Is Smoking Shisha Or Hookah Safer Than Cigarette Smoking?

September 18, 2021 | Written By: Nurul Afiqah

Is Smoking Shisha Or Hookah Safer Than Cigarette Smoking?


Nowadays, shisha or hookah sparks a developing interest in Malaysian society. Shisha is available in many restaurants, especially Middle Eastern theme restaurants.  This is because shisha is indeed popular in the middle east. When it was first introduced, most people just wanted to try for fun as shisha was something new at that moment. But some people consider shisha as a smoking alternative because it feels safer than cigarettes. Is this true? 

What Is Shisha?

Shisha is a method of smoking that has existed for the past 400 years among the Indian community. Shisha has various names such as Narghile , Hookah , Hubble Bubble , Goza , Boori and Arghile in various countries around the world.

Shisha is designed in different shapes, colours and sizes. The basic structure of shisha consists of a hose, grommet, body and bowl. The interesting thing is that there are various types of shisha tobacco flavours. The tobacco is first soaked in different types of interesting fruit flavours such as strawberries, grapes, honey and even apples. Flavoured tobacco is known as mouassal. There are three types of commonly used tobacco that include Mouassal, Jurak and Tumbak which each contain different ingredients. In short, Mouassal is an Arabic translation for "honey" containing 30% tobacco and about 70% honey, sugar cane, glycerol and flavours. It is estimated that the nicotine content in Mouassal is approximately 3.4mg / g.

Other than that, Jurak contains tobacco, sugarcane and about 20% other spices and dried fruits. Jurak is commonly used in the Middle East region. Tumbak is used mainly in Asian countries. It is a pure form of tasteless tobacco leaves (Ajami), that uses charcoal to create the smoke.

The tobacco used in shisha is usually imported from Arab countries, however, there are also traders in our country who mix their own tobacco for shisha. The various flavours of shisha depend on the ingredient used. 

Studies proved that shisha also contains nicotine, carbon monoxide gas, tar and polyaromatic gas hydrocarbon (PAH). Although there is water inside the vase or in the base of the shisha jar which is believed to filter out harmful substances from the smoke created, the fact is that the water in the jar can filter only a small part of the chemical. Users will tend to smoke shisha more frequent to replace the nicotine content that has been filtered out.

Health Effects of Smoking Shisha 

Shisha has a negative impact on body health. The effects of smoking shisha are often associated with heart and lung problems. Side effects of smoking shisha include:

  • Heart Disease



Shisha can cause heart problems due to blood vessels being damaged. The chemicals in shisha cause the blood vessels to become narrow and increase your blood pressure. Besides, high cholesterol levels in the blood are one of the multifactorial causes of heart disease. Bad cholesterol such as LDL, triglycerides and malondialdehyde were found to be much higher in shisha smokers compared to those who did not. The total capacity of antioxidants and vitamin C are found to be much lower in shisha smokers. Hence, it is proven that smoking shisha can increase the risk of heart disease.

  • Vulnerable to Infections

Due to pipe sharing, shisha smokers are highly susceptible to bacterial and viral infections such as hepatitis, herpes and tuberculosis. As shisha smokers gather in large groups, either with friends or family members, this will also increase the risk of those infections. The sharing of shisha mouth tips causes the spread of various organisms and pathogens through saliva. The moist-to-wet environment of the mouth tips promotes the growth of various microorganisms. 

  • Cancer



Shisha, just like cigarettes, can cause cancer, especially in the lung and mouth. Other studies have also reported that shisha smoking is associated with bladder cancer, prostate cancer, lips squamous cell carcinoma and keratoacanthoma, nasopharyngeal cancer, oesophagal cancer and mouth dysplasia.

  • Ageing

Inhaling shisha will cause you to look older. This is due to the damage in your skin structure which is exposed to chemicals from shisha.

  • Effects on Pregnancy



A study has proven that shisha is dangerous to pregnant women. Shisha smoking during pregnancy increases the risk of having low birth weight babies. It can also cause respiratory problems in the fetus in the first trimester. Plus, pregnant women who are exposed to secondhand- smoke from shisha can have fatal complications. 

What Is The Difference Between Shisha And Cigarettes?

The most noticeable difference between cigarettes and shisha is the way they are used. Shisha has a jar structure that contains water. Flavoured tobacco is heated in this jar. Then, the tobacco smoke produced will be inhaled through an inhaler connected to a hose. As the smoke passed the water, this is believed to be able to clean the smoke. However, this has proven to be wrong and has been repeatedly questioned by the medical community.

Despite their different structures and ways to use, the content of shisha is the same as cigarettes. Shisha contains tobacco and other toxic substances such as nicotine, tar, carbon monoxide, arsenic and tin. Although the content is the same, shisha is more dangerous than regular cigarettes because the smoke released contains higher levels of tar, carbon monoxide, arsenic and nickel.

Is Shisha Safer Than Cigarettes?

Shisha is popular among young people nowadays due to misconceptions about shisha which is said to be safer than cigarettes. Plus, shisha has more attractive shapes and flavours. The fact that it is affordable also precipitates this growing interest.

Users of shisha or hookah are actually exposed to various toxic substances, the same as or even more serious than smokers. Other than the risk of various heart-related diseases, the most worrying thing is the sharing of hookah or shisha causes the spread of various infectious diseases. It causes germs to spread easily!

Shisha also contains nicotine that causes addiction. Some people may think that they do not inhale the smoke but keep it in their oral cavity or mouth so that they will be safe from the effects of nicotine absorption or addiction. However, the reality is, nicotine can be easily absorbed through the mucous membranes in the oral cavity. Take this quiz to find out if you have nicotine dependency!

For your information, you inhale more tobacco smoke containing nicotine while smoking shisha as it produces more smoke than regular cigarettes. According to the CDC ( Centers of Disease Control and Prevention ), one hour of smoking shisha is equivalent to smoking 200 regular cigarettes. The amount of smoke produced by shisha is 90000 millilitres, while smoke from cigarettes is about 500 to 600 millilitres.

So, Shisha Or Cigarette?

Forget your intention to try shisha if you think it is a way for you to quit smoking. Both still pose a danger to the health of your body. If you have difficulty quitting smoking, you are advised to consult your doctor. As explained above, people need to know about the dangers of shisha to the body. The myth spread by shisha distributors should be eradicated as it is far from the truth. Stay away from shisha and cigarettes. 

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