Lesser of two evils: Shisha is more harmful than cigarettes, says expert

More tar, smoke and toxins are produced in a half-hour session with the water pipe.

KARACHI: Shisha is more harmful than cigarettes and to prove it, Dr Nadeem Rizvi, who runs the department of chest medicine at Jinnah hospital, gave a breakdown of the toxins.

A cigarette may last for about five minutes, but a normal shisha session runs 30 minutes. They have 36 times the tar produced by a cigarette, 1.7 times the nicotine. One hour of shisha can deliver 50 liters of smoke and a single cigarette delivers only 0.5 liters of smoke.

These numbers were presented at Jinnah hospital at a seminar on the hazards of tobacco use organised by the Pakistan Chest Society on Wednesday.

Nearly 100 million people around the world smoke the water pipe, traditionally known as hookah or shisha. Its use was more prevalent among Arabs and in the Middle East but now it is popular in our part of world; 60% of people start smoking shisha at age of 16 to 18 during their college life, he said.

According to a study by the department of chest medicine at JPMC, shisha smoking sessions increase the level of carbon monooxide (a toxic gas which reduces the oxygen carrying capacity of the blood) seven times than cigarette smoking.

Around 600,000 deaths every year in the world is attributed to passive smoking, one third of these are of children often exposed to smoke at home. Karachi Additional Commissioner Abdul Wahab Soomro said at the seminar that the anti-tobacco law ordinance in Pakistan was approved in 2002, yet very little has been done to make people follow it.

Chest physician Dr Javaid Khan of the Aga Khan University highlighted that although scientific research has confirmed that exposure to second-hand smoke can lead to a whole plethora of diseases, including lung cancer, heart disease, asthma and pneumonia, implementation of the law in Pakistan is scarce.

In countries where clean air laws are implemented, smoking has declined and as a result fewer people are contracting related diseases. According to the World Health Organisation, enforcing a ban on smoking in public places is the single most important step any country can take to decrease the burden of tobacco-related diseases. In our case however the implementation was rated as 2 out of a possible 10 by the WHO. Our government needs to increase the price of tobacco products if it is serious about tobacco control. Quoting a report from World Bank, Prof. Khan said Pakistan has the cheapest cigarettes in the world.

Dr Mirza Saifullah Baig of Dow University of Health and Sciences remarked that the tobacco industry makes the only legal consumer product that can harm everyone exposed to it - even non-users - and kills up to half of those who use it.

Speakers highlighted misconceptions as well such as the fact that chewing tobacco is just as dangerous as smoking it. It has the same addictive substance Nicotine in even higher concentrations. India, Pakistan and Bangladesh have the highest rates of oral cancer in the world because of tobacco chewing. Bidis contain up to three times the amount of tar and carbon monoxide and seven times the amount of nicotine as a cigarette.

Dr Shahina Qayyum of the Pakistan Chest Society and Ojha Institute of Chest Diseases said that tobacco use among women is rising partly because of the aggressive marketing of tobacco targeting women.

Women make up 20% of the world’s one billion smokers. On average 22 per cent of women in developed countries and nine per cent of women in developing nations are daily smokers.

Published in The Express Tribune, May 31^st, 2012.