Waterpipe tobacco

In many parts of the world people use a waterpipe to smoke tobacco. This is particularly true in the Eastern Mediterranean Region, where waterpipes are known variously as shisha, goza, narghile, ghalyoon or hookah.

A waterpipe works by placing a tobacco product in a small bowl with holes in the bottom which is attached to a tube linked to a water container. When the tobacco product is heated by hot charcoal placed on the tobacco it emits smoke that the user inhales by puffing on a hose connected to the water container. This draws it through the water and into their lungs.

Health risks of waterpipe tobacco use

Waterpipe tobacco use is damaging to health in similar ways to cigarette tobacco use. However, the health dangers of waterpipe tobacco use are often little understood by users. For instance, it is often wrongly believed that the smoke is purified by passing through the water in a waterpipe. Waterpipe tobacco use is not a safe alternative to cigarettes, and there is no proof that any device or accessory can make waterpipe smoking safer.

Using a waterpipe to smoke tobacco may seriously damage the health of smokers and the health of those exposed to the second-hand smoke emitted. It is important to remember that:

Waterpipe tobacco has significantly higher nicotine content than cigarettes. One head of unflavoured tobacco has the nicotine equivalent of 70 cigarettes.

Waterpipe tobacco also contains numerous toxins known to cause lung disease, cancer, heart diseases and other illnesses. Even after it has been passed through water, the smoke produced by a waterpipe 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.

The fuels used to heat waterpipes, including wood cinders and charcoal, produce toxins that contain high levels of carbon monoxide, metals and cancer-causing chemicals. Second-hand smoke from waterpipes is a mixture of tobacco smoke and smoke from the fuel, and therefore poses a serious risk for those inhaling it, especially children. Waterpipe use or exposure to second-hand smoke from a waterpipe can also have adverse effects during pregnancy.

Waterpipe use is linked to chronic bronchitis and respiratory disease. It also facilitates the transmission of hepatitis and herpes viruses, as well as being implicated in the transmission of an estimated 17% of cases of tuberculosis in the Region.