Why Shisha Is A Health Risk

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WINIFRED OGBEBO writes on the rising trend of Nigerian youths’ addiction to shisha, another form of tobacco use,  which if not checked, could be another menace in the country.

For Musa O, a 24-year-old undergraduate of Economics, smoking shisha is the perfect way to relax after a hard day at school. “After school, I go to the shisha bar/joint to relax. Some persons need a bottle of beer to relax or a stick of cigarette. For me, Shisha is the bomb. I feel it’s safer because it is filtered through water. If I don’t smoke some shisha, my day isn’t complete”.
John D, a business man, had his first experience with shisha while on a business trip. He began smoking regularly four years ago, and established a shisha café in Abuja. His bar attracts a lot of young people as customers who come to smoke with their friends. “It’s great seeing youngsters smoking the shisha. It’s been good business for me. My customers say it calms them down and they get excited seeing it bubbling”.
These young men are not alone. Usually shared between friends and associates, shisha smoking is now fast becoming a phenomenon that is causing a lot of anxiety among physicians and public health practitioners.
The hookah or shisha has become quite popular recently in Nigeria, with some persons having it in their possession for private use.
However, in many bars you can see individuals smoking the hookah or shisha in public. Majority of persons who smoke the shisha say its harmless and feel they are taking puffs of flavored water.
A hookah is a single or multi-stemmed instrument for vaporizing and smoking flavored tobacco [called shisha] or sometimes cannabis, whose vapor or smoke is passed through a water basin, often glass based before inhalation.
The origin of the hookah is not certain; however, some authorities believe it originated in India during the era of the Mughal empire while some others believe it originated from Persia.
The hookah is composed of a bowl which holds the coal or tobacco during the smoking session, a windscreen [cover that sits over the bowl area, with some form of air holes. This prevents wind from increasing the burn rate and temperature of the coal, and prevents ash and burning embers from being blown onto the surrounding environment.
This may also offer some limited protection from fire as it may prevent the coal from being ejected if the hookah is bumped],  It also boasts of a hose; a slender flexible tube that allows the smoke to be drawn for a distance, cooling down before inhalation, a purge valve designed to purge stale smoke that has been sitting unused in the jar for too long,  a water base/vase, where smoke passes through the body and out the down stem where it bubbles through the water. This cools and humidifies the smoke. Liquids such as fruit juice may be added to the water or used in substitution. Pieces of fruit, mint leaves, and crushed ice may be added,  and a plate which sits below the bowl to catch ashes falling off the coals.
Meanwhile, the executive director, Gynae Care Research and Cancer Foundation, Dr Uche Onwufor, stated that there’s a growing misconception amongst the populace that shisha smoking is not as bad as cigarettes smoking, because the tobacco is flavored and passes through water first.
He said, “ But the cancer-causing agents and nicotine are still there. People who smoke shisha regularly are at risk to similar health problems that cigarette smokers face, whether its respiratory, heart disease or cancer. Also, people who smoke shisha are at risk of spreading Tuberculosis (TB), oral herpes, influenza and some other airborne diseases. As with other tobacco product, regular shisha smokers will find it addictive, to the point that they may need it every day.”
According to research carried out by the World Health Organization (WHO), the volume of smoke inhaled in an hour-long shisha session is estimated to be the equivalent of smoking between 100 and 200 cigarettes. The estimated findings go on to show that, on average, a smoker will inhale half a liter of smoke per cigarette, while a shisha smoker can take in anything from just under a sixth of a liter to a liter of smoke per inhale. Some tobacco experts however think this finding is not true and that there’s not enough research into long term effects of shisha.
Hookah smoke contains numerous toxic chemicals most of which are not filtered by water. Hookah smoke contains noxious chemicals that come from the burning of the charcoal, tobacco, and flavorings. Smokers inhale several chemicals that can cause cancer, heart disease, lung disease, and other health problems.  Hookah sickness is frequent among smokers. It presents as headache, nausea, light headedness and fainting and is caused by the very high doses of carbon monoxide inhaled and transported into the blood.
Second-hand smoke from hookahs contains substantial amounts of carbon dioxide and other respirable particulate matter (particles small enough to enter the lungs). The air in hookah bars also contains significant amounts of toxic chemicals and concentrations in the air of all these toxic substances are greater than for cigarettes (for the same number of smokers per hour). During a typical one-hour hookah session, a user expels into the air 2-10 times the amount of cancer-causing chemicals and other harmful chemicals compared to a cigarette smoker.
“ No studies have examined the long-term health effects of exposure to secondhand hookah smoke, but short term effects may include experience respiratory symptoms such as wheezing, nasal congestion, and chronic cough. Hookah bar employees and customers who frequent such bars, who often are exposed to toxic air for extended amounts of time, may be at especially high risk of health problems from secondhand smoke.
Onwufor also noted that, “Hookah smokers are liable to get addicted to smoking because of the inhaled nicotine, which is a drug of dependence. A typical hookah/shisha smoking session delivers about 2 times the nicotine dose of one cigarette and the nicotine absorption rate in daily waterpipe users may be equivalent to smoking 10 cigarettes per day.”
He noted that many shisha smokers show withdrawal symptoms when they have been off smoking for a while, making it difficult to quit smoking.
He advised young people to keep off from smoking shisha and to stay away from environments where shisha is smoked.
He also wants the Nigerian government to enforce strict controls against indiscriminate smoking of shisha in public.

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