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Objective of study
The objective of study is to find out how many number of people are aware of danger of shisha
smoking. This study also reveals that what is psychology behind increase in trend of shisha and
why people especially youngster love shisha as a part time if they are aware of its harmfulness. The
main objective of this study is also to create awareness among the people about its dangers.

Definition of Shisha
According to online dictionary the word shisha is a noun, it¶s defined as an oriental tobacco pipe
with a long flexible tube connected to a container where the smoke is cooled by passing through
water

History and Introduction of Shisha

One of the oldest and deep rooted traditions in Turkey is the Nargile (Hookah), with both men and
women finding great pleasure in smoking the water pipe. The nargile started a whole new culture
which endured for many, many years. Even today the nargile gives enjoyment to a special breed of
smokers. The original nargile came from India, but it was rather primitive as it was made out of
coconut shell. Its popularity spread to Iran and then to the rest of the Arab world.

But it was in Turkey that the nargile completed its revolution, and did not change its style for the
last few hundred years. The nargile became a very important part of the coffee shop culture, finding
its popularity in Turkey around the time of Murat the IV'th, 1623-40. The joy that the smokers
received from this very simple yet beautiful smoking apparatus was unbelievable. Rules were
created even for lighting the pipe, and if a professional smoker saw anyone lighting it the incorrect
way, the culprit would be told in no uncertain term. Do yourself and the sacred nargile a favor and
put out the coals by blowing into it.

There are three distinct types of water pipe i.e. Gouza or Nargile, Bouri and Shisha. The gouza is the
oldest form of water pipe. It has a small water container (about 200±500 ml) that is made of metal;
coconut shell was formerly used. The bouri has a water container made of brass (about 200±500
ml). The authentic shisha is a larger (about 1000±2000 ml) and more decorated form of water pipe,
usually with a glass water container. However, it is common to see shisha water containers made of
ceramics, rock-crystal or metal, including silver. Note on terminology. Water pipes come in different
shapes in Egypt

  

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The most famous one is the shisha. Other names, such as narghile, hubble-bubble and hookah, are
not used in Egypt. They all share the structure of a small container half filled with water, which acts
as a .filter for the smoke drawn by suction from a funnel-shaped tobacco holder. The tobacco is
usually burned by smouldering charcoal placed on top of it. We suggest the term water pipe to
cover all these different names for publication purposes, to have a common search name for this
type of tobacco smoking.

  

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Shisha Today
"Shisha is an oriental tobacco pipe. It has a long tube that connects to a container on the bottom
where the smoke passes through water to cool. Shisha, traditionally known as hookah was
considered to be an integral part of rural south Asia. One can still picture a shaded spot under a
tree in rural Pakistan where three or four elderly folks sit on a Charpai and take turns in sucking
tobacco from the contraption which is known as a water pipe. Even a decade ago, one could not
have imagined that this rural derelict will become a fashionable pastime. While latest µShisha¶
means ³flavoured water pipe smoking´ and different Shisha cafe offer a mixture of crude types of
tobacco fermented with molasses and fruits and the sweet odour of fruits conceals the natural
smell of tobacco¶s tar and nicotine

Shisha is different from the traditional hookah in that instead of plain tobacco the tobacco that is
used in it had certain added flavours and aromatic substances. In a survey conducted last year by
the Aga Khan University it was observed that over 90 per cent of the children surveyed have
experimented with this form of tobacco. This included both boys and girls as young as six years
old. The sad part of the survey was that most of these youngsters did not know that shisha smoke
contains tobacco.

The research conducted on the use shisha clearly shows that it has serious health consequences,
particularly on the lungs, heart and the food pipe. Its smoke contains hundreds of potentially
dangerous substances including carbon monoxide, charcoal, nicotine, arsenic, cobalt, chromium
and lead.

  

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Trend of Shisha in Pakistan

As we Pakistanis are trend lovers and we love innovations without going into the reality of that, we
readily accept that change. Same thing we have done with shisha but this time our youngsters have
become victim of it. Our youngsters are very passionate and energetic in copying the things but we
don¶t know the pros and cons of that thing that we are accepting from others. Now, here comes the
situation that we love to associate our self with shisha brand and we have made it a part of our life
style.

Now starting this trend from big cities like Karachi, Islamabad and Lahore, the trend is moving
towards small cities and towns. This is spreading in our country like a fire. Most of people say that
it¶s a source of relaxation of mind but never know the inside effects of it.

Looking at the growing trend amongst the youth of Islamabad, Karachi and Lahore to puff shisha as
a symbol of autonomy and freedom believing that it¶s harmless fun is factually incorrect.

A recently-released World Health Organization report on the hazards of shisha raised concerns on
its growing popularity in developing countries. Shisha also known as hookah or water pipe is a
century-old habit but until recently the elderly people living in villages were its main users.
Unfortunately in the past few years its use has markedly increased in major cities of Pakistan.

One study has also shown that shisha use increases the risk of tuberculosis. Using shisha in
restaurants or at home where children are present increases the risk of pneumonia, asthma attacks
and sudden infant death syndrome. There is an urgent need to educate the public about the
dangers of shisha.
³I play sports and would never smoke a cigarette because it harms the body and you get cancer,
but `shisha¶ is quite safe,´ Hasan Sheeraz, 20, told IRIN at another restaurant where he and a friend
were both puffing away.

Among those affected by the current craze are an increasing number of young women, especially in
urban areas.
The growth in `shisha¶ smoking has been rapid. A 2008 survey of 450 students in Karachi found that
64.2 percent of males and 37.9 percent of females had smoked a `shisha¶ at least once in their
lifetime; 77.3 percent of males and 33.3 percent of females smoked a `shisha¶ regularly.
³When something becomes fashionable, It is very hard to change the trend. Peer pressure and the
need of the young to do something new all play a part in this,´ said Salim Khan, 50, the father of
two teenage sons. He said he had explained the risks of `shisha¶ smoking, but ³very few parents are
aware of these and« we have a growing problem.´
In a smoke-filled room in Lahore, Pakistan, a small group of teenagers pass a `shisha¶ (water pipe)
round a table. Strawberry essence has been added to the tobacco, making a fruity aroma. ³We
come to this café at least once a week to share a `shisha¶,´ said Zeeshan Ahmed, aged 16.

  

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³Our parents don¶t mind us smoking `shisha¶ and it is not dangerous,´ said Fyza Imad, also 16.
Shisha smoking has become fashionable over the last decade in Pakistan. The misconception that
it is harmless, a belief shown to be widely held among `shisha¶ users, means that young people and
their parents are largely unaware of the health risks.
A survey was done by private organization that when people were asked about the awareness of
harmfulness of shisha, 67.8 of them said that they don¶t think that its harmful for them. In last 2
years 11.2% of boys have increased towards shisha trend and 27.5% of girls have shown their trend
towards shisha.

List of ingredients used in shisha

ÃÕ Tobacco
ÃÕ Charcoal pieces
ÃÕ Glycerin
ÃÕ Flavors
ÃÕ molasses
ÃÕ Other herbs

  

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LAHORE: Shisha smoking, a modern way of addiction, is spreading among youngsters in the
provincial capital like a jungle fire and this latest menace rapidly infecting the school and college
students of upper class.

Shisha houses have been established in the posh localities of the city during the last 4 to 5 years
and this mushroom growth of modern smoking dens is attracting the youths and the number of
Shisha Houses has increased massively.
The most disgusting aspect of this awful practice is that smoking is on the rise among young
adults under the very nose of authorities, but steps are being taken to control the stretch of Shisha
smoking to other areas.

Children below 18 who can¶t directly buy cigarettes off the shelf, throng the µShisha Houses¶ spread
across the city including Model Town, Johar Town, Board of Revenue Society, Defence Housing
Authority, Gulberg, Tech Society and some other upper class restaurants, hotels and clubs to have
a puff or two.

An influx of vehicles filled with teenagers, boys and girls, can be observed standing outside Shisha
Houses in the evening that continued till late at night. It has been a practice that a large number of
school and college students of both genders belonging to under-18 age group hang out the Shisha
houses for smoking as they don¶t face any hurdle here to satiate their desire.

An eyewitness, ACCA student of a local college, claimed that he has seen students of class 7th and
8th having Shisha smoking and even drugs in one of such Shisha houses. ³Once I went to a Shisha
House at Bank Square area in Model Town around lunch time and I saw 10 to 15 school girls
smoking and enjoying shisha´, he claimed.

Another social worker Munir Khan who visited more than 5 Shisha Houses in Model Town, Johar
Town, Tech Society, DHA and M M Alam road Gulberg told this scribe that he talked to a group of
teen-agers sitting in a Shisha House and they told him that their parents were unaware about water
pipe smoking habit and if they knew, they would have no objection, he added.

Social organizations in the town while expressing concerns at the aftereffects of Shisha smoking
said that it could cause diseases like cancer or other ailments. Shahla, an NGO worker, alleged that
as the influential people were running Shisha houses therefore the authorities were unable to take
action. People termed the increased use of water pipe smoking among the most vulnerable groups
as alarming and urged a complete ban on Shisha houses and smoking.

  

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She said that Shisha should be subjected to the same regulations as cigarettes and other tobacco
products and it should contain health warnings. She added that the restaurants should inform their
clients of the actual contents of Shisha and media should be involved in creating awareness
against the hazards of Shisha smoking.

Awareness sessions against the hazards of Shisha smoking and other substance abuses should be
made a regular feature in all educational institutions, she said and added that surveys should be
conducted to assess the extent of the problem and its prevalence in our society.

When The Post talked with Punjab Law Minister Rana Sana Ullah about imposing restriction on
Shisha smoking, he said that presently it was not an unlawful act and considered as a type of
smoking and legal action could not taken against the Shisha Houses being run in the city until the
assembly introduced a law to restrict this practice.

It is notable here that a recent World Health Organization says, tobacco is one of the most addictive
substances available in the world and the life spans of tobacco users can be cut down by 15 to 20
years

The opening of tobacco houses at different places of city is the signal of the fact that the future of
our young generation and coming generation is not in safe hands. Steps must be taken to avoid
such kind of poison which is spreading like a fire. Otherwise, the time will come when shihsa would
be as common in our country as now cigarettes are.

  

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More harmful than cigarettes
Medical experts warn that the `shisha¶ can be more harmful than cigarettes. ³Smoke from a `shisha¶
contains hundreds of potentially dangerous heavy metals like arsenic, cobalt, chromium and lead.
Under normal `shisha¶ use the smoke produced from a single pipe use contains approximately as
much nicotine and tar as 20 cigarettes,´ said Javaid Khan, a chest physician at Aga Khan University
Hospital in Karachi. He warned that apart from lung and other cancers, ³additional dangers not
encountered with cigarette smoking are infectious diseases resulting from pipe sharing [especially
TB] and the frequent addition of alcohol or psychoactive drugs to the tobacco.´
Young sportsman Sheeraz said he knew of people who added narcotics to their shisha, and
accused some of the restaurants of turning ³a blind eye´.
People who use these devices [water pipes] don¶t realize that they could be inhaling what is
believed to be the equivalent of a pack of cigarettes in one typical 30-60 minute session, because
such a large quantity of pure, shredded tobacco is used.´
Attitudes of youngsters towards Shisha

âÕ Associated with relaxation and a peaceful social setting

âÕ As part of the ritual is passing the pipe to others, taking turns, and enjoying the
camaraderie
âÕ Believe that the tobacco is less toxic
âÕ Does not stain the teeth
âÕ Also, does not have the ash smell like cigarette

Why Shisha Trend has increased in Pakistan?

Unawareness
According to a survey, most of people don¶t know about the fact that shisha contains harmful
ingredients that could be harmful for their health. Almost 67.5% people do not know that shisha is
harmful for them. They think that its just for time being fun and its just smoke with flavors and
nothing else. They don¶t know to what extend the amount of smoke they are inhaling could be
harmful for their lungs, lever, heart and brain. For the time being, it might be ok, but if we look at
long term prospective it can be a root cause of many other diseases. It¶s very strange to hear that
the trend people are promoting and they don¶t know about the facts about its consequences. Even
parents, who proudly allow their children to go to cafes and smoke shisha with their friends, don¶t
know that what social sin they are doing.

If aware, then don¶t bother

After a research another interesting fact came in front that some people who in spite of having
awareness about shisha are not ready to leave this habit. They think that its doing nothing wrong to

  

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them, even its become source for them to improve their social relationships. They said its nothing
just a flavor which gives them relaxation.

Status symbol

Another reason for the increase in the ratio of shisha users in Pakistan is that people have
considered it as a symbol of status. They love to associate themselves with shisha or a particular
shisha brand. They think that they would be out of this world if they would not smoke shisha. So,
that thing compel them to go to cafes and show off to other people of their level that they love
shisha.

Peer pressure

Another reason for increase in shisha trend is peer pressure. It is thing that really works, especially
when you are youngster. At the age of 15-35, people are psychologically and emotionally more
influenced by their friends, colleagues, and other members of primary group. So, to influence each
other or to show each other that you are not alone, we are also a part of this trend, people tend to
accept that trend without knowing about its pros and cons

Easily available

With the increase in the interest of people towards shisha, numbers of shisha cafes have increased.
At first, cafes were seen only on porch areas, but now they have spread all around in the city. You
don¶t need to move so long to have one session of shisha. Shisha is also available in some family
restaurants as well, so that people can enjoy shisha in their family.

The following are some places located in posh areas where shisha is available 24/7:

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Easy to make

Shisha is not only easily available but also easy to make as its ingredients are easily available every
where. Most of people enjoy shisha at home. There is another trend of serving shisha to guests like
tea of coffee. So we can say that shisha is bringing ridiculous changing in our values, lives and
trends.

Disadvantages of Shisha

"Shisha is an oriental tobacco pipe. It has a long tube that connects to a container on the bottom
where the smoke passes through water to cool. Shisha is, in effect, tobacco. So it will have the
same side effects on your body as other types of smoking; coronary heart disease, high blood
pressure, lung cancer, emphysema, blood vessel damage, chronic bronchitis, pneumonia, stomach
problems, and increased aging process. Now, who wants to get old faster!

When smoking it try putting a tissue between your mouth and the mouthpiece from which you
inhale, the tissue will have yellow residue of the tobacco which for sure would enter your lungs.
Shisha or hubbly bubbly or hookah as some countries call it, is as 11 times worse than smoking a
cigarette in harming the bronchi and by time causes a mucus in the alveoli. It will harm your lungs
and give you difficulty in breathing. After all its a kind of smoking and that is bad for the health at
any amount.

While many may argue that Shisha smoking is not harmful, medical experts say otherwise.
Kuala Lumpur health department deputy head Dr Sellehudin Abu Bakar said Shisha was tobacco
mixed with molasses and fruit flavours and tobacco product in any form contained nicotine.

He said all tobacco products were equally dangerous as it contained more than 3,500 chemicals of
which 200 were toxic and 43 were carcinogenic.

³It is difficult to compare which product is more dangerous.

³It depends on several factors such as frequency of use, how deep the inhalation or if other
ingredients are added besides tobacco itself,´ said Dr Sellehudin.

He added that Shisha smoking was also addictive as it contained nicotine from tobacco smoke.

³Shisha smoking can lead to physical addiction and can also create psychological and habitual
dependence to the user.

  

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³The water filter is a gimmick. Most of the toxic chemicals and nicotine are not water-soluble.
Hence, they pass through the filter and is inhaled by a smoker, although other irritant substances,
which are water-soluble, will get filtered.´

Meanwhile Reuters reported last week that the World Health Organisation (WHO) had announced
that a single session of smoking Shisha yields a nicotine intake equivalent to more than one pack
of cigarettes.

It is also reported that Shisha smoke retained all the carcinogens of cigarette smoke while adding
more carbon monoxide and a separate set of carcinogens from the use of burning coals to keep the
nicotine flowing, coupled with the risk of infection with tuberculosis or hepatitis from shared
mouthpieces

At the usual shisha smoking session, which lasts for over an hour, the smoke inhaled contains
nicotine and tar equivalent to 100 cigarettes. Research has also shown that after 45 minutes of
shisha use air carbon monoxide, plasma nicotine and heart rate are significantly elevated. Nicotine
dependence may also result from repeated inhalation of tobacco smoke.

Smoking is also linked to increased risk of cancer of the lungs, mouth and urinary bladder. It is also
some evidence that it may also decrease the sperm count in men. Regular users have lung
functions approximately 25 per cent lower than those who do not use this.

Lost of Social Values

The most importantly, shisha is effecting our social values. Youngsters stay out of their houses and
hang out with friends till late at night. Not only boys but the percentage of girls among the shisha
users is also increasing day by day and parents are happy with that. That¶s really a point of
discussion. What could be worst than that a young child is puffing shisha in front of his mother
without having any kind of hesitation. Parents must have some strict check and balance on their
children¶s activities.

Remedies

ÃÕ Shisha¶ should be subjected to the same regulations as cigarettes and other tobacco
products.
ÃÕ It should contain health warnings.
ÃÕ Restaurants should inform their clients of the actual contents of `shisha¶.
ÃÕ Media should be involved in creating awareness against the hazards of `shisha¶ smoking
ÃÕ Parents should take strong action and forbid the use of shisha among their children.
ÃÕ Youngsters should also aware of what culture they are promoting and should know about
the consequences of the trend of which they are running after.

  

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Conclusion

From the report, conclusion can be drawn that shisha is a social problem in our society which has
strengthen its roots firmly. Unfortunately, our youngsters have become victimized of it. We can still
do a lot to throw such poison out of our society. If we take responsibility as an individual to create
awareness and stop others of using it, then we can have a control of it to some extend. On the other
hand, some actions at national level should also be taken. We are the present generation and we
have to stop it from moving towards coming generation.

Bibliography
ÃÕ http://www.emro.who.int/tfi/pdf/shisha.pdf

ÃÕ www.opfblog.com
ÃÕ http://www.buzzpk.com/shisha-is-dangerous-for-health-and-life/
ÃÕ http://www.smokersinfo.net/pakistan-youth-blase-about-shisha%E2%80%99-smoking-
risks/http://thestar.com.my/news/story.asp?file=/2007/3/24/central/17078985&sec=central
ÃÕ http://www.reference.com/motif/Health/side-effects-of-shishaÕ
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