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LAs told to monitor shisha use

Katie Coyne08/03/2017 - 16:49

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High risk shisha smoke
High risk shisha smoke

Waterpipe smoking carries the same risks as smoking including cancer, respiratory and heart disease despite it being seen as healthier, according to new joint report from Public Health England and ADPH. 

The report Waterpipe smoking (shisha) in England The public health challenge also found that ‘high quality’ studies are needed into the health effects of shisha smoking. However, available research recommends reducing waterpipe use, especially regular use.

It quoted British Heart Foundation data that found the number of shisha bars in the UK had risen by 210 per cent from 179 to 556 between 2007 and 2012. This is a huge rise, and other research indicates that waterpipe use is a growing concern in certain areas and sub groups such as in BME populations.

However, nationally its use is not prevalent and so currently represents a ‘negligible’ public health risk. But the report recommended its use must be monitored and action taken if it emerges as one. By monitoring waterpipe use in their areas local authorities can identify where and in whom waterpipe use is a public health threat.

Dr Andrew Furber, president of the Association of Directors of Public Health said in the report’s foreword: ‘Tobacco use is likely to be the major preventable contributor to ill health and health inequalities in most if not all local authority areas. Although smoking cigarettes will make up the bulk of this, it is important to address other forms of tobacco use, which are more common in certain communities.

‘Waterpipe smoking (shisha) is one such use. The populations where this is most commonly used are the same communities which are at higher risk of diseases such as heart attacks and stroke from other causes, such as genetic predisposition or diet. It is therefore important that local tobacco control strategies take this form of use into account.

‘Clearly any public health programme needs to be sensitive to local cultural context. However not to take action where there is a proven threat to health is to do a disservice to those who will lose loved ones to tobacco related disease.’

Waterpipe smoking is subject to UK smoke free legislation that prohibits smoking in all enclosed public places and workplaces. Yet, the report highlighted challenges to local authorities in enforcing tobacco and health and safety regulations in relation to shisha premises and recommended that all relevant agencies work collaboratively.

This approach, said the report, could include the education of businesses alongside robust enforcement.

It also found several studies indicating that smokers perceived waterpipe smoking to be less harmful, less addictive, and more socially acceptable than regular cigarettes. This is likely to be wrong and this misperception is also likely to contribute to its use.

The report noted an increased risk of infectious disease and a risk of carbon monoxide poisoning due to the constant heating of tobacco by burning charcoal. 

The report suggested that local authorities could consider interventions to raise awareness of the health risks of its use, especially among current waterpipe smokers and young people.

It also recommended that standardised questions should be used in surveys of local areas so that the data yielded could be compared nationally. Where action is taken to reduce waterpipe use, the report urges that best practice be shared in the relevant peer-reviewed journals.

National data shows that waterpipe smoking, up to twice per month, in the general population is very low at 1 per cent.

Young adults are more likely than older adults to have tried waterpipe smoking. However, current use is still low at around 2 per cent in 18 to 24 year olds. In 11-15 year olds, less than 1 per cent, and among 16-18 year, less than 3 per cent, say they smoke at least once a month.

In BME groups, waterpipe smoking is higher – almost 7 per cent among Asian/Asian British.

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