"A single puff¹ from a water pipe is nearly equal to the volume of smoke inhaled² from an entire cigarette," said The Tobacco Atlas³ launched at the World Conference on Tobacco OR Health in Abu Dhabi.

 

And World Health Organization tobacco expert Edouard Tursan d'Espaignet said "one session of shisha (water pipe) can be equal to smoking 20 to 30 cigarettes in one go, which can be very dangerous."

 

The water pipe, variously known as a hubbly-bubbly, hookah, shisha or nargileh, has become a major worry for anti-tobacco campaigners as its is popularised across university campuses, overlooked by regulators.

 

In recent years, its use has spread to the United States, Europe and, to a lesser⁴ extent,South America.

 

Gemma Vestal of the WHO's Tobacco Free Initiative told AFP that while shishas were previously⁵ the domain⁶ of older males, "younger people between 18- and 24-years old living in cities and educated" are increasingly smoking them.

 

The chairman of pathology and laboratory medicine at the American University of Beirut, Ghazi Zaatari, says aromatic⁸ flavourings known as maasal added to the tobacco offer younger smokers¹⁰ a "smoother and more tolerated" alternative to the taste of traditional tobacco.

 

And the "water pipe has an interesting design because it somewhat engages your five senses. You're holding the hose, there’s something you're looking at, there is the aroma⁷, there is the sound of the bubbling and there is this kind of sensational¹¹ thing with the social gathering¹²."

 

In social gatherings¹³ that last for an average of an hour, the smoker⁹ can quickly get "hooked on it because of the nicotine¹⁴."

 

Moreover, the smoke from charcoal¹⁵ used to heat the tobacco contains toxins¹⁶.

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