Shisha in Saudi Arabia: Health Risks, Facts and Rules

Shisha smoking, also known as hookah or waterpipe smoking, is common in social settings across Saudi Arabia and the wider region. Despite its popularity, shisha is often misunderstood as a "safer" alternative to cigarette smoking.

Public health authorities strongly disagree.

According to global health organizations, shisha smoking exposes users to nicotine, toxic chemicals and carcinogens, largely because of charcoal combustion and long periods of smoke inhalation. This guide explains how shisha works, why it is harmful, and what Saudi law says about where it can be smoked.

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, and it is one of several common shisha myths.

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. Read more in Is Shisha Worse Than Cigarettes?

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.

"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. See Mu'assel vs Herbal Shisha for a full comparison.

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 risks also reach people nearby: secondhand shisha smoke exposes others in the room to the same toxic substances.

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 and the Law in Saudi Arabia

The Anti-Smoking Law (Royal Decree M/56) treats shisha as smoking. It bans smoking in places including mosque surroundings, government buildings, educational, health and sports facilities, workplaces and public transport. Anyone under 18 may not enter designated smoking areas, and tobacco products may not be sold to them. Read more in shisha and public health in Saudi Arabia.

What This Means If You Use Nicotine

The safest choice is not to use nicotine at all. If you want to stop, a doctor, a pharmacist or the Ministry of Health's tobacco cessation clinics can help.

Nicotine pouches do not involve charcoal, combustion or smoke, but they contain nicotine, which is addictive, and they are not risk-free. They are intended only for adults aged 18 and over who already use nicotine. See alternatives to shisha and shisha vs cigarettes vs nicotine pouches.

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. Read the full comparison.

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.

Where is smoking shisha banned in Saudi Arabia?
Under the Anti-Smoking Law, in places such as mosque surroundings, government buildings, schools, health facilities, workplaces and public transport.

How are nicotine pouches different from shisha?
Nicotine pouches are placed under the lip and do not use charcoal, combustion or smoke. They still contain addictive nicotine and 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, and water, herbal mixtures or premium brands do not change that.

Nicotine pouches contain nicotine, which is addictive. They are intended only for adults aged 18 and over who already use nicotine and are not a smoking-cessation product. If you want to stop using nicotine, speak to a doctor or pharmacist. Adults 18+ can browse nicotine pouches and DZRT at Haypp KSA.