Shisha ban: A doctor’s view on why you should drop that ‘dirty’ pipe

Shisha smoking is gaining a lot of popularity in Kenya. Today if you visit shisha lounges in our major cities, you are likely to find youngsters smoking shisha. This is mainly because of the misconception it is harmless…But is it safe?

Of late, the drug has been considered as a global threat and given the status of an epidemic by public health officials. Tobacco smoke contains over 4,800 different chemicals out of which 69 are carcinogens and several others are tumor promoters.

It is popular due to the common misconception that the nicotine content in shisha is lower than that of cigarettes and that water used in this form of tobacco intake works as a filter, removing all the hazardous chemicals such as carbon monoxide, nicotine and tar.

These common misapprehensions lead the general public to believe that shisha smoking is not a hazard to their health or others.

The data

Early findings of a recent survey by a group of young doctors in Kenya suggests that the drug’s prevalence among the youth and young adults is on the rise.

It concluded that about 60 per cent of them had smoked it at least once in the past month as opposed to only 10 per cent of them being cigarette smokers.

Survey from different high schools in Kenya indicate the prevalence of 12.6 per cent shisha users with universities standing between 19 per cent and 20 per cent.

In Nairobi alone, the survey conducted on youngsters aged between 15-20 years, discovered that 58 per cent of respondents had smoked shisha at least once in their life time.

The coastal region was evaluated that 52.6 per cent of youngsters and 29.8 per cent above 30 years were regular smokers.

As for gender, survey from two large universities in Nairobi shows that more males aged between 15–25 years use the drug.

In Mombasa, the scenario is similar as 63.8% of students there start smoking shisha at the age of between 16–18 years with the male gender being dominant.

In some rural areas, the average age of commencement of shisha smoking is found to be 19 years for males and 21 years for females.

However, in social places like night clubs and Shisha lounges, the trend was found to be totally opposite as more females are found smoking shisha as compared to males with about 60 per cent being non cigarette smokers and teetotallers.

Shisha or cigarette?

Recent studies have shown that peak concentration of nicotine in cigarette and shisha are the same but, the relatively long duration users smoke the shisha result in considerably greater nicotine exposure.

It is also a fact that the number of puffs and their volume from using shisha are about 10 times higher than cigarettes. The smoke contains a higher concentration of metals while shisha’s burning temperature is about 900°C which is higher as compared to 450°C for cigarette.

Shisha smoking has many dangerous effects on health. The increasing trend of smoking observed in the last few years is mostly due to the misconceptions regarding its use, for instance that nicotine content is lower than that of cigarettes and that water filters out all the toxic chemicals including carbon monoxide (CO), nicotine and tar.

New research has suggested that the water pipes have three additional lethal risks over cigarette smoking.

• Flavoured tobacco is smoked over coals and fumes from these fuels add new toxins to the already dangerous smoke;

• Shisha smokers inhale up to 200 times more smoke in a single Shisha session than from a cigarette;

• Its social acceptance has resulted in high levels of second hand smoke.

Shisha smoke contains hundreds of potentially dangerous heavy metals like, Arsenic, Cobalt, Nicotine, Coaltar, Carbon Monoxide (CO), Lead and Chromium.

Research has shown that 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.

The research also showed that after 45 minutes of Shisha use, expired air, carbon monoxide, plasma nicotine, and heart rate are significantly elevated.

While research about Shisha smoking is still emerging, evidence shows that it poses many dangers.

• The smoke contains high levels of toxic compounds, including nicotine, tar, carbon monoxide, heavy metals and cancer-causing chemicals (carcinogens). In fact, smokers are exposed to more carbon monoxide and smoke than are cigarette smokers.

• As with cigarettes, Shisha smoking is linked to lung and oral cancers, heart disease and other serious illnesses.

• It delivers about the same amount of nicotine as cigarette smoking does, possibly leading to tobacco dependence.

• Shisha smoke poses dangers associated with second hand smoke (CO).

• Shisha smoking by pregnant women can result in low birth weight babies. Young female smokers are often motivated more by the desire to “stay thin” or “look cool” than to avoid an illness in middle life.

• The pipes used in Shisha bars and cafes may not be cleaned properly, risking the spread of infectious diseases (T.B, Hepatitis).

• Shisha flavours can easily be laced with hard drugs sometimes without the knowledge of the smoker.

Conclusion

A major concern is the use of dangerous drugs being mixed in with the shisha and steps should be taken to stop it as a means of taking drugs “legally”, thanks to the social acceptance of it.

The government should begin to put some legislations in place, for example, the government can take steps to ensure that Shisha and cigarettes are not sold to people under the age of 18.

Furthermore, like cigarette smoking, Shisha also falls into the grey area where freedom to use it cannot be prohibited in “adults” but steps can be taken by the government to ensure that people are aware of the dangers of smoking.

Apart from awareness campaigns the government can also levy a handsome tax hence, discouraging the use of Shisha and ensuring that most, if not all of the general public, can live a safe and healthy life.

As for the workers, the government should inquire the suppliers about their safety precautions, and can pass out a law to ensure the health of workers.

Recommendations

According to a research by British Heart Association, it was found that the young generation is heavily getting dependent on the Shisha ignorant of the health hazards it causes.

There is an urgent need to educate the public against the dangers of the Shisha use. Our medical practitioners , religious leaders as well as non-governmental organizations should come forward and educate the public against the Shisha epidemic which is rapidly spreading in not only urban areas but also rural areas.

Special seminars should be held in schools across Kenya, warning the children against the dangers of Shisha use. Government must also bring laws restricting restaurants owners serving Shisha to its customers.

The government ought to conduct investigations in order to avoid any further worker exploitation. The workers have a right to work under safe and healthy conditions.

It is not only government’s responsibility to discourage Shisha smoking but also the youth. Campaigns in universities should be held in order to increase awareness of the drug’s hazards.

The concern is not only about the dangers of its ingredients but also the malpractice done using it. It can be very dangerous when one mixes drugs in Shisha. Therefore sale of Shisha should be strictly controlled and only sold in licensed tobacco shops.

The ban on Shisha might not be 100% tenable but public education and awareness will immensely reduce the harm.

Source:Kenyan Star