The Facts About Shisha: Understanding the Difference
Shisha, also known as hookah or waterpipe tobacco, has been enjoyed for centuries across many cultures. Today, it’s a popular way for friends to gather, relax, and share time together.
Yet, despite its long history, there are still many misunderstandings about what shisha is and its effects. People often assume that smoking shisha/hookah waterpipe tobacco is significantly more harmful than cigarettes since a session may last for an hour or more, but is it really? Let’s take a closer look.
Cigarettes and waterpipes tobacco produce “smoke” in different ways.
The visible smoke from waterpipe tobacco is largely comprised of glycerol and water, whereas cigarette smoke contains thousands of chemical substances produced by the combustion of tobacco (often including additives that control the burn rate).
The difference in the composition of the “smoke” from cigarettes and waterpipe tobacco is best visualised by examining filter pads following collection of the same volume of “smoke” under laboratory conditions.
Figure 1. a.) 1925 ml of Al Fakher Two Apples waterpipe tobacco “smoke” collected on a filter pad, and b.) 1925ml of reference cigarette smoke collected on a filter pad showing extensive deposition of by-products of combustion.
Cigarettes burn tobacco at temperatures between 400°C and 900°C, while waterpipe tobacco is heated using charcoal at lower temperatures, typically between 120°C and 190°C.
Despite these differences in process and temperature, both methods still produce harmful chemicals that either already exist in the tobacco or are generated during heating or burning, and these substances are ultimately inhaled by the user.
Usage Patterns
When scientists study the health risks of tobacco products, they need to consider how people use them in real life. For example, research has estimated that people might smoke about two waterpipe sessions per week, compared with around 20 cigarettes per day for cigarette smokers.
Furthermore, a cigarette is generally smoked individually and quickly, usually lasting around 5–7 minutes. Waterpipe sessions are typically longer and more social, often lasting 45-90 minutes, with a single pipe shared among multiple people.
These patterns affect how much nicotine and other harmful chemicals a person is exposed to.
Some people believe that waterpipe tobacco contains much more nicotine than cigarettes, however, research suggests the situation is more complex.
Studies show that the nicotine yield in waterpipe tobacco aerosol can appear higher than cigarette smoke when comparing one session of waterpipe use to one cigarette. But waterpipe sessions usually last much longer and involve many more puffs than smoking a cigarette. When nicotine is measured per puff or per amount inhaled, waterpipes tend to deliver less nicotine than cigarettes, and some newer waterpipe systems deliver even less.
Previous research also suggests that waterpipe users may take in less nicotine and lower amounts of certain harmful chemicals compared with cigarette smokers.
Overall, when typical usage patterns are considered, available research suggests that exposure to harmful chemicals from waterpipe use may be lower than from cigarette smoking. However, this does not mean waterpipe smoking is safe, as it still exposes users to harmful substances.
While both cigarettes and shisha contain tobacco, how they operate are quite different. From the heating process to the composition of the tobacco mixture, shisha and cigarettes are designed in fundamentally different ways.
Understanding these differences helps explain why the two products offer very different experiences for adult consumers.
*Tobacco products, including waterpipes (hookahs), can pose health risks.
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