Shisha (or Hookah) has become a globalised trend which is deemed to be a socially acceptable alternative to smoking cigarettes. Whilst the negative public image of cigarettes has riled up international debate and resulted in highly effective campaigns to curb cigarette smoking, Shisha smoking continues to rise as a hip trend for the youth, as cafés litter the streets of many cities across the world, including London. Given that Shisha is widely considered an ‘Arab’ tradition (in reality, it originates from Persia), many people believe they are being culturally diverse by indulging in Shisha and a glass of mint tea, as they drift away from the streets of London to the dusty lanes in Cairo.
However, amidst the ever-increasing popularity of Shisha smoking, there is a greater public health issue that is being neglected. Shisha is mistakenly regarded as a safe alternative to cigarettes, with common misconceptions being that it does not cause addiction as cigarettes do, and does not contain toxic substances due to the ‘efficiency’ of the water filter. Whilst this is what Shisha cafe owners would have us believe, scientific studies tell another story. Shisha does contain harmful toxicants such as carbon monoxide, tar and polyaromatic hydrocarbons, and numerous studies have concluded that smoking Shisha is just as destructive as smoking cigarettes, if not more . Strikingly, in a single shisha session, one may inhale up to 200 times more smoke than from a cigarette , during which carbon monoxide levels reach at least four times the levels found whilst smoking a solitary cigarette. Shisha also maintains harmful carcinogens (cancer-causing agents) as well as high levels of nicotine , adjudicating its similarity to cigarettes. However, given that Shisha is a relatively new phenomenon, rigorous scientific research is not as extensive as for cigarette smoking, but in despite of this links between Shisha smoking and serious ill-health have been established, such as an increased propensity to developing cancer , respiratory maladies and pregnancy-related problems .
Alongside the chemical addiction through nicotine, a behavioural addiction has also been attributed to Shisha. Shisha smoking is a habit that starts off in cafes or restaurants, leading many smokers to purchase their own pipes and engage in solitary, home-based smoking. This has made the Shisha pipe industry an increasingly profitable market, with various types of pipes and genres of flavoured tobacco available for consumption. With Shisha smoking now readily available to the smoker within the confines of their own home, coupled with the emerging evidence that shisha smokers are increasingly likely to progress to cigarette smoking , the public health problem is made even more acute.
Policy makers have acknowledged the public health issue of cigarette smoking and as a result of various initiatives over the last 30 years, from banned advertising to heavy taxation, the cigarette industry is now one of the most heavily regulated in the UK. This, combined with the increasingly negative attitude society holds towards cigarettes has helped to curb cigarette smoking greatly. However, the exponential rise in the uptake of shisha smoking poses a novel challenge for public health experts and policy makers. A fundamental problem lies in the lack of regulation within the UK Shisha industry, with blurred rules about licencing. Although legally, tobacco should not be sold to those under the age of 18, Shisha cafes are often open to minors. Shisha cafes do not formally identify the age of their customers to ensure legal sale, allowing those younger than 18 also get away with smoking it. In a time when there is a strong impetus to curb underage smoking (as this is when lifelong habits are most likely to become established), surely Shisha cafes that allow minors to freely smoke shisha must be taken to task?
Moreover, policy makers are extremely vigilant on the sale of fake cigarettes, which are generally sold at a cheap price and tend to be of extremely poor quality, posing an even higher risk to smokers. There is, however, no such regulation of shisha tobacco, with most shops importing their products from the Middle East, and subsequently they are not exposed to the same stringent standards as cigarette tobacco. Policy makers need to start applying the same levels of rigour to shisha tobacco as they do cigarettes, and must come down hard on those who try to dodge the system. Alongside this, shisha tobacco should be heavily taxed, to act as a deterrent to those who smoke it, and at a time when our NHS is overburdened, heavily taxing those who make a choice to harm their bodies would be a sensible course of action.
A further point of contention lies on the issue of public smoking. Since the ban of smoking in public places, Shisha bars became forced to splay onto public footpaths. I believe there is an important debate to be had as to whether this should be acceptable. Whilst politicians are seriously discussing whether smoking should be banned within public parks to prevent young children from witnessing adults smoking, should a similar policy be implemented on those streets populated with outdoor shisha cafes? After all, won’t children be equally lured by the sight of a fancy water pipe and the smell of fruity smoke?
It may smell nicer, taste better and appear as an innocent social activity, but Shisha is a danger to society that must be discussed, particularly amongst Muslims who often appear oblivious or ignorant in regards to its health effects. We must begin to take the dangers of shisha smoking seriously; after all, we have a religious duty to look after our health, and to prevent widespread harm within society. Given that Shisha smoking is a pastime that many Muslim youth partake in on a regular basis, perhaps the time has come for us to be at the forefront of the debate.
 Jensen, P., Cortes, R., Engholm, G., Kremers, S., & Gislum, M. (2010). Waterpipe use predicts progression to regular cigarette smoking among Danish youth. Substance