BMJ experts argue shisha smoking requires urgent recognition, law reforms via the Tobacco and Vapes Bill, and targeted community campaigns to address rising harms.
The sweet scent of apple and mint tobacco drifts through a dimly lit lounge in Bradford, where young adults gather around ornate water pipes, believing they’re choosing a safer alternative to cigarettes. They couldn’t be more wrong.
Writing in The BMJ this week, public health experts have sounded the alarm about shisha smoking’s overlooked status as a major health threat across the UK. Despite mounting evidence of serious risks, the practice continues to slip through the cracks of national tobacco control strategies.
The numbers tell a stark story. Shisha bars have multiplied steeply across Britain – from just 179 establishments in 2007 to over 570 by 2012. Following the 2007 smoking ban, shisha use surged by 210% as venues found ways to circumvent regulations.
The Hidden Health Risks
But the rapid growth masks dangerous health consequences that many users simply don’t recognise. Research reveals shisha smoking carries risks including heart and circulatory diseases, various cancers, nicotine addiction, carbon monoxide poisoning, bacterial infections, and high blood pressure.
The water filtration system – often seen as making shisha “cleaner” – is largely a myth. Users still inhale tobacco smoke, often in greater quantities and for longer periods than traditional cigarette smoking.
Nearly one in ten people aged 18-24 have tried shisha, with especially high usage rates among young adults and ethnic minority communities. Many remain unaware that the flavoured tobacco still contains the same harmful substances found in cigarettes.
Calls for Legislative Action
Bradford Council has launched targeted research to raise awareness in communities where shisha use is most prevalent. Their work highlights the need for culturally competent support services that understand the social and cultural contexts surrounding shisha smoking.
The upcoming Tobacco and Vapes Bill, currently progressing through Parliament, presents an opportunity to address these legislative gaps. Experts argue the bill should include specific provisions for shisha regulation, building on recommendations from the Khan Review.
Local government bodies are pushing for central government to introduce shisha-specific licensing requirements, stronger penalties for non-compliant venues, and extended bans on flavoured tobacco products. Currently, enforcement relies on existing health and safety legislation, which often proves inadequate for addressing shisha-specific risks.
The Enforcement Challenge
Local councils face particular challenges in regulating shisha establishments. Unlike licensed premises for alcohol, there’s no specific licensing regime for shisha venues, making it difficult to monitor compliance with health and safety standards.
Poor ventilation in many establishments compounds the risks, creating environments where carbon monoxide can build to dangerous levels. The communal nature of shisha smoking also raises concerns about infectious disease transmission through shared mouthpieces.
Yet enforcement action remains patchy. Without dedicated regulatory frameworks, councils must rely on general environmental health powers, which weren’t designed for the specific challenges posed by shisha venues.
What This Means for Kent Residents
Kent residents face similar risks from shisha lounges operating across the county, with potential carbon monoxide poisoning and infectious disease transmission in poorly ventilated venues affecting local public health. Kent County Council and district councils can only enforce existing laws like the Health Act 2006, but lack shisha-specific licensing powers that would enable more effective regulation of premises. Residents concerned about local venues should contact their council’s environmental health team to report compliance issues, while those seeking help to quit shisha can access NHS Kent and Medway’s tobacco cessation services, which provide culturally appropriate support for all forms of tobacco use.
Source: @bmj_latest
Key Takeaways
- Shisha bars increased from 179 in 2007 to over 570 by 2012, with usage rising 210% after the smoking ban
- Health risks include heart disease, cancers, carbon monoxide poisoning and bacterial infections, despite perceptions of safety
- The Tobacco and Vapes Bill could introduce new regulations, but experts call for shisha-specific licensing and enforcement powers