Smoking sheesha is as good as heaping piping hot coals on your head, says Dr Chris Ellis.
There is a lot of confusion over what sheesha is and how it affects the body and the lungs. It used to be considered a manly thing but now women too are begining to puff on the water pipe. Sheesha, which can be spelt as shisha, is the tobacco and smoke that comes from the hookah, sometimes spelt as hukka, which is known as the water pipe or hubble-bubble.
I first came across the hookah in prep school in England while reading Lewis Carroll's Alice in Wonderland. There, created by the imaginative mind of the Reverend Charles Dodgson (Lewis Carroll was his pen name) is the caterpillar sitting on a mushroom quietly smoking a hookah.
So how does it work? The tobacco is placed in the receptacle on the top with a piece of perforated aluminium foil over it. The hot coals are then placed on top of this. A tube leads down to the water in the bowl at the bottom. The hose pipe, that you suck on, does not go into this water but creates a vacuum above the water and draws the smoke through it. This causes the hubble-bubble.
Research has shown that the tar content in sheesha is higher than in cigarettes. Tar is the black sticky stuff that they put on the roads.
The smoke in sheesha is also high in carbon monoxide which , dear readers, is the stuff that comes out of your car exhaust pipe.
The tobacco used in the water pipes is sweetened and flavoured with fruits skins such as apple or mint. The fruit skins are fermented and treated with molasses. In the UAE if you want a mild smoke then ask for 2 Apple but if you want the strong stuff then ask for Saloom. If you are not used to it you may feel a bit giddy, get palpitations and want to vomit.
Water pipe use is centuries old but its origins are obscure. It is smoked all the way from China, across India and then into the Eastern Mediterranean and goes under several other names such as "boory", "nargile" and "goza".
Sharing the water pipe is common without changing disposable mouth pieces. In India it is often considered an insult not to offer to share a water pipe with a guest, rather like smoking the pipe of peace in the Wild West. This practice has been shown to spread tuberculosis, herpes and hepatitis.
There is a wide spread belief that the water pipe is not as dangerous as cigarette smoking but along with the tar, nicotine and carbon monoxide there are other toxic things inhaled such as arsenic and lead. All in all there are about 400 constituents that can start cancer of the mouth, lungs and surprisingly, the bladder from excreting all the muck.
Comparisons vary but a full smoke of a water pipe is equivalent to a pack of 20 cigarettes.
The million-dollar question is how does one stop smoking. Behavioural science research has outlined this in several steps: giving smokers information about the risks of cancer and heart disease. This is the easy part and all smokers really know this. The difficult step is the next one of behaviour change and quitting smoking.
In spite of the knowledge of the risks there are many reasons why smokers continue to puff away. One, which is often quoted, is denial.
Cancer and heart attacks happen to someone else, not me (this is called Somebody Else's Disease). It seems one of the most cherished assumptions that we hold is that of personal indestructibility.
Another reason for continuing to smoke is that it is just not worth it for the person to stop. The enjoyment (gains) outweigh the risks and disadvantages. This is where perception often outweighs reality. As our old friend, Seneca, said, "it is part of the cure to wish to be cured."
One of the other major reasons for not quitting (the theory behind all of this is called the Health Belief Model) is that the person, who smokes does not believe they can quit, even if they wanted to stop.
Of the 250 or so substances worldwide that you can get addicted to, nicotine is in the top five of the most addictive.
Nevertheless there is a growing recognition of the effects of smoking in all its forms which has prompted the coming legislation of no smoking areas in the UAE.
Brooke Shields at the tender age of 18, said, "Smoking kills you and if you are killed you've lost a very important part of your life". Now we don't want to do that, do we?
– Dr Chris Ellis is a family physician. (The opinions expressed are those of the columnist. Readers are advised to seek the advice of their personal physician for all health concerns.)
