Shisha tobacco smoking is increasing among university students in the UK and worldwide with many feeling it's more socially acceptable and less harmful than cigarette smoking - according to a study presented at the British Thoracic Society (BTS) Winter Meeting on Friday 9th December 2016.
However a review of evidence indicates that the habit can cause significant harm to health, aligning with a recent World Health Organisation (WHO) warning that it could be as harmful as smoking cigarettes. Studies show that:
- During a typical water pipe tobacco smoking session, the user can potentially draw on large doses of toxic substances (which can be equivalent to smoking between one and around ten cigarettes). These have been linked to addiction, heart and lung diseases, and cancer.
- During the past five years, significant evidence has become available for an association between water pipe tobacco smoking and respiratory disease, mainly chronic bronchitis.
- Its use is also significantly associated Chronic Obstructive Pulmonary Disease (COPD) and lung cancer.
- It is also associated with increased risk of cardiovascular disease.
Adam Arshad, Jaideep Matharoo, Simardeep Sadhra and Rosemary Norton-Wangford, a team of students from the University of Birmingham Medical School, alongside Dr Mohammed Jawad at Imperial College London decided to investigate existing evidence on knowledge, perceptions, and attitudes towards shisha tobacco use amongst students.
According to a study across six UK universities, two thirds (66%) of students had smoked shisha tobacco. And amongst medical students at one London University, when asked if they had ever used shisha tobacco, 51.7% admitted they had, compared to 16.8% who had ever used a cigarette.
The main findings of the review, which analysed both national and international studies, were as follows:
- Shisha tobacco smoking is often perceived as 'safer' than cigarette smoking i.e. less harmful and addictive
- Many students believe quitting shisha tobacco is 'easy'; yet few are able to do so successfully
- Social factors and peer influence are the main contributors in students to start shisha tobacco use
- Shisha tobacco smoking 'addiction' has two components - physiological and social
Adam Arshad a medical student at the University of Birmingham who helped lead the research team, said:
"There are many reasons why university students get involved in shisha tobacco smoking - it's often seen as fun, sociable and less harmful than smoking cigarettes.
However our research has laid bare the incorrect perceptions and addictive nature of shisha tobacco, and we need an educational campaign to dispel the misconceptions of shisha tobacco being a 'safer' activity. It isn't.
We really need to reverse this upsurge in use amongst university students by de-glamorising the habit and highlighting its harmful effects."
Fellow student and researcher, Jaideep Matharoo, points to studies where students who undertake shisha tobacco smoking state they believe it provides an effective filtration method for the toxins in tobacco. However, evidence highlights that the inhaled smoke still contains high levels of carcinogens and heavy metals despite having passed through water, and there is additional evidence to suggest that 95% of the nicotine is still inhaled.
Dr Sanjay Agrawal, consultant lung specialist and Chair of the British Thoracic Society's Tobacco Group, said:
"Over many years shisha tobacco smoking has been increasing - and the harms are mostly under the public radar.
The habit can be addictive and its use is associated with real harms to lung health. Students, and other users of shisha tobacco, need to be aware of the facts and the real risks involved.
Universities and public health teams need to do more to alert students to the risks."