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
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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.”

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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


Iraq’s political future in limbo as factions vie for power

Updated 58 min 20 sec ago
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Iraq’s political future in limbo as factions vie for power

  • The government that eventually emerges will be inheriting a security situation that has stabilized in recent years

BAGHDAD: Political factions in Iraq have been maneuvering since the parliamentary election more than a month ago to form alliances that will shape the next government.
The November election didn’t produce a bloc with a decisive majority, opening the door to a prolonged period of negotiations.
The government that eventually emerges will be inheriting a security situation that has stabilized in recent years, but it will also face a fragmented parliament, growing political influence by armed factions, a fragile economy, and often conflicting international and regional pressures, including the future of Iran-backed armed groups.
Uncertain prospects
Prime Minister Mohammed Shia Al-Sudani’s party took the largest number of seats in the election. Al-Sudani positioned himself in his first term as a pragmatist focused on improving public services and managed to keep Iraq on the sidelines of regional conflicts.
While his party is nominally part of the Coordination Framework, a coalition of Iran-backed Shiite parties that became the largest parliamentary bloc, observers say it’s unlikely that the Coordination Framework will support Al-Sudani’s reelection bid.
“The choice for prime minister has to be someone the Framework believes they can control and doesn’t have his own political ambitions,” said Sajad Jiyad, an Iraqi political analyst and fellow at The Century Foundation think tank.
Al-Sudani came to power in 2022 with the backing of the Framework, but Jiyad said that he believes now the coalition “will not give Al-Sudani a second term as he has become a powerful competitor.”
The only Iraqi prime minister to serve a second term since 2003 was Nouri Al-Maliki, first elected in 2006. His bid for a third term failed after being criticized for monopolizing power and alienating Sunnis and Kurds.
Jiyad said that the Coordination Framework drew a lesson from Al-Maliki “that an ambitious prime minister will seek to consolidate power at the expense of others.”
He said that the figure selected as Iraq’s prime minister must generally be seen as acceptable to Iran and the United States — two countries with huge influence over Iraq — and to Iraq’s top Shiite cleric, Grand Ayatollah Ali Al-Sistani.
Al-Sudani in a bind
In the election, Shiite alliances and lists — dominated by the Coordination Framework parties — secured 187 seats, Sunni groups 77 seats, Kurdish groups 56 seats, in addition to nine seats reserved for members of minority groups.
The Reconstruction and Development Coalition, led by Al-Sudani, dominated in Baghdad, and in several other provinces, winning 46 seats.
Al-Sudani’s results, while strong, don’t allow him to form a government without the support of a coalition, forcing him to align the Coordination Framework to preserve his political prospects.
Some saw this dynamic at play earlier this month when Al-Sudani’s government retracted a terror designation that Iraq had imposed on the Lebanese Hezbollah militant group and Yemen’s Houthi rebels — Iran-aligned groups that are allied with Iraqi armed factions — just weeks after imposing the measure, saying it was a mistake.
The Coalition Framework saw its hand strengthened by the absence from the election of the powerful Sadrist movement led by Shiite cleric Muqtada Sadr, which has been boycotting the political system since being unable to form a government after winning the most seats in the 2021 election.
Hamed Al-Sayed, a political activist and official with the National Line Movement, an independent party that boycotted the election, said that Sadr’s absence had a “central impact.”
“It reduced participation in areas that were traditionally within his sphere of influence, such as Baghdad and the southern governorates, leaving an electoral vacuum that was exploited by rival militia groups,” he said, referring to several parties within the Coordination Framework that also have armed wings.
Groups with affiliated armed wings won more than 100 parliamentary seats, the largest showing since 2003.
Other political actors
Sunni forces, meanwhile, sought to reorganize under a new coalition called the National Political Council, aiming to regain influence lost since the 2018 and 2021 elections.
The Kurdish political scene remained dominated by the traditional split between the Kurdistan Democratic Party and Patriotic Union of Kurdistan parties, with ongoing negotiations between the two over the presidency.
By convention, Iraq’s president is always a Kurd, while the more powerful prime minister is Shiite and the parliamentary speaker Sunni.
Parliament is required to elect a speaker within 15 days of the Federal Supreme Court’s ratification of the election result, which occurred on Dec. 14.
The parliament should elect a president within 30 days of its first session, and the prime minister should be appointed within 15 days of the president’s election, with 30 days allotted to form the new government.
Washington steps in
The incoming government will face major economic and political challenges.
They include a high level of public debt — more than 90 trillion Iraqi dinars ($69 billion) — and a state budget that remains reliant on oil for about 90 percent of revenues, despite attempts to diversify, as well as entrenched corruption.
But perhaps the most delicate question will be the future of the Popular Mobilization Forces, a coalition of militias that formed to fight the Daesh group as it rampaged across Iraq more than a decade ago.
It was formally placed under the control of the Iraqi military in 2016 but in practice still operates with significant autonomy. After the Hamas-led attack in southern Israel on Oct. 7, 2023 sparked the devastating war in Gaza, some armed groups within the PMF launched attacks on US bases in the region in retaliation for Washington’s backing of Israel.
The US has been pushing for Iraq to disarm Iran-backed groups — a difficult proposition, given the political power that many of them hold and Iran’s likely opposition to such a step.
Two senior Iraqi political officials, who spoke on condition of anonymity because they weren’t authorized to comment publicly, said that the United States had warned against selecting any candidate for prime minister who controls an armed faction and also cautioned against letting figures associated with militias control key ministries or hold significant security posts.
“The biggest issue will be how to deal with the pro-Iran parties with armed wings, particularly those... which have been designated by the United States as terrorist entities,” Jiyad said.