(Candidate’s Full Name)
Effects of Hookah Smoking
A hookah is a water pipe used to smoke (usually) flavored tobacco which is specifically made for this purpose. It has various names in various languages, such as water pipe, narghile, argileh, shisha, hubble-bubble, goza and etc. The origin of the device dates back to the 16th century in Persia. Today, hookah bars and cafes are gaining popularity around the world, including Britain, France, Middle East, Russia and the United States. Hookah smoking has now become a trend and Hookah itself has been classified as a socially-acceptable drug, with countries all over the world making minimal efforts to create awareness against the harmful effects of hookah smoking. If this problem persists, we will have a new generation that is much more susceptible to cancers and other health risks than their elders. Hence, the issue of hookah smoking needs to be addressed at a global level and immediate steps should be taken to create awareness among hookah smokers regarding its detrimental health effects.
Hookah pipes make use of tobacco sweetened with either fruit or molasses sugar. This makes the hookah smoke more aromatic and pleasant than a normal cigarette smoke. Popular hookah flavors include apple, plum, pineapple, coconut, mango, mint, strawberry and cola. These flavors vary from culture to culture and certain “custom” or combination flavors can also be created and used. The fruit or molasses sugar dampens the tobacco. The damp tobacco is then heated up in the hookah pipe using wood, coal or charcoal to create the smoke.
Data obtained from the 2012 National Youth Tobacco Survey (NYTS) reveals that hookah smoking among high school students in the United States and Canada increased from 4.1% to 5.4% from 2011 to 2012, compelling a dire need to address the issue through emphasizing on the harmful effects of hookah smoking and the solutions to alleviate the problem.
Problems of Hookah Smoking
The health risks associated with hookah smoking are numerous and devastating. Ask any hookah smoker and they’ll tell you that hookah is neither as harmful nor as addicting as cigarettes. Or that the filter used in the water pipe “filters out” the harmful effects of tar and carcinogens. This is far from the truth. Hookah smoke contains high levels of toxic compounds; such as tar, carbon monoxide, heavy metals (such as arsenic and lead) and several other carcinogens. Therefore, hookah smokers are exposed to more carbon monoxide and smoke than normal cigarette smokers. An average one-hour hookah smoking session is as damaging to your health as smoking over 100 cigarettes. Furthermore, hookah contains nicotine, which causes addiction. What starts as a style or a trend quickly becomes a routine. .
A study has shown that the level of nicotine and cotinine increased up to 250% and 120% respectively in hookah smokers, after a smoking session of forty to forty-five minutes. It further reiterates the fact that one hookah smoking session is much more devastating to health as compared to cigarette session. The study further concluded that hookah smoking leads to the following conclusions: .
- In China and Northern India, the tobacco used in hookah is unprocessed and heated by charcoal. This leads to an increase in the risks of Lung Cancer diagnosis and mortality.
- The use of tobacco in cigarettes and hookah is closely linked with the rising Bladder Cancer among the smokers
- Hookah smoking has also been linked to Oesophagal and Nasopharyngial Cancers
- Tobacco juices from hookah increase the risk of Oral Cancers
- The toxic ingredients from hookah can cause the arteries to clog and lead to Heart Diseases and increase the risk of Heart Attacks
- Babies born to women who smoked hookah on a daily basis during pregnancy weighted, on an average, at least 3 ounces less than babies born to non-smoking women
- Such babies are also highly susceptible and vulnerable to Respiratory Diseases
- Prolonged use of hookah also leads to Stomach Cancer, Respiratory Failure, Reduced Lung Function and Decreased Fertility
Another study states that the social aspects of hookah smoking are equally profound. Sharing of mouth pieces and the exchange of heated and moist smoke may increase the risk of communication and transfer of infectious diseases and viruses such as tuberculoses, hepatitis and herpes. Passive smoking from hookah is equally injurious to health as it contains smoke from both the tobacco itself and the heat source used to burn the tobacco.
The exposure to benzene, a volatile compound, is much higher in a hookah smoker as compared to a cigarette smoker. Researchers have detected twice the amount of a metabolite of benzene in the urine excretion of hookah smokers, as compared to cigarette smokers. This is an alarming situation considering the fact that benzene exposure caused leukemia (blood cancer) in human beings. Hence, hookah smokers are twice as susceptible to blood cancer as normal cigarette smokers. .
According to recent statistics from survey data collected across the state of Michigan, over 27% of teenagers (between the ages of 14 and 18) of Arab-American descent (living in Michigan) used water pipes. In the United States, the trend of hookah smoking and addiction, among 18 to 24 year olds, has reached an alarming figure. This is mainly due to emergence and viral marketing support techniques of Hookah Bars and Cafes, all across California, Illinois, Texas and Virginia. Furthermore, hookah smoking is viewed by most college and university students as an inexpensive way to get together and have fun. This creates a dire need for the state and society to take drastic measures to eliminate or alleviate this problem.
Solutions to Hookah Smoking
The solutions to eliminate or alleviate hookah smoking have not been fully researched, explored and documented. This is mainly due to lack of awareness among individuals and incumbent legal and administrative reforms to address the issue at a global level. Various countries have introduced various laws and reforms to address the issue of hookah smoking. Most of these reforms, however, have not yielded a significant result in terms of eliminating and alleviating the problem. Some of the measures introduced by various economies are listed below:
- In the United States, 22 States and the District of Columbia have clean air laws. 13 states have prohibited smoking in all workplaces and adopted an exhaustive definition of the term “smoking” so as to incorporate hookah smoking within the definition. However, this reform has produced little effect especially in the state of California and New York where certain Middle Eastern hookah bars bypass smoke-free laws by making their employees the owners, thereby qualifying for exemption from the said laws as an “establishment without any employees”. Furthermore, these hookah bars operate as “retail tobacco establishments” or “tobacco bars and cigar lounges”, since the bulk of their revenue derives from the sale of tobacco products or they engage in selling such products to their customers on the premises. .
- In England, the Leicester PCT Stop Smoking service, on reporting on a rise in the number of teenagers in the city smoking hookah, announced that Birmingham's three PCT will launch a city-wide tobacco control strategy, which includes increasing the awareness of hookah smoking. The Niche Tobacco Advisory Group (NTAG) for North England also introduced an educational campaign on hookah smoking. Even these reforms yielded little results. .
- Countries, like Ireland, Norway and Sweden have also passed clean air laws
- In the Middle East and several Eastern Mediterranean countries, there is a complete lack of awareness regarding the potential health effects of hookah smoking. Researchers found that in such societies, it is perfectly acceptable for some families to share a hookah after every meal, even with children. Clean air and anti-smoking laws are virtually absent and cannot be implemented in such countries.
The most important way to reduce or alleviate hookah is by creating awareness amongst hookah smokers, especially the youth across the globe. For this purpose, a report was presented by the World Health Organization in 2005 that explained the potential health risk factors associated with hookah and what measures can be introduced to address the issue. The proposals presented by the report include the following: .
- Regulation of water pipes and water pipe tobacco under the same laws as cigarettes and other tobacco products
- Strong health warning advise and indicators on water pipes and their tobacco used
- Use of any claims of harm reduction or “safe-hookah” to be prohibited
- Any misleading statements, such as “contains 0% tar” should be prohibited and any person(s) found placing such signs shall be liable to criminal prosecution
- Water pipes should be incorporated as part of an overall comprehensive tobacco control efforts initiative. Prevention strategies and cessation procedures and reforms should also be framed
- Where there are public places or workplaces which prohibit the use of cigarettes and other tobacco products, the use of water pipes should also be prohibited
- Training of health professionals and regulators and educating the public at large about the hazardous effects of water pipe smoking, including the effects of high levels of passive smoking exposure among children, pregnant women and others
- Development of a Technical Report Series at an international level to evaluate thoroughly the effects of water pipes.
Policies banning hookah smoking in public places may also help reduce this menace. Limiting the power of hookah bars to claim exemption from clean air laws on the precondition of using not more than 20% of their floor area for hookah smoking and the remaining area for sale of tobacco products is also seen as a positive step to curb hookah smoking at public places.
More health education and campaign materials should be launched to raise public awareness on the devastating effects of hookah. These measures include, but are not limited to, the following:
- Creating peer groups and peer-to-peer presentations on the hazardous impacts of hookah smoking, since peer-to-peer model has been proven to be the most effective way of educating and learning
- Encouraging individual initiative to come up with alternatives to hookah smoking, such as nicotine chewing gums and patches and electronic cigarettes
- Raising the issue of hookah smoking at national and international level conferences and workshops
- Introduction, at the academic level, of subject(s) related to the harmful effects of tobacco and water pipe usage; and
- Creating awareness regarding the deceptive tactic employed by certain hookah bars, such as claiming to serve hookah with 0% tar and carcinogens
Works Cited
American Association for Cancer Research. (2013). Waterpipe Smoking May Not be an Alternative to Cigarette Smoking. American Association for Cancer Research.
American Lung Association. (2007). Tobacco Policy Trend Alert, An Emerging Deadly Trend: Waterpipe Tobacco Use. New Jersey: American Lung Association.
Gaddam S, G. S. (2010). The effects of waterpipe tobacco smoking on health outcomes: a systematic review. International Journal of Epidemiology .
Lowell Dale, M. (2012, July 20). Is Hookah Smoking Safer than Cigarettes? Retrieved from www.mayoclinic.org: http://www.mayoclinic.org/healthy-living/quit-smoking/expert-answers/hookah/faq-20057920
Qureshi, H. (2011, August 22). Smoking shisha: how bad is it for you? The Guardian , p. 1.
WHO. (2005). Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators . Geneva: WHO Press.
