A hookah is a single or multi-stemmed (often glass-based) water pipe for smoking. Originally from India, the hookah has gained immense popularity, especially in the middle east. A hookah operates by water filtration and indirect heat. It can be used for smoking herbal fruits, tobacco, or cannabis.
The Hookah was invented in India in the court of the Mughal emperor Akbar Following the European introduction of tobacco to India, Hakim Abul Fateh Gilani who was a physician in the court of Mughal raised concerns after smoking tobacco became popular among Indian noblemen, and subsequently envisaged a system which allowed smoke to be passed through water in order to be ‘purified’. Gilani invented the Hookah after Asad Beg, then ambassador of Bijapur, encouraged Akbar to take up smoking. Following popularity among noblemen, this new device for smoking soon became a status symbol for the Indian affluent.
In the United Kingdom Hookah cafes or “Shisha Bars” exist in most major cities. London’s Edgware Road area is noted for a high distribution of shops which serve hookah, but hookah cafes can be found in most cities in the south. There are several bars in Leeds and Bradford.
Smoking was banned inside public places in England in July 2007. Since then, hookahs are only allowed to be smoked outside.
Hookah is often found in Indian restaurants but is most commonly found in Lebanese restaurants and Egyptian-run “hubbly-bubbly” bars. Concentrations of these hookah establishments are often found in close proximity to University campuses, as on Rusholme’s Curry Mile in Manchester or in Oxford, and they cater to a mixture of British and Middle-Eastern clientele amongst students.
The idea that hookah is not as dangerous as cigarettes is a popular misconception. Studies by tobacco companies have shown that use of hookah over many sessions can be as detrimental to a person’s health as smoking cigarettes. It seems the water moisture induced by the hookah makes the smoke less irritating and may give a false sense of security and reduce concerns about true health effects.
In 2005, the experts of the World Health Organization published an important report against the use of water pipes. One year later, this document was criticised in the Journal of Negative Results in Biomedicine for sociological, anthropological, historical, and experimental errors. The criticisms focused on a lack of citations about the historical uses of hookah, and how the hookah was tested for tar production in a manner that may not reflect all cultures’ frequency of puffing.
Each hookah session typically lasts more than 40 minutes, and consists of 50 – 200 puffs which range from 0.15 – 0.50 litre per puff .
Studies show that there are high levels of nicotine in hookah, and that this can lead to addiction, however despite the supposedly high nicotine content, the usage of hookah does not eliminate a smokers desire to smoke.
Other research shows that a single 45-minute session of hookah tobacco smoking delivers slightly less tar and carbon monoxide (around 3-6%) than a full pack of cigarettes.
Some hookah tobaccos claim to contain 0.0% Tar, but this is misleading because tar is a by-product of plant combustion. Tar may not be added to the shisha before smoking, but burning plant material always produces tar. Hookahs are designed to heat rather than burn tobacco, but for smoke to be produced some combustion must take place- although possibly at a slower rate than burning with direct flame.
The level of impact on a smoker’s health is linked to the set-up and components of the hookah as well. A hookah only utilizing the basic components listed above is believed to have much harsher health consequences than one set-up properly and with various safety devices installed: Since the tobacco in a hookah is roasted as opposed to burned, the density and temperature of the tobacco may possibly ensure a safer quality of smoke. Distancing somewhat the coal from the tobacco and placing a perforated thermal cover (not to be confused with a wind cover) over the bowl may reduce tar output.
The first aetiologic study on hookah smoking and cancer ever carried out was published in May 2008. The authors conclude to various levels of carcinogenicity. Reference: Sajid KM, Chaouachi K, Mahmood R. Hookah smoking and cancer. Carcinoembryonic Antigen (CEA) levels in exclusive/ever hookah smokers.
While hookahs originated from Muslim lands, some Muslim scholars assert that smoking is haraam and thus prohibited for Muslims due to its harmful effects on the human body.
Hookahs can also be smoked with tobacco-free flavors. There have been few studies to show the impact of smoking herbal flavors in Shisha pipes. However, considering that carcinogenic aromatic hydrocarbons are produced whenever plant matter is combusted, these brands of smoking material are unlikely to be safe.