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http://www.theglobeandmail.com/serv...ienceandHealth/
Are hookahs really harmless?
By ANDRÉ PICARD
Tuesday, December 13, 2005 Posted at 8:34 AM EST
From Tuesday's Globe and Mail
Montreal — Orange, cherry, strawberry, apple, guava, coconut, mint and even house blends like "After Eight": The menu reads like that of a chi-chi tea house, or an upscale gelato bar.
But the sweet delights being offered up at Montreal's Hookah Lounge are all flavoured tobaccos -- the latest indulgence of young trendsetters across North America.
"It tastes so sweet, and it's really, really relaxing," says Roxanne Martin, a 20-year-old university student. "It's also a lot more sociable than just having a cigarette."
Ms. Martin is sitting on comfy cushions with three other friends, laughing, drinking and smoking in the St. Denis Street bar.
The foursome is smoking cherry-flavoured tobacco from a large hookah pipe sitting on the table. Each has a long tube with a filter tip, and they are absentmindedly sucking in the smoke as they talk.
"I'm not a smoker, but I like sheesha," says François Guérin, a 23-year-old psychology major. "The smoke isn't harsh like a cigarette, and it's not bad for your health because the toxins are filtered out."
Hookah, a centuries-old practice (which also goes by the names sheesha and arguileh) is a glorified form of smoking a water pipe. Flavoured tobacco is burned on red-hot coals and the smoke is inhaled after passing through cooling water, all of it contained in an elaborately artful brass receptacle.
Many believe the water filters out the health-damaging byproducts of smoking, such as nicotine, tar and other carcinogens.
But new research shows that is not true.
"Water filters out nicotine a little bit, but not entirely," said Rima Nakkash, a tobacco researcher at the London School of Hygiene and Tropical Medicine. "There is an alarming amount of tar and smokers are inhaling a tremendous amount of carbon monoxide.
"We need to correct the misconception about the safety of arguileh," she said.
Ms. Nakkash said that while cigarette smoking has become an anti-social habit, hookah smoking is very sociable. As a result, people will smoke virtually non-stop for hours, which more than makes up for the small amount of nicotine that is filtered out.
"There's an end point to a cigarette but there's no end point to arguileh. The evening can just go on and on."
The popularity of hookah bars, however, could be short-lived -- at least in Canada. Many municipalities have adopted tough anti-smoking bylaws that have been interpreted as applying to all forms of tobacco smoking. Still, in some communities, bars owner can sidestep the rules by setting up rooms for private parties where hookah smoking can take place.
In Quebec, where bars will not be smoke free until January of 2007, there is an exemption for lounges (such as cigar-tasting facilities) and hookah-bar owners believe they will be allowed to remain open under those provisions.
Meanwhile, Ms. Martin and her friends while away a whole evening in the Hookah Lounge, ordering up "coals" (20-gram packages) of flavoured tobacco along with pitchers of sangria. Each package of tobacco costs $7.50 -- the student price, which is less than a pack of cigarettes (the regular price is $11.50) -- and lasts almost an hour.
They've come for the atmosphere to the bar with the hookah-smoking Santa painted on the front window, Ms. Martin said.
The crowd here is young and laidback; there are comfortable lounge chairs and pillows, along with background music, and remarkably smoke-free air.
"I've invested in a good ventilation system," said Patrick St. Onge, the youthful owner of the Hookah Lounge. "I know that my clients come here for the ambience."
In fact, hookah smoking has become trendy precisely because the practice has moved out of the more traditional confines of mostly Middle Eastern cafés and into urban bars.
That worries Linda Waverley, program manager of research for international tobacco control at the International Development Research Centre in Ottawa, which is sponsoring research on the burgeoning hookah habit.
"These machines are quite attractive and fascinating, and there's a whole mythology built up around their safety," she said. "This is a form of smoking that is really being targeted at youth, and that's disturbing."
Monique Chaaya, an associate professor in the faculty of health sciences at the American University of Beirut, said young people are attracted to hookah smoking because it tends to be cheaper. That's because tobacco is imported -- and sometimes smuggled in -- and not subject to punitive taxes or to health warnings on packages.
In the Middle East, where there were long social prohibitions, women are now taking up the habit, including large numbers of pregnant women, according research done by Dr. Chaaya.
But she said the principal selling point of hookah, in both the developing and developed world, is that it is not viewed in the same way as other forms of tobacco consumption. "You look down on someone who smokes cigarettes but it's still socially acceptable to smoke arguileh," she said. "It's considered charming and adventurous." With a sigh, she added: "Anti-smoking activists have some education work to do, particularly with young people."
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