Shisha Facts
History of Shisha
Shisha is thought to have originated in 16th century in Persia. Some of the earliest descriptions of shisha use, as we would recognise it today, were from the 1600´s from European travellers to the court of the Mughal Emperor Akbar the Great in India. Shisha use spread following established trade routes throughout Asia and to the Middle East. In the Arab world shisha became highly popular in cafes, bazaars and souks.
In these communities, shisha, rather than alcohol is the social glue around which people have historically come together, connected, bonded, conducted business and resolved differences.
The word shisha is thought to be derived from the Turkish word for ´glass base´, and although its manufacture has modernised and quality improved, the overall experience has been very similar for hundreds of years.
Historically, two distinct forms of shisha have been used. The first is moist, flavoured shisha molasses which are heated via an external heat source – usually a few small cubes of charcoal - to produce a flavourful aerosol inhaled through a waterpipe, also known as a hookah pipe. The charcoal is separated from the shisha head by a layer of metal foil or a heat management device which prevents the burning of the molasses. Today, this form of shisha is by far the most common globally.
The second, known as black molasses, is preferred mainly in Egypt and is not widely available in Europe. Black molasses are drier than flavoured molasses and contain more tobacco. The charcoal must be placed directly on the tobacco itself, creating smoke which is then inhaled through the pipe. This product has very limited availability outside of Egypt, is not widely available in Europe and is not represented by ESCA.
Shisha Use
Flavoured shisha tobacco and non tobacco products are consumed through a large water-pipe in which the shisha is heated to a maximum of 200C, passed through a water vessel and inhaled through a hose. Shisha tobacco is a mixture of tobacco leaf, flavours, fructose and glycerine. The tobacco content is around 20%, the lowest tobacco content of any tobacco-containing product.
Shisha is placed in a bowl on top of the waterpipe and covered with metal foil or a heat management device, which supports a few small cubes of charcoal. After being heated, the aerosol generated is inhaled through a bowl of water, creating a diffused and flavourful vapour. It is sometimes assumed that the purpose of the water is to filter the aerosol. This is incorrect. The water creates suction in the device and enables the aerosol to be pulled through the pipe. Its purpose is purely functional.
Setting up a shisha session takes time and patience and the session itself can last between forty-five minutes to an hour. The preparation of shisha is a skill in itself and a poorly prepared or incorrectly used shisha spoils the experience. The waterpipe is around 3 feet tall, not easily carried around and impossible to conceal. This is why use of shisha by minors is low compared to other age controlled products.
Shisha is a social activity that is characterised by occasional use. For example, FDA sponsored research in the United States indicates that 90% of hookah users enjoy it just monthly.
For these reasons, shisha is a fundamentally different from cigarettes or e-cigarettes, which are characterised by ease of use, solitary use and high usage frequency.
Culture
In many parts of the Arab world, shisha is a part of traditional culture, and is considered a social custom, a centrepiece in social gatherings, celebratory events, and business meetings and for resolving differences.
In many ways it fulfils the social function that alcohol has come to serve in the West with the important difference that shisha does not have the intoxicating effects of alcohol.
Traditionally, it is common for one shisha to be shared among a group of people with a single hose, which is passed around the group. Social convention dictates that when being passed from one person to another, the mouthpiece and hose should be folded back on itself in such a way that the mouthpiece is not pointing at the recipient. These days’disposable mouth tips are ubiquitous and as a precaution against COVID, people are not sharing shisha and are using disposable hoses.
Most cafés in the Middle East offer shisha. Shisha cafés are widespread and are common social gathering places just like bars and nightclubs in the West.
In Europe, many shisha cafes were originally established to cater for ethnic communities that have roots in the Middle East, North Africa and the Asian sub continent. However, it also plays a role in helping diverse cultures to connect with and understand each other in increasingly multicultural societies.
Facts & Science
Is enjoying shisha the same as smoking cigarettes?
No. All tobacco products have risks but comparing shisha to cigarettes is erroneous and misleading.
Shisha is heated at a temperature that is four times cooler than a burning cigarette and creates an aerosol that is 75% water (60%) and glycerol (15%). By contrast, cigarette smoke is 75% tar, carbon monoxide, and nicotine[1].
Most people enjoy shisha in moderation, far less often than typical smokers light up a cigarette. In Germany, for example, average shisha users do so once or twice a week. In comparison, the average German cigarette smoker will smoke 20 to 30 cigarettes per day[2].
Shisha takes time to prepare and cannot be transported easily or used “on the go.” Shisha is a unique cultural and social experience, whose history, ingredients, and use make it incomparable to other tobacco products characterized by high frequency use.
[1] Cooperation Centre for Scientific Research Relative to Tobacco. A Preliminary Comparison of flavoured waterpipe tobacco aerosol with cigarette smoke. Wilkinson, Oct 2019
[2] German Federal Institute of Risk Assessment, Waterpipe - Frequently Asked Questions, Online, October 17, 2011
Is using Shisha safe or risk free?
No, shisha products contain tobacco and are NOT risk free or safe. All tobacco containing products are harmful to varying degrees. Products that are combusted, such as cigarettes, produce the most harmful or potentially harmful compounds compared to products, such as shisha, that are only heated at much lower temperatures.
Does the water bowl act to purify the shisha aerosol?
No. Water does not purify the aerosol. Its purpose is purely functional. Without the water, the aerosol from the shisha head cannot be drawn into the pipe.
Is a one-hour shisha session the same as smoking 100 or 200 cigarettes[3]?
No. Shisha aerosol and cigarette smoke are fundamentally different from each other.
A study[4] commissioned by a leading shisha tobacco manufacturer and published by the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA) found that a popular shisha brand - which has a much lower tobacco content than cigarettes – generates an aerosol that is 75% water (60%) and glycerol (15%). This is completely different from cigarette smoke that is 75% tar, nicotine and carbon monoxide. The same study found that flavoured shisha molasses are heated at much lower temperatures, and create aerosol with far lower concentrations of nicotine and other constituents compared to cigarette smoke.
For example, in the CORESTA study the aerosol generated from one hour of heating the flavoured shisha product contains less nicotine than two cigarettes.
In Germany, the Federal Institute of Risk Assessment reviewed the claim that waterpipe corresponds 100 cigarettes[2]. However, the opinion of the BfR, was that this comparison is unsuitable firstly because it could lead to the misleading impression that a waterpipe was as dangerous as 100 cigarettes. Secondly, robust comparisons are only possible on the basis of ingested smoke ingredients. An evaluation of other scientific studies by the BfR indicate that occasional water pipe consumption corresponds to the consumption of two cigarettes a day[2].
Innovations in heating shisha molasses can decrease chemicals in the aerosol even further and warrant further study.
[3] Arabian Business 7 Nov 2019. Is shisha really as bad for you as the world health experts say? New report from UAE-based manufacturer shines light on 'misleading' comparisons between shisha and cigarettes.
[4] Cooperation Centre for Scientific Research Relative to Tobacco. A Preliminary Comparison of flavoured waterpipe tobacco aerosol with cigarette smoke. P Wilkinson, Oct 2019
Is shisha contributing to youth tobacco use?
No. Shisha is not a major contributor to youth tobacco use.
Extensive evidence from the United States of America shows very few teens have tried shisha compared to other adult orientated products, including cigarettes and vapes. For example, the U.S. Centers for Disease Control found that just 2.6% of teenagers used shisha in the last 30 days. More than ten times as many teenagers use e-cigarettes (27.5%)[5].
Shisha waterpipe devices are generally around three feet tall on average and cannot be easily transported or concealed. In the United States of America, Politicians including the mayor of San Diego and the Governor of California, have publicly stated that hookah is “not the problem” for teens[6].
[5] CDC, National Youth Tobacco Survey - Tobacco Product Use Among Middle and High School Students — United States, 2019.
[6] L.A. County Board of Supervisors Unanimously Votes for Tobacco Flavor Ban Despite Pleas for Hookah Cultural Exception, prweb.com, 01 Oct 2019
Is there a difference between flavoured and unflavoured shisha?
Yes. Flavoured shisha is a completely different product from unflavoured shisha. Unflavoured shisha is very uncommon, contains a fundamentally different ingredients mix, including a higher tobacco content, and can only be consumed by burning tobacco and releasing tobacco smoke.
For example, black molasses from Egypt, which are unflavored, contain much higher levels of tobacco and nicotine. Their glycerin content is low and because of this, they can only be smoked by placing charcoal directly on the tobacco mixture, thereby burning it and releasing higher levels of toxicants.
ESCA members do not produce or sell any unflavoured shisha products. Our flavoured shisha products include around 40% glycerin and cannot be consumed by direct application of charcoal to the shisha Glycerin is a critical component in our members’ hookah products because it enables consumption without burning the mixture.
