KARACHI, Sept 7: Unaware of the fact that shisha, or water-pipe smoking, is just as harmful as cigarette smoking, the city’s youth, particularly university-level students, are getting hooked to these hookahs and that too with parental approval, reveals a study.

The study, titled ‘Knowledge, attitudes and practice of university students regarding water-pipe smoking in Pakistan,’ was jointly carried out by the Aga Khan University Hospital’s department of pulmonary and critical care medicine and the Dow University of Health Sciences (DUHS).

The findings of the study have also been printed in this month’s issue of The International Journal of Tuberculosis and Lung Disease.

As many as 450 students – 268 male and 182 female – from the AKU, DUHS, Institute of Business Management and the National University of Computer and Emerging Sciences took part in the research.

The study says that for decades, water-pipe smoking was restricted only to rural areas. But the last few years have seen a rapid growth in the number of shisha smoking venues in major cities of Pakistan increasingly attracting the youth.

A country that already has a high prevalence of tobacco use is now witnessing a surge in water-pipe smoking in both urban young men and women with greater parental approval for the addiction as compared with cigarette smoking.

The study found that of the total 450 students, 64.2 per cent of the male and 37.9 per cent of the female participants had smoked shisha at least once in their lifetime, with 77.3 per cent of the males who had smoked shisha continuing with the habit. The same is the case with 33.3 per cent of the women participants.

Regarding the characteristics of water-pipe smoking, it was observed that 56.4 per cent of the participants smoked shisha less than once per month, 30.2 per cent did so at least once a month, 10 per cent at least once per week and only 3.4 per cent were found to be regular smokers of shisha. The majority smoked for more than 30 minutes at each sitting and also shared their water-pipes with others.

According to the research findings, the flavour is the most likeable attribute of water-pipes and about a third of the current water-pipe smokers consider themselves addicted to shisha, but only about a fifth are willing to quit it.

When asked about parental attitudes towards shisha smoking, 78.5 per cent of the participants claimed that their parents had no problem with this practice. By contrast only 21.1 per cent of the parents approved of cigarette smoking.

Another aim of the study was to ascertain how well aware the youth are about the health hazards posed by smoking. It was noticed that around 17.6 per cent of the participants were unable to identify even a single harmful effect of water-pipe smoking.

The study also revealed that most of the participants considered cigarette smoking more hazardous than shisha smoking.

The study identified curiosity, pleasure-seeking, peer pressure, boredom and stress and a lack of entertainment as the key factors behind the initiation of water-pipe smoking.

A widespread myth about water-pipe smoking, the study points out, is that the passage of smoke through the steaming water in water-pipes ‘purifies’ the smoke of all harmful elements.

It has now been established, however, that exposure to carbon monoxide and nicotine after water-pipe smoking is at almost the same levels as those associated with cigarette smoking.

“It has also been proven that long-term habitual use of water-pipes, as with regular cigarette smoking, is associated with lung, gastrointestinal and bladder problems as well as pulmonary, cardiovascular and haematological disease. Other dangers include infections such as tuberculosis, hepatitis C, pulmonary aspergillosis and Helicobacter pylori infection, which have been assumed to spread from pipe sharing,” the study says.

The study recommends that water-pipe tobacco should be subjected to the same regulations as cigarette and other tobacco products. Besides creating awareness about the health hazards of pipe smoking, Pakistan needs to broaden the scope of the Tobacco Control Programme to encompass water-pipe smoking as well.