants, hotels and Shisha cafes. As compared to cigarette smoking it is readily acceptable and has become part of social gatherings. This survey estimated that almost 70% children have experienced this form of tobacco, including both boys and girls as young as seven years old.5 The tragedy is that most of these youngsters did not know that Shisha smoke contained tobacco, even though the nicotine content of Shisha tobacco has been reported as 2% to 4%, as compared to 1% to 3% for cigarettes. Its smoke also contains hundreds of potentially dangerous substances including carbon monoxide, charcoal, nicotine, arsenic, cobalt, chromium and lead.
Shisha smoking though a part of our cultural heritage is damaging the youth of our country. It is imperative to prevent our younger generation from indulging in a habit which will have detrimental effects not only on their health but also on the health of the country.
SHISHA AND RESIDENTIAL AREA
Serving shisha in the residential areas has become very annoying to most people in the city. I personally believe authorities concerned should intervene to regulate the spread of shisha outlets, especially in residential areas. Besides health risks of shisha, it distracts youth from becoming creative and utilizing their leisure time for doing something useful. I believe shisha cafes and restaurants distort the beautiful look of cities. They also allure young people to taste the much promoted type of smoking (shisha), which I fear might soon become a habit of elegant and educated young people. I believe authorities concerned should be alert to control prevalence of this harmful phenomenon. It is not only to ban shisha use in the restaurants but also to take other practical steps for the full implementation of the “Prohibition of smoking ordinance 2002” in the country.
COMPARED WITH CIGARETTE
While many shisha smokers may consider this practice less harmful than smoking cigarettes, shisha smoking carries many of the same health risks as cigarettes.
Shisha smoking delivers the addictive drug nicotine and is at least as toxic as cigarette smoke.
Due to the mode of smoking—including frequency of puffing, depth of inhalation, and length of the smoking session—shisha smokers may absorb higher concentrations of the toxins found in cigarette smoke.
A typical 1-hour-long shisha smoking session involves inhaling 100–200 times the volume of smoke inhaled from a single cigarette.
Shisha smokers are at risk for the same kinds of diseases as are caused by cigarette smoking, including oral cancer, lung cancer, stomach cancer, cancer of the esophagus, reduced lung function, and decreased fertility.
URGENT NEED
There is an urgent need to educate the public against the dangers of the Shisha use. Our religious scholars as well as non-governmental organizations should come forward and educate the public against the Shisha epidemic which is rapidly spreading in not only in the Muslims countries but also in the developed world. Special seminars should be held in schools warning the children against the dangers of Shisha use. Government must also bring laws restricting restaurants owners serving Shisha to its customers. Water-pipe tobacco should be subjected to the same regulations as cigarette and other tobacco products. Besides creating awareness about the health hazards of pipe smoking, Pakistan needs to broaden the scope of the Tobacco Control Programme to encompass water-pipe smoking as well.
OUT LOOK
Remember, they are not only burning our health, but they are also destroying yours and mine by contaminating our air with the thick clouds of their second-hand smoke. Our silence only encourages the harmful practices of the few.
Clean air is our God-given right. We should protect it from any kind of pollutants and our health from damage.
Most scholars now agree that cigarette smoking is haram, i.e. prohibited for Muslims due to its harmful effects on the human body, which directly go against an injunction in the Quran.
“AND DO NOT KILL YOURSELVES. SURELY, ALLAH IS MOST MERCIFUL TO YOU. AND WHOEVER COMMITS THAT THROUGH AGGRESSION AND INJUSTICE, WE SHALL CAST HIM INTO THE FIRE AND THAT IS EASY FOR ALLAH” [QURAN 4:29]
“AND DO NOT THROW YOURSELVES INTO DESTRUCTION.” [QURAN 2:195]
posted @ 11:52 PM,
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