On May 31, 2013, the World Health Organisation (WHO) and partners everywhere marked the World No Tobacco day, highlighting the health risks associated with tobacco use and advocating effective policies to reduce its consumption.
The WHO selected “Ban tobacco advertising, promotion and sponsorship” as the theme, well-knowing that tobacco is currently responsible for killing one in 10 adults worldwide and yet it is the single most preventable cause of death globally.
If you have been to some bars in and around Kampala of late, you will agree with me that shisha smoking is one of the commonest activities taking place, in addition to the usual alcohol drinking, and its popularity has grown steadily over the recent years unabated, especially among the youths.
Shisha, the origins of which are not clear (some say India, others Persia or Turkey), is a glass-bottomed water pipe in which fruit-flavoured tobacco is covered with aluminium foil and roasted with charcoal. The tobacco smoke passes through a water chamber and is inhaled deeply and slowly; the fruit-flavoured tobacco tastes smooth and smells sweet, enthusiasts say, making it an enjoyable and an unrushed experience.
Most people believe that shisha does not contain tobacco and that when they smoke, they inhale herbal products. They have a misconception based on a wrongful and unscientific notion that tobacco used in shisha is herbal and does not affect body organs.
The added flavours make them feel they are smoking herbs, while they are actually taking in tobacco and are likely to become addicted to nicotine. More so, shisha smokers should also be aware of the fact that when smoke goes through water, humidity in smoke increases, which then tends to make the smoke stay for a longer time in the lungs. Inhaling this smoke is like inhaling toxic gases and compounds as well as some heavy metals, thus leading to severe failure of the heart to function properly.
For Daniel, 26, smoking shisha is the perfect way to unwind in an evening. “After a long day, I’ll go to a shisha lounge. It relaxes me. In the same way that some people will enjoy a beer or a cigarette to keep going, I like to enjoy my shisha.
If I don’t do it, it feels like I’m missing something.” Like Daniel, most people believe that shisha is equal to smoking cigarettes, but a 60-minute shisha session produces 100 to 200 times more smoke than one cigarette i.e. a single shisha session is the same as smoking 200 cigarettes.
And some germs, mainly bacteria, live in the shisha pipe. This makes the pipe a good medium for conveying bacteria causing infectious diseases like tuberculosis and hepatitis.
Moreover, while smoking the shisha, the aluminium foil, which is usually of poor quality, reacts with the burning charcoal and produces aluminium fumes that cause cancer. The amount of carbon dioxide inhaled through shisha is very high compared to cigarette smoking, depending on the packed ingredients.
Much as research on shisha smoking in Uganda is still limited, the health concerns around shisha are not just a load of hot air. If you watch the way people smoke shisha, they take deliberate, deep breaths before exhaling so there is a lot of smoke being inhaled. And for sure, inhaling tobacco smoke, whether it’s from shisha or cigarettes, is never going to be good for anyone.
The writer is a Makerere University School of Public health - CDC fellow.