Shisha smoking, also known as hookah or waterpipe smoking, is deeply embedded in social culture across Saudi Arabia and the wider Middle East. Despite its popularity, shisha is often misunderstood as a “safer” alternative to cigarette smoking.
Public health authorities strongly disagree.
According to global and regional health organizations, shisha smoking exposes users to nicotine, toxic chemicals, and carcinogens, largely due to combustion and prolonged smoke inhalation. As awareness grows, many adult consumers are now questioning the real health impact of shisha and exploring smoke-free alternatives such as nicotine pouches and vaping products.
What Is Shisha and How Does It Work?
Shisha is a method of smoking flavored tobacco (commonly called mu’assel) using a waterpipe. A typical shisha setup includes:
- A bowl filled with shisha tobacco
- Burning charcoal placed on top
- A water-filled base
- A hose through which smoke is inhaled
When charcoal heats the tobacco, smoke is produced and drawn through water before inhalation.
A critical misconception is that the water “filters” harmful substances. Public health evidence shows that this is not the case.
Why Shisha Is Harmful: What Public Health Authorities Say
Shisha Smoke Contains Dangerous Substances
The World Health Organization (WHO) states that waterpipe smoke contains:
- Nicotine (which is addictive)
- Carbon monoxide
- Heavy metals
- Cancer-causing chemicals
WHO clearly states that passing smoke through water does not make shisha safe and does not eliminate these harmful substances.
Long Sessions Mean Higher Exposure
A typical shisha session can last between 45 and 90 minutes, significantly increasing total smoke exposure compared to smoking a single cigarette.
The U.S. Centers for Disease Control and Prevention (CDC) reports that a single shisha session may involve inhaling much larger volumes of smoke than cigarette smoking, increasing exposure to toxic compounds.
Charcoal Makes Shisha Worse
Unlike cigarettes, shisha requires burning charcoal. Charcoal combustion produces:
- High levels of carbon monoxide
- Fine particulate matter
- Additional toxic gases
According to the WHO, charcoal is a major contributor to carbon monoxide exposure and other health risks associated with shisha smoking.
WHO – Tobacco Control and Exposure Reports
“Herbal” or Tobacco-Free Shisha Is Not Safe
Some products are marketed as “tobacco-free” or “herbal” shisha. These products replace tobacco leaves with plant-based materials.
Health authorities emphasize that any product heated with charcoal produces harmful smoke, regardless of whether it contains tobacco.
Tobacco-free does not mean risk-free.
Health Risks Associated With Shisha Smoking
Based on public health evidence, shisha smoking is associated with:
- Nicotine addiction
- Lung and respiratory disease
- Cardiovascular disease
- Increased cancer risk
- Carbon monoxide poisoning
The World Health Organization has stated that shisha smoking is a serious public health concern and should not be considered a safe alternative to cigarettes.
Shisha in Saudi Arabia: Health Awareness and Regulation
Saudi Arabia has strengthened public health policies in recent years, including tobacco control measures overseen by the Saudi Food and Drug Authority (SFDA) .
These measures reflect increasing awareness of:
- The health risks of smoking, including shisha
- The importance of reducing exposure to harmful substances
- Encouraging informed adult consumer choices
Smoke-Free Alternatives: Nicotine Pouches and Vaping
Public health authorities consistently identify combustion and smoke inhalation as the primary drivers of smoking-related disease.
Nicotine pouches and electronic cigarettes:
- Do not involve combustion
- Do not produce smoke
- Do not generate carbon monoxide from charcoal
Public Health England and the Royal College of Physicians have stated that nicotine itself is not the primary cause of smoking-related disease and that smoke-free alternatives may significantly reduce exposure to harmful substances compared to smoking.
Important: These products are not risk-free. Nicotine is addictive, and long-term effects are still being studied.
Frequently Asked Questions
Is shisha worse than cigarettes?
Both are harmful. Shisha exposes users to toxic smoke, nicotine, and carbon monoxide, often over longer sessions.
Does water make shisha safer?
No. WHO states that water does not effectively filter harmful substances.
Is herbal shisha safe?
No. Heating any material with charcoal produces toxic smoke.
Are nicotine pouches safer than shisha?
Public health authorities indicate that smoke-free nicotine products expose users to fewer harmful substances than smoking, but they are not risk-free.
Conclusion
Scientific evidence is clear: shisha smoking is harmful due to smoke inhalation, charcoal combustion, and prolonged exposure to toxic substances.
As awareness grows in Saudi Arabia, many adult consumers are exploring smoke-free nicotine alternatives as part of a harm-reduction approach. Understanding these differences is essential for making informed decisions.
Adults 18+ in Saudi Arabia can browse the full nicotine pouch collection, including the DZRT range at Haypp Saudi.
