Has coronavirus killed off shisha cafes forever?

A street vendor makes a hookah or smoking pipe at a roadside shop in Lahore on January 15, 2019. (AFP/File Photo)
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Updated 12 August 2020

Has coronavirus killed off shisha cafes forever?

  • Compared with non-smokers, studies show smokers overall are more likely to develop severe COVID-19 symptoms
  • WHO warning says shisha smoking could facilitate coronavirus transmission in social settings

DUBAI: The age-old, convivial practice of sharing the shisha, or the waterpipe, during an evening of conversation and laughter has long been an integral part of many cultures, including in the Middle East. But now it is facing its biggest test of survival in living memory.

The World Health Organization (WHO) says using shisha involves the sharing of mouth pieces and hoses, which could facilitate the transmission of the coronavirus in social settings. The Middle East, with its thousands of shisha cafes, is particularly vulnerable.

As the pandemic gripped the world, many countries in the region — including Saudi Arabia, the UAE and Kuwait — imposed bans on shisha use. But this practice was drawing flak even before the COVID-19 era, with health experts warning that it was even more harmful than cigarette smoking.

According to the WHO advisory on shisha, “one hour of shisha use is equal to smoking approximately 100 cigarettes. It can be less or more, depending on the many factors.”

A review of studies by public-health experts convened by WHO on April 29 found that compared with non-smokers, smokers overall are more likely to develop severe COVID-19 symptoms. It also found that smoking impairs lung function, making it harder for the body to fight off coronaviruses and other respiratory diseases.

Dr. Assem Youssef, specialist pulmonologist at Medcare Hospital in Dubai, says shisha smoke contains high levels of tar, carbon monoxide, heavy metals and cancer-causing chemicals.

It increases the risk of lung and oral cancers, heart diseases and other circulatory diseases. “Shisha use by pregnant women can result in low birth-weight babies,” Dr. Youssef told Arab News. “Shisha pipes, if not cleaned properly, may lead to serious infectious diseases.”

FASTFACT

Shisha and COVID-19

Smokers overall are more likely to develop severe COVID-19 symptoms, compared to non-smokers (WHO).

“In shishas, only the nozzle is replaced after every use,” said Dr. Rami Sukhon, a specialist in family medicine at Dubai’s Al Zahra Hospital. “When smoking the shisha, there is a risk of the particles of saliva travelling through the nozzle down to the shisha base, which is not sterilized after a smoker is done with it,” he said.

“Further, shisha cafes are usually closed spaces, especially in summer, where several people exhale large volumes of smoke through their mouths and nose into the same air – this also poses the risk of spreading the virus through droplets released into the air.”

However, more research is required to assess the exact level of risk, Dr. Sukhon said.

On the matter of e-shishas, electronic water pens which operate in the same manner as an e-cigarette, experts say these are just as harmful.

The WHO has strongly recommended their ban in public places. However, the spread of the virus through the e-shisha has a different context.

“In e-shishas, if the shisha pen is not shared between people and is not smoked within a closed room with other people, the risk of spreading the virus can be considered as being lower,” Dr. Sukhon told Arab News. “Also, the volume of smoke from a shisha pen is less than from an actual shisha.”

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E-products’ emissions typically contain nicotine and other toxic substances that are harmful to both users and non-users, who are exposed to the aerosols second-hand, say health experts. Evidence reveals that these products are particularly risky when used by children and adolescents.

“Nicotine is highly addictive and young people’s brains develop up to their mid-twenties,” said the WHO.

“Exposure to nicotine (in) children and adolescents can have long-lasting, damaging effects on brain development and there is risk of nicotine addiction. Furthermore, there is a growing body of evidence in some [cases] that minors who use (are first-time users of) e-nicotine products increase their chances of (switching to) traditional tobacco cigarettes later in life.”

Tobacco kills more than 8 million people globally every year. More than seven million of these deaths are from direct tobacco use and around 1.2 million due to non-smokers being exposed to second-hand smoke.

Does this mean the shisha is in danger of becoming a thing of the past? Dr. Sukhon believes that before countries decide on reopening shisha cafes, they need to thoroughly evaluate the risks involved.

The WHO says it is up to countries to decide on the return of the shisha cafes, adding that if countries have been successful in banning it during the pandemic, they could ban them beyond COVID-19 as well.


Shisha in history

Known by different names — huqqa, sisah or shisha, qalyan, arjilah, nargil — depending on the region, the shisha has a long and illustrious history.

The shisha is said to have its origins in India back in the 16th century. There may be references to the shisha being used in Persia before then, but scholars point to the lack of evidence of the use of the water pipe until the 1560s. Some hold that the word nargil, as the shisha was called in Persia, derives from the Sanskrit word narikela, meaning coconut, suggesting that early shisha bowls were crafted from coconut shells.

According to Fumari’s Hookah Blog, the origin of the word shisha dates back to 16th-century India when the British East India Company began exporting glass to India and India glass makers crafted hookah bowls. The device was invented to purify smoke through water in a glass base called a “shisha” (or glass).

During this period, smoking tobacco became popular in high society. Shisha then migrated to the Turkish culture and during the 18th century increased its footprint, spreading through the Middle East in the 19th century.

In Egypt, traditional forms of tobacco were reformulated into a mix called Mu’Assel (meaning with honey) by mixing honey or molasses with the tobacco. By the late 1900s, shisha had migrated to virtually every continent as immigrants brought along with them a custom to share with their new home country.

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@CalineMalek


Pan-Arab poll: Biden better for region, but must shun Obama policies

Updated 26 October 2020

Pan-Arab poll: Biden better for region, but must shun Obama policies

  • Majority of respondents to Arab News/YouGov survey consider neither candidate good for region
  • Findings show strong Arab support for Trump on Iran but not on Jerusalem embassy move

RIYADH: Nearly half the respondents in an Arab News/YouGov poll conducted in 18 Middle East and Africa (MENA) countries believe neither candidate in the upcoming US elections will necessarily be good for the region.
Of the rest, 40 percent said Democratic Party candidate Joe Biden would be better for the region while 12 percent said the same thing about incumbent President Donald Trump. But a key takeaway of the poll is that if Biden, who served as vice president to Barack Obama until 2017, wins the White House race, he would be well advised to shed the Obama administration baggage.
When asked about policies implemented in the Middle East under the Obama administration, the most popular response (53 percent) was that the Democratic president left the region worse off, with another 58 percent saying Biden should distance himself from Obama-era policies.
The study surveyed a sample of 3,097 respondents online to find out how people in the MENA region feel about the Nov. 3 US elections.

Opinion

This section contains relevant reference points, placed in (Opinion field)

Containing Iran was found to be one of the top four issues that respondents wanted the next US president to focus on. Strong support for Trump both maintaining a war posture against Iran and imposing strict sanctions against the Tehran regime was noticed in Iraq (53 percent), Lebanon (38 percent) and Yemen (54 percent), three countries that have had intimate regional dealings with Iran.
President Trump’s 2017 decision to move the US Embassy in Israel to Jerusalem proved overwhelmingly unpopular, with 89 percent of Arabs opposing it. Surprisingly, in contrast to most other Arabs, Palestinian respondents inside the Palestinian Territories indicated a greater desire for the US to play a bigger role in mediation with Israel.
Arab opinion was largely split on the elimination this year of Iran’s regional “satrap” Gen. Qassem Soleimani, with the single largest proportion of respondents from Iraq (57 percent) and Lebanon (41 percent) seeing it as a positive move, as opposed to those in Syria and Qatar, where most respondents — respectively 57 percent and 62 percent — saw it as negative for the region.

Iran also figured in the list of perceived threats to US interests, although well behind white nationalism (32 percent) and China (22 percent). The other critical challenges for the US as viewed by Arabs were cybercrime, radical Islamic terrorism and climate change.
For a country that touts itself as an ally of the US, public attitudes in Qatar were found to be surprisingly out of sync with US objectives in the Middle East. The perception of radical Islamic terrorism, Iran and Islamist parties as the “three biggest threats facing the region” was much softer in Qatar compared with the region as a whole.
It came as little surprise that three quarters of respondents want the next US administration to make it easier for people from Arab countries to travel to the US. The figure for Lebanon, for instance, was even higher, 79 percent, underscoring concerns that many young Arabs are actively trying to leave the region.
Among other findings, Arabs remain overwhelmingly concerned about such challenges as failed government (66 percent) and the economic slowdown (43 percent).
Close to half of the respondents (44 percent) would like to see the next US president focus on empowering young people in the Arab region and solving the Arab-Israeli conflict (44 percent), followed by containing COVID-19 (37 percent), reining in Iran and Hezbollah (24 percent), quashing radical Islamic terrorism (24 percent) and tackling climate change (17 percent).