New moves to turn off shisha smokers

Health authorities to curtail popularity of Middle Eastern practice

By Joan Chew, The Straits Times, 22 Mar 2012

EVERY three months, Ms Collette Claire Miles, 20, meets a few friends at a shisha cafe in Kampong Glam's Haji Lane.

There they puff on fruit-flavoured tobacco from a shared mouthpiece for an hour or so, in between chats.

The polytechnic graduate, who first smoked shisha when she was 15, said: 'They are all my friends, so I trust they are not sick.'

But viruses could abound in the mouthpiece, exposing users to infectious diseases such as tuberculosis and influenza, said the Health Promotion Board (HPB). Furthermore, shisha cafes do not regularly wash their equipment, it added.

HPB wants shisha smokers like Miss Miles to know these facts about the Middle Eastern practice of inhaling tobacco smoke that is passed through water, via its new campaign starting tomorrow.

It is banking on the 'ick' factor to turn off some shisha smokers who may not bother about the main reason that it is bad: It has the same health risks as cigarette smoking, including cancer, heart disease and respiratory disease.



From tomorrow till April 6, SingTel mobile phone subscribers who come within 1km of shisha hot spot Kampong Glam will receive a multimedia message in the form of an 18-second video.

In it, a man called Tony urges them to 'draw deeply on the hose, that will give them a better chance of catching TB or whatever virus that may be left behind by the person before you'. The video ends by directing viewers to a nine-minute clip which will bring home the dangers of shisha smoking.

Tomorrow, young people in bright yellow T-shirts will distribute flyers against the practice in Kampong Glam.

The campaign launch coincides with the 15th World Conference on Tobacco or Health at Suntec Singapore, which ends on Saturday.

Though it is not known how many people in Singapore have taken up shisha smoking, there were 44 such cafes in January, up from a single one in 2002. Most are in the Kampong Glam area.

HPB is targeting a shisha hot spot for the first time. Previously, it concentrated its outreach efforts on secondary schools and polytechnics.

It is worried about young people's mistaken belief, highlighted in focus groups, that shisha smoking is a safe alternative to cigarette smoking due to its fruity smell and lack of tobacco aftertaste, said Dr K. Vijaya, director of HPB's youth health division.

Another worry is that the number of smokers has grown, from an-all time low of 12.6 per cent of the population in 2004, to 14.3 per cent in 2010. The habit is most prevalent among young adults in the 18 to 39 age group.

This campaign comes after the ban on lighting up was extended to more public areas earlier this month.

Five shisha cafe operators interviewed yesterday think the campaign will not hit their business hard, as less than 10 per cent of their customers smoke shisha.

One of them, Ms Shima Haqeem, 29, said offering shisha is not lucrative, but her cafe does so to retain customers.

She said: 'When a big group of 15 to 20 people come and one or two of them ask if we offer shisha, we lose the whole group to other cafes if we reply no.'

When shown the anti-shisha brochure, technician Mohamad Razali, 38, who smokes shisha daily at Kampong Glam after work, was unfazed.

He knows it is bad for health but said: 'If I get a disease from shisha smoking, then what can I do?'

He and two shisha cafe operators said that the only way to make people stop shisha smoking is to ban the practice.

But Miss Miles, who had been unaware that shisha smoking had so many adverse health effects, made an immediate decision to quit after reading the brochure.

Four public hospitals with smoking cessation programmes have not had patients who seek help to quit shisha smoking.

But smoking tobacco in any form - even shisha smoking which is seen as a social rather than addictive habit - puts one at risk of adverse health consequences, said Associate Professor Loo Chian Min, the head and senior consultant at the department of respiratory and critical care medicine at Singapore General Hospital.

Psychiatrist Munidasa Winslow, who runs a private clinic, warned that former smokers who use shisha, even infrequently, put themselves in danger of relapsing.

Clearing the air
Joan Chew peers through the smoke to uncover what goes into a shisha and a cigarette
Mind Your Body, 22 Mar 2012

The Health Promotion Board (HPB) will roll out its first campaign to educate young people on the ills of shisha smoking tomorrow.
Over two weeks, youth volunteers will visit hot spots for shisha smoking, such as Haji Lane and Arab Street, to distribute brochures and spread the message.

It is a move to stem the rising popularity of shisha smoking, which some people mistakenly believe to be a safer alternative to cigarette smoking.

CIGARETTE

What it is: A thin cylinder of finely cut tobacco rolled in paper for smoking, which can be held between the fingers.

Also known as: Cig, fag and smoke.

Duration of use: An average of three to five minutes.

Why it hurts: Cigarette smoke contains 4,000 chemicals, of which 400 are poisonous and at least 60 are cancer-causing. They include nicotine, which is what make cigarettes addictive.

Cigarette smoking increases one's risk of coronary heart disease, stroke, infertility, lung cancer and death from chronic obstructive lung diseases.

About 11 minutes are cut off from the life of a smoker for each cigarette smoked.

A gram of tobacco in a cigarette contains:

- An average of 11.2mg of tar, or a range of 1 to 27mg of tar

- An average of 0.77mg of nicotine, or a range of 0.1 to 2mg of nicotine

- An average of 12.5mg of carbon monoxide, or a range of 1 to 22mg of carbon monoxide

Effect on others: Second-hand smoke from the burning tip of a cigarette causes premature death and disease in children and adults who do not smoke.

Children of parents who smoke may have breathing difficulties and slow lung growth.

SHISHA

What it is: A pipe with a long flexible hose connected to a chamber in which tobacco is heated over charcoal and the smoke is cooled by passing it through water in the chamber before it is sucked through the mouthpiece. The tobacco is available in a variety of flavours such as apple and watermelon.

Also known as: Narghile, argileh, hubble-bubble and goza.

Duration of use: An average of 40 to 60 minutes, sometimes shared with others.

Why it hurts: Despite its sweeter smell, shisha smoking causes the same health risks as cigarette smoking, including that of oral cancer, lung cancer, stomach cancer, reduced lung function and decreased fertility.

Even after the smoke has passed through water, it still contains high levels of toxic compounds, including nicotine, carbon monoxide, heavy metals and cancer-causing chemicals. The chemicals are absorbed into the bloodstream.

A single shisha-smoking session involves inhaling as much smoke as that from 100 or more cigarettes.

Daily shisha smoking leads to absorption of nicotine at levels similar to that of smoking 10 cigarettes a day.

The social nature of shisha smoking, with many people sharing one mouthpiece, increases one's risk of infectious diseases such as tuberculosis and influenza.

A gram of tobacco in a shisha contains:

- 802mg of tar, about 72 times that in a cigarette

- 2.96mg of nicotine, almost four times that in a cigarette

- 143mg of carbon monoxide, about 11 times that in a cigarette

Effect on others: Second-hand smoke from shisha contains smoke from tobacco and also from the heat source, charcoal.

Non-smokers exposed to the smoke face the same health risks as those who breathe in second-hand smoke from cigarettes.

Source: Health Promotion Board; American Journal Of Preventive Medicine (2008); Food & Chemical Toxicology (2005)