Big trouble in ‘Little Cairo’

The UK government’s neverending, evidence-lite assault on smokers threatens to bankrupt London’s shisha bars.

shisha

When the UK government decided to impose a blanket smoking ban in enclosed workplaces and some open public spaces in England in July 2007, it wasn’t just pubs that were affected. Many cafés that depended on the revenue from the rental of shishas – water-filled pipes through which flavoured tobacco is smoked – were also affected by the ban. Many of these cafés were unable to accommodate smokers outside and were forced to close.

However, the remaining cafés are reportedly flourishing. For example, the cafés in areas such as London’s ‘Little Cairo’ in Edgware Road are attracting a wider clientele than ever before who want to try out the pipes. Predictably this has caused concern amongst authorities that refuse to tolerate anything that may be seen as detrimental to health, no matter how enjoyable it is. The UK Department of Health now seems to be on a mission to ‘enlighten’ users about the dangers of shisha smoking.

While acknowledging a lack of an evidence base, the World Health Organisation (WHO) stated in 2005 that the shisha should be included in smoking bans due to its adverse effects (1). A recent study by the Department of Health and the Tobacco Control Collaborating Centre has endeavoured to fill the evidential gap. The study measured the levels of carbon monoxide in exhaled shisha smoke and compared it to that of cigarette smoke. It found that, on average, the amount of carbon monoxide exhaled by a shisha smoker was at levels ‘at least four to five times higher than the amount produced by one marlboro cigaretts’ (2).

This finding apparently ‘shocked’ Dr Hilary Wareing, director of the Tobacco Control Collaborating Centre, who claimed, ‘our mouths opened at the level of harm – none of the tests we did showed anything other than shisha is hazardous to health’. At worst, Dr Wareing claimed, ‘shisha was 400 to 450 times worse than having a cigarette’ (3).

Wareing’s shock must have come from the finding that shishas are even more dangerous than believed following a 2007 study suggesting it was ‘200 times worse than a cigarette’, or 100 times worse, depending on who reported the study’s findings (4, 5). The Department of Health is now working hard on ‘how best to get the message – that it is dangerous – across to the consumer’, grappling with the fact that it’s not easy to slap a warning sticker on a shisha pipe.

The research, however, has come under fire from some quarters, notably Dr Kamal Chaouachi, a tobacco expert from Paris IX University, who criticises the fact that the data has not yet been ‘peer reviewed or published’. Dr Chaouachi points out that shisha smoking is typically not ‘chronic’, with users usually partaking only one-to-three times a week, and criticises the way the study singles out carbon monoxide, which is relatively quickly flushed out of the body, for study: ‘Carbon monoxide is only one chemical out of thousands in cigarettes, so one cannot compare. But even if we look only at that chemical, shisha is not “worse” than cigarette smoking. The BBC should apologise [for its report on these findings].’ (6)

‘Obviously I’d need to look at the data’, Izabela, one shisha smoker from Poland said, puffing on a pipe outside the swish-looking Salt café on Edgware Road in London. ‘But as a smoker – now just a social smoker – intuitively that sounds wrong. When I used to smoke, I’d really suffer if I had chain-smoked a pack of 20 the night before. But even after a couple of shishas I wake up and I don’t even notice.’

But is Izabela just a hapless victim, ignorant of the harm she is doing to herself? A Department of Health spokesman recently asserted that many people regard shisha smoking as ‘not even smoking’. ‘I guess I figure the water filters out some of the heat… and [some of the] impurities’, says Izabela. ‘But I’m not naive enough to think it’s good for me. But it makes for a nice evening. You just weigh it all up.’

Despite the cloudy, cool evening, a mixture of tourists and locals sat on covered areas outside cafés on the Arab-influenced Edgware Road smoking shishas, which typically costs between £10 and £12 for a smoke. None of the people I spoke to had heard of the recent research.

One Middle Eastern man, smoking a shisha by himself while waiting for friends, was annoyed that he was forced to do so on a narrow piece of pavement. He couldn’t think of anyone in his family who didn’t smoke shisha at least occasionally, going back several generations: ‘That’s evidence enough for me that it is all right.’

‘I can’t think of the last time I had shisha’, said a German lady, exhaling a small cloud of sticky ‘double apple’ flavoured smoke and passing the pipe to a friend. ‘And you’re hardly smoking it non-stop. The study seems to be working hard to try to scare people.’ ‘This doesn’t contain nicotine anyway’, her friend added, talking about the particular type of herbal molasses he was smoking, ‘so it’s not addictive either’.

When asked whether smoking shisha was as bad as smoking cigarettes, one vendor said, ‘It’s not good for you. But just don’t have too much.’ He pointed out the range available – enclosed behind a glass case with a homemade sign declaring ‘smoking kills’ on it – and pointed out his most popular shisha tobacco barely had any tobacco in it at all. You had to ask specially for the very expensive ‘pure tobacco’. And it was evident that people who did so knew what they were getting.

Some shisha café staff were wary of answering questions, but they seemed angered by the fact that further regulation on shisha smoking may be on the horizon. ‘You have to understand that many shisha café owners invested a lot of money to set up their cafés only for many to lose everything when the smoking ban came in force’, explained one Lebanese woman. Indeed, it’s understandable that those who have survived want to continue developing their business. But new developments always seems to bring bad news, such as recent fines for shisha café owners due to the fact that outdoor rain shelters gave smokers too much cover, therefore classifying them as ‘enclosed spaces’ (7).

Many people I spoke to emphasised the ‘social experience’ of smoking shisha while conversing and relaxing with friends. But what about concerns, such as those voiced by representatives of the NHS Stop Smoking service, that tuberculosis or other diseases could be passed on via the shisha pipe. ‘People aren’t stupid, they just give it a wipe’, the Lebanese woman said. ‘It’s not like sharing syringes, is it? Will the government be giving advice on kissing next?’

The rise of shisha smoking in the face of concerted anti-smoking campaigns is deemed to be a deeply negative trend by authorities intolerant of people choosing to do anything that is considered unhealthy. This is despite the positive social experience and cultural traditions attached to shisha. What’s wrong with people enjoying a smoke in spite of the negative side effects it might have on their health?

Despite many generations smoking shisha before them, shisha smokers are now cast as ignorant in the light of this new evidence base and in need of the ability – given to them by authorities – to make an ‘informed’ choice. Which, given the ever-tightening government restrictions on smoking, looks increasingly to be the choice not to partake at all.

Patrick Hayes is a co-founder of the IoI Current Affairs Forum and volunteer co-ordinator for the education charity WORLDwrite, producers of the debate ‘Shopping: are we all ethical now?’ at this year’s Battle of Ideas festival.

source: http://www.spiked-online.com

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