'Sheesha' smoking: Why should we be worried?

In the week that the world-first initiative of the plain packaging of cigarettes has finally been introduced in Australia, we should be incredibly proud of our achievements in the tobacco area. We have one of the lowest rates of daily smoking in the world and data that we have available from the latest 2011 ASSAD Survey indicates that we continue to see an upward trend in the number of Australian high school students who have never smoked cigarettes. That said, I am seeing a very worrying trend across the country that may be removing some of the existing barriers around smoking - the increasing popularity of 'sheesha' smoking.

About six months ago I was at a school in Sydney's eastern suburbs when a Year 10 student asked me about the harms associated with smoking a 'hubbly bubbly'. He had gone to a friend's 15th birthday and the parents of the birthday boy had given their son and his friends a sheesha to use at the party! I was absolutely floored - I couldn't believe a parent would do such a thing but since that time I've travelled the country and found that sheesha smoking is becoming increasingly popular, across all age groups, and most worryingly some see it as a 'healthy' way of smoking!

A sheesha (also known as a 'hookah' or 'hubbly bubbly') is a waterpipe, usually used to smoke flavoured tobacco. The smoke travels through a water basin before it is inhaled and, as such, many believe that this makes it a 'safer' way of smoking. Certainly this is what I'm hearing from young (and not so young) people across the country who truly think the water, plus the flavouring added to the tobacco, somehow reduces the risks associated with smoking. I even had one Year 12 girl who told me "it must be good for you, it's got fruit in it!" - truly scary ...

It has only been in recent years that some of the most significant harms have been identified. The sheesha has been used in many cultures for centuries and it is for this reason that harms are often downplayed. A World Health Organisation (WHO) report was released in 2005 and reported that sheesha smoking posed a serious potential health hazard and was certainly not a safe alternative to cigarette smoking. One of the most concerning findings was that during a 'sheesha session' of about 30mins, a smoker could be smoking the equivalent of between 30-100 cigarettes!

As much as we should be concerned about the fact that young people are smoking, more worrying is the belief that there is such a thing as 'healthy smoking'. It has taken such a long time for us to change community attitudes towards tobacco smoking that it would be really sad to see all our efforts undermined by sheesha use. Where we have managed to make cigarette smoking an 'antisocial' activity (who would have believed 25 years ago that if you wanted to have a puff of a cigarette you would have to stand in the middle of a freeway to do it?), you couldn't get further from the truth for sheesha smoking. Most adults are usually introduced to it at Middle Eastern restaurants, others when they were travelling internationally (particularly as backpackers), and now teens are first trying sheesha at gatherings on Saturday nights, usually while drinking alcohol. It is a social activity and that is a worry ... 

I am currently looking at the many Australian websites that sell sheesha products and trying to establish whether any of them are breaking advertising regulations. Claims that the products are "tar free" (they are until you smoke them!) and that they provide a "healthy smoking experience" (is there such a thing?) do push the boundaries of truth and it'll be interesting to see whether we can prove they are breaking the law ... Watch this space ....