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Sunday, September 19, 2021

The wolf in sheep’s clothing

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“I need it to focus; it helps me concentrate; it calms my nerves.”

“It’s not the same as cigarette smoking, it’s much safer.”

“I can’t get addicted to it….”

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These were the words from someone very close to me when after several advices to stop the use of HOOKAH. as I felt it will be detrimental to one’s health. I however spoke without proof, this prompted me to make a lot of findings on the use of the hookah and these findings are what I will love to share in this work.

Every young person wants to have a taste of a better life, a state where they feel free from the stress and troubles of living. Some use music to wipe out that stress, some use religion to find an inner peace, some use success to distract themselves by using all their energy to achieve their goals, while most use other filthy habits like pornography, alcohol abuse , smoking of tobacco and the use of drugs like heroin , marijuana , opium , cocaine e.t.c to wash away the truth about the reality of life in their eyes. They actually feel better after using these , but this feeling only lasts for a while when the effect of the substances abused begin to wear off or changes in the body  created by the watching of pornographic films or pictures begin to come back to normal. As a result, these young people waste most of their lives on trying to always have that feeling again and again leading to addiction to these filthy habits. The bad thing about these filthy habits is that they live in a very close association that the abuse of one leads to abuse of others. Take for example a guy starts smoking and gets addicted to the act he begins to look for other alternatives like alcohol abuse and drug abuse. The truth is that problems and troubles will never go away by addiction to the filthy habits.

We may have heard so many works and articles on substance abuse but I will like to centre this work on tobacco abuse in the form of HOOKAH use. Sit back and enjoy the ride as we adventure into the land of myths, facts and truths.

What is HOOKAH?

Hookah smoking is also known as shisha smoking, Hubble bubble smoking, Narghile (Turkish water pipe) smoking. Hookah is an instrument used for heating or vaporizing and then smoking either tobacco, flavored tobacco or sometimes cannabis, hashish and in the past opium. The use of hookah involves a flavored tobacco (mixed with dried fruits and/or honey or sweeteners) that is heated by a burning wood or coal or charcoal. The smoke from the heated flavored tobacco passes through a bottle which contains water in a bowl at the base. The water moisturizes this smoke. The device has a pipe connected to the bottle and through the mouth piece of this pipe the hookah user inhales the moisturized smoke into his or her body (lungs).

The use of hookah is prominent in the Middle East but there is an obscurity as to whether its use began in the India or Persia. Hookah use was however popularly associated with Indians. The device was then used to smoke original or natural tobacco. Despite the use of this substance seen as a taboo back then, idea of smoking tobacco through the device as the water purifies it seemed considerate, pleasing and sensible that noble men began to smoke tobacco through the device to display their high social status. Not only did it help the noble men but the use of hookah became so widespread among all classes of the society in India, Persia, Egypt, Turkey, Pakistan, Israel e.t.c as it was instrument to promote peace and unity, to show hospitality, acceptance and build bonds and relationships. The use of hookah had been so rooted in their cultures that refusal to accept a puff or use of the hookah was termed an insult and a showcase of enmity. When hookah entered Egypt, the tobacco used was modified by adding honey (MU’ASSEL) and dried fruits like apple , mango , orange etc to produce a flavored tobacco which we today call shisha. This flavored tobacco is what is smoked by most hookah users, however in some parts of south Asia the original tobacco known as “Tumbak” is still in use. People that practiced the hookah smoking carried and shared this culture as they migrated. This has led to the extensive use of hookah across all continents of the world.

Is hookah smoking different from smoking cigarette?

There may be some differences between the use of hookah and cigarettes mainly in the method of use and equipments but the fact is that hookah use is not “all that different” from cigarette smoking.  One difference as we may already know is that cigarette smoke passes directly from the cigarette stick into the lungs, however in the hookah smoking, the smoke from the tobacco is passed through the water in the bowl at base of hookah before going into the lungs. This water is believed to purify the tobacco smoke from toxins. Statistics and research however show otherwise. Even if the water does filter toxins, the smoke produced after passing through water still contains huge amount of toxins. The water only relatively moisturizes the smoke making the smoke feel smoother and cooler as it goes down the lungs, nothing more.

Actually, shisha contains tobacco which is the same harmful ingredient in cigarette. The “smoking kills” warning on a pack of cigarette is because of this dangerous substance, tobacco. The difference between the tobacco in cigarette and that in shisha is that, the tobacco in shisha is flavored while that in cigarette isn’t. This flavored tobacco makes the shisha smoke smell better and nicer than cigarette making it more pleasing for use in the mind’s eye.  Now the question is, what exactly is tobacco?

Tobacco is actually a derivative of the curved leaves of the tobacco plant and it contains nicotine, tar, carbon monoxide, heavy metals and other cancer-causing chemicals (carcinogens). The tobacco in shisha and cigarette has varying amounts of these chemicals. According to research from the University of Pittsburgh School of medicine, it was shown that a session of shisha smoke which is typically an hour long use of the hookah, delivers 25times the tar in cigarette, 125 times the smoke, 2.5times the amount of nicotine and 10times the Carbon monoxide as that delivered by a single session of cigarette use which usually involves one stick and 10-20 minutes of use on an average. The CDC (Centre of Disease Control) also established that in an hour’s long session of shisha smoking, 9 times the carbon monoxide and 1.7 times the nicotine of a single cigarette session is delivered into the body. CDC also established that a single hour’s session of shisha use involves 200 puffs and roughly delivers 90000 milliliters of smoke as compared to a single cigarette session that involves typically 20 puffs and delivers up to 500- 600millilters of smoke. These statistics and data may not be the same but they both point in one direction and that is, “a single session of shisha smoking (an hour) delivers more chemicals in tobacco to the body than the single cigarette smoking”.

Another difference is the motive. Cigarette smokers are mostly nervous and competitive people, driven by strong desire to achieve success in life. While the use of hookah is to promote friendship and makes bonds stronger, abuse of shisha is not inevitable. As a matter of fact most people using the shisha become so used it, they don’t have to wait for an occasion anymore , they smoke the shisha at any point in time.

Is shisha safer than cigarette?

In short, hookah use is not safer than cigarette smoking as many perceive. This perception that water makes shisha less toxic is not really true. The same toxins as eluded earlier found in cigarette are found in hookah and a session of hookah use produces or causes more intoxication by the substances to the body than a single cigarette session. The occasional use of hookah produces negative health effects as cigarette use. Study shows that an hour’s session of shisha smoking is equal to 100 -180 cigarettes sticks.

People believe hookah use is not addictive like cigarette is, but this is another wrong notion. Nicotine a substance found in tobacco, which is present in both cigarette and shisha is an addictive substance. This substance is what makes people crave for the use of cigarette and has the propensity to cause addiction in shisha users. The fact that alot of nicotine is delivered to the body. In a session of hookah use supports this fact. Study reveals that most youths that begin the use of shisha are likely to become cigarette addicts, and I have seen this manifest in reality in the life of a guy, who started with hookah before eventually becoming a chronic cigarette addict.

Shisha smoking and cigarette smoking all pose the same risk to health but the downside is that, many people believe that shisha smoking is safe, as a result its abuse is very likely. This ignorance about the safety of shisha causes it to be very harmful to health as shisha smokers and others are unaware of the risk that this habit poses to a healthy living. Suffice to say, that a cigarette smoker knows that cigarette use is dangerous and may be cautious and concerned about its use. This is not so in a shisha smoker or abuser.

Adverse effects of shisha smoking

The adverse effects of shisha smoking are the same as those effects experienced by cigarette smokers and even more. More in the sense that, the use of hookah puts a person at risk of acquiring infections through the sharing of pipe. Oral bacteria and viruses like herpes virus, hepatitis C and other respiratory infections like Tuberculosis can be transmitted by this medium. This phenomenon is hardly seen in cigarette smokers as hardly do cigarette smokers share sticks as done by shisha smokers.

Other effects of shisha use include

  Cancer. The tobacco in shisha still contains a lot of toxins and cancer-causing chemicals (carcinogens) that lead to development of lung cancer, oral cancers, esophageal cancers, cancer of larynx (voice box), and cancer of the bladder. These cancers ensue due to DNA damage done by constituents of tobacco smoke.

    Heart and blood vessels related disease (cardiovascular diseases). The smoking of shisha can lead to the development of hypertension, myocardial infarction and other heart and blood vessel diseases. Excessive carbon monoxide intake or inhalation decreases the oxygen carrying capacity of the body, causing the depletion of oxygen supply to the heart and other tissues like kidney, brain etc.

    Lung diseases, Asides the cancer that can be caused to the lungs, tobacco can cause bronchitis and chronic emphysema, simply put, destruction of the lung tissues. The lung also has a part to play in protecting us from several infectious diseases as it stands as a barrier to the entry of bacteria and viruses and other injurious substances, but the use of hookah cause damage to this beautiful lung making one prone to more infections.

   Addiction to tobacco is also another negative effect; the nicotine content which is addictive is the culprit.

   As we may see often, shisha use is widely accepted that women smoke it. This can lead to abortion of the fetus, premature birth and intrauterine growth retardation (the baby size and weight will be way below normal).

     What about the money that shisha use consumes when it becomes an addiction. This depletes the economic status of a person leading to increase likelihood of acquiring other infectious diseases due to poor hygiene.

  Secondary smoking of shisha. Inhalation of the smoke  without actually smoking it increases  the risk of cardiovascular diseases, cancers and lung diseases as highlighted above. This happens when you are within a vicinity where shisha is being smoked.

Points to note

    Smoking Hookah does not carry less risk of tobacco-related diseases than smoking cigarettes.

  Hookah is not less harmful than cigarettes.

     It’s not okay if you go to a tobacco bar and do not smoke hookah. You can acquire treats to your health through secondary smoking.

   The water jar does not filter the harmful chemicals from the Hookah smoke.

   A hookah session is more harmful than a session of cigarette smoking and even more than a pack.

?   Hookah is addictive.

?  It’s more dangerous to share hookah in a group due to risk of infectious diseases acquisition.

The use of HOOKAH in The Gambia

Like in most parts of the world, the high rate of hookah smoking in The Gambia is alarming. Despite government restrictions placed on its use, people still fail to abstain from this deadly act. One big issue here is how many of our high school kids, students of universities and other tertiary intuitions, girls and women are all in an entanglement with hookah smoking. This is mainly due to the myth that the smoking of shisha is not harmful. This year the Gambia joined Kenya, Tanzania and Rwanda to be the only African countries to impose a ban on the use of shisha use in public places, its advertisement and sales.  Shisha use was prominent in night clubs, restaurants and bars before a ban was placed on its use and the typical shisha session in The Gambia was 3hours unlike the WHO 1 hour session, as people are mostly ecstatic in such places. Hookah smokers have now resolved to indoor smoking of shisha which simply means no more restrictions to how much time they can spend as it’s done in public places, leading to relatively longer sessions. The likelihood of having a generation that has embraced tobacco use and addiction is high if our future leaders (young kids) are already misguided and entangled with tobacco use at a tender age, I feel the hurt of the innocent tomorrow’s people.

The someone close spoken about at the beginning thought using shisha was an easy way out to use tobacco and save oneself from the damaging effects, today that someone is a chronic tobacco abuser and has even graduated to marijuana use. It is important to note that marijuana is the major cause of substance induced psychosis (loss of touch with reality), which is also the highest reason for admission into Tanka Tanka, a home for the mentally unstable in the Gambia. This benign new trend of tobacco use is a “wolf in sheep’s clothing”. Let’s expose and drive out this wolf from our societies before we fall prey to its viscous attack.

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