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Shisha

Key points:

  • there has been a huge surge in the number of shisha bars in the UK
  • shisha is increasingly popular with young people
  • some shisha users believe it to be neither as harmful nor as addictive as smoking cigarettes
  • shisha containing tobacco exposes users to the harms of tobacco and the threat of addiction
  • shisha smoking produces second-hand smoke
  • herbal waterpipe products are not a healthy alternative to tobacco products
  • shisha bars which sell tobacco must be on the Scottish Tobacco Retailers Register and display the relevant signage
  • bars which sell lit, smoked tobacco-free shisha still need to comply with smoke-free legislation
  • it is illegal to supply shisha to under 18s
  • the global epidemic of shisha smoking is a serious public health problem.

shishabriefletcover.jpgASH Scotland briefing paper
Smoking shisha (Feb 2013)

Download the brieflet we have developed in partnership with Fast Forward:
We need to talk about shisha (pdf, 1.15Mb)

Additional information:

Updates

NEW
Kumar SR, Davies S,  Weitzman M, et al . A review of air quality, biological indicators and health effects of second-hand waterpipe smoke exposure. Tobacco Control 2015;24(Suppl 1):i54–9.
The negative health consequences of second-hand waterpipe exposure have major implications for clean indoor air laws and for occupational safety. There exists an urgent need for public health campaigns about the effects on children and household members from smoking waterpipe at home, and for further development and implementation of regulations to protect the health of the public from this rapidly emerging threat.

May 2015
World Health Organization advisory note:
Waterpipe tobacco smoking: 2nd edition.
Health effects, research needes and recommended actions for regulators
After 10 years of accumulating evidence for the increasing prevalence and untoward health effects of waterpipe tobacco smoking, the World Health Organization announces publication of the second edition of the WHO Study Group on Tobacco Product Regulation scientific advisory note on waterpipe tobacco smoking. This advisory note addresses growing concern about the increasing prevalence and potential health effects of tobacco smoking with waterpipes, a practice that dates back at least four centuries in Africa and Asia. The note will provide a more thorough understanding of the health effects of waterpipe smoking for WHO Member States and research agencies.

16 May 2014
Young adults who smoked water pipes in hookah bars had elevated levels of nicotine, cotinine, tobacco-related cancer-causing agents, and volatile organic compounds (VOC) in their urine, and this may increase their risk for cancer and other chronic diseases, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
Media release, American Association for Cancer Research, 16 May 2014

October 2013
Hammal F et al. ‘Herbal’ but potentially hazardous: an analysis of the constituents and smoke emissions of tobacco-free waterpipe products and the air quality in the cafés where they are served. Tobacci Control doi:10.1136/tobaccocontrol-2013-051169.http://tobaccocontrol.bmj.com/content/early/2013/10/15/tobaccocontrol-2013-051169.abstract
High levels of toxicants that are classified as carcinogenic, or known to have harmful effects on health, are present in ‘herbal’ shisha sold in Canada. The mainstream and sidestream smoke produced when these products are burned in a waterpipe contain numerous carcinogens and potentially unhealthy concentrations of CO and tar. The air quality of waterpipe cafés is in consequence less than optimal. These findings do not support the common belief that smoking ‘herbal’ shisha is a safe and healthy alternative for smoking tobacco waterpipe. To the contrary, ‘herbal’ waterpipe products produce many of the major tobacco disease-related toxicants in equal or greater quantities as their tobacco-based counterparts.

July 2013
Jawad, M., Bakir, A. M., Ali, M., Jawad, S., and Akl, E. A. Key health themes and reporting of numerical cigarette-waterpipe equivalence in online news articles reporting on waterpipe tobacco smoking: a content analysis. Tobacco Control . 18-7-2013. Abstract or full text available at: http://www.ncbi.nlm.nih.gov/pubmed/23868396

Briefings