Shisha

What is shisha?

Shisha is smoking a heated tobacco smoke which bubbles through a bowl of water and into a long hose-like pipe to be breathed in. Shisha pipes have a mouthpiece fitted to inhale the smoke.

Shisha is also called hookah, narghile, waterpipe, or hubble bubble. It can increase your risk of developing heart and circulatory diseases.

The tobacco can come in different flavours and sometimes it’s mixed with a dark brown sugar (also called molasses sugar), often making the smoke smell sweet. It is usually heated by burning wood, coal or charcoal.

Shisha smoking is popular in Southeast Asian, Middle Eastern, and North African communities, especially among young people. It’s becoming increasingly popular in the UK.

Effects of shisha on heart and circulatory health

Shisha can increase your risk of heart and circulatory diseases because it usually contains harmful chemicals. Sometimes, they are the same chemicals used in cigarette tobacco which is harmful.

Like cigarettes, shisha can contain:

• nicotine
• tar
• carbon monoxide
• heavy metals such as arsenic and lead.

These chemicals can make the walls of your arteries sticky, so fatty material can stick to them. This process is known as atherosclerosis.

If the arteries that carry blood to your heart get damaged and clogged, it can lead to a heart attack. If this happens in the arteries that carry blood to your brain, it can lead to a stroke.

Because of this, shisha smokers can be at risk of the same kinds of diseases as cigarette smokers.

Even if you use tobacco-free shisha, the smoke still produces harmful levels of toxins which can be just as bad for you or even more harmful than smoke from tobacco-based shisha.

Is shisha safer than cigarettes?

No, smoking shisha is not safer than smoking cigarettes. Many people think that drawing tobacco smoke through water makes shisha less harmful than cigarettes, but that’s not true.

In a shisha session (which usually lasts 20-80 minutes), a shisha smoker can inhale the same amount of smoke as a cigarette smoker consuming over 100 cigarettes.

Like cigarette smoking, these toxins from tobacco-based shisha puts smokers at risk of developing:

• heart and circulatory diseases
• cancers
• nicotine addiction
• respiratory infections and conditions.

Even if you use tobacco-free shisha, the smoke still produces harmful levels of toxins which can be either just as bad for you or even more harmful than smoke from tobacco-based shisha and cigarettes.

Are shisha pens safer than shisha pipes?

Like a shisha pipe, shisha pens can still be addictive because the liquid that’s used in them usually contains nicotine.

Shisha pens are devices that allow you to inhale flavoured liquid and nicotine as smoke like an e-cigarette (also known as vapes).

Some people use them to help them quit smoking, but more research is needed on the long-term impact of using a shisha pen on your heart and circulatory system.  Shisha pens should not be used by non-smokers or anyone under the age of 18.

Second-hand shisha smoke

Second-hand smoke (also known as passive smoke) is when you breathe in the smoke in the air from someone else’s shisha pipe and the smoke they breathe out.

Second-hand smoke from shisha pipes is dangerous because it contains harmful substances like carbon monoxide, toxic chemicals, and toxic particles.

Even if you use tobacco-free shisha, the smoke still produces harmful levels of toxins which can be just as bad for you or even more harmful than smoke from tobacco-based shisha.

The best way to protect your loved ones from second-hand smoke is to quit smoking.

Second-hand smoke can stay in a room for up to five hours. It can even travel through stairwells, plumbing, and ventilation units.

Opening windows, using fans, air conditioners, air purifiers, air fresheners, and or smoking in another room do not protect others from second-hand smoke.

Particles from tobacco smoke settle on surfaces and can last several months. This is called thirdhand smoke.

• Learn more about the effects of second-hand smoke.

Is shisha addictive?

Yes, shisha is addictive. Shisha usually includes nicotine which is addictive. Nicotine is the same chemical used in cigarettes which makes them addictive.

Nicotine is a chemical that makes your brain produce feelings of pleasure, but the effects do not last very long. When the effects wear off, you feel the need to smoke again to trigger the feelings of pleasure. The more you smoke, the more nicotine you need to feel good which is how an addiction to nicotine can happen.

How to quit shisha

If you’ve decided to quit smoking shisha, then you’ve made a great decision for your health. It may be hard at times, but there is help available to you.

Make an appointment with your GP or practice nurse. Your local pharmacy may offer stop smoking programmes. They will help you find the best way to stop smoking and suggest medication or nicotine replacement therapy.

If you’re struggling to quit, it might help to pay attention to the situations that make you want to smoke. If you always smoke when you’re stressed, tired or drinking alcohol, plan for these moments so you develop new ways to cope.

Even if you’ve tried and failed before, every fresh start counts.

Quick tips:

• Tell your friends and family that you have quit, they can help you stick to it and will know not to suggest a smoke.
• Try socialising with your friends and family in new places, or plan new activities to stop smoking being the activity you usually share together.
• Have healthy snacks and drinks available so you’re not tempted to smoke or reach for unhealthy treats.
• Keep track of the money you’re saving by not smoking shisha. Use it to give yourself a reward when you reach milestones to stay motivated.

Help and support

If you smoke shisha and want to quit, it's important to know you're not alone. In fact, you’re more likely to quit for good if you have the proper support that’s right for you. 

• Speak to your GP, pharmacist, or practice nurse about how to quit smoking. They can give you advice, enrol you in stop smoking clinics, and provide guidance on medicine and nicotine replacement therapy (NRT) to help you quit. 
• Get support from NHS Stop Smoking Services near you or call the Smokefree National Helpline on 0300 123 1044 (England only). Support is also available in Wales, Northern Ireland, and Scotland.
• Let your family and friends know that you're quitting. Some people find that talking to friends and relatives who’ve stopped smoking can be helpful.
• Call our Heart Helpline to speak to one of our Cardiac Nurses.
• Read tips for quitting smoking in this Heart Matters article