Does Shisha Contain Tobacco?
Yes, shisha contains tobacco. Shisha (also known as hookah, water pipe, or narghile) is a tobacco product where smoke passes through water before inhalation. 1
What Shisha Is
Shisha is definitively a tobacco product described as "a single or multi-stemmed instrument for smoking in which the smoke is cooled by passing through water." 1
The practice involves inhalation of tobacco smoke after it passes through water, making it fundamentally a tobacco delivery system. 2
Research confirms shisha products contain nicotine levels ranging from 0.80 to 20.52 mg/g, demonstrating the presence of tobacco-derived nicotine. 3
Common Misconception About Safety
Over half of young people (58.3%) incorrectly believe shisha does not contain tobacco, representing a dangerous knowledge gap that facilitates use among youth who would otherwise avoid tobacco products. 4
This widespread misperception leads to the false belief that shisha is a "safer alternative to cigarettes," when in fact a 40-minute shisha session is equivalent to smoking 100 or more cigarettes. 5
Toxic Content Beyond Tobacco
Shisha products contain tar levels ranging from 1.68 to 11.87 mg/g, in addition to the tobacco-derived nicotine. 3
The longer duration of smoking sessions and deeper inhalation leads to much higher smoke intake than cigarette smoking, exposing users to greater quantities of carcinogens and toxic products. 1
Shisha smoke contains several human carcinogens and other toxic products, with recognized adverse effects on both active and passive smokers. 5
Clinical Implications
Shisha smoking is significantly associated with lung cancer and shows acute cardiovascular effects including elevated heart rate and blood pressure. 6
Users face high risk of lung cancer, chronic obstructive pulmonary disease, emphysema, and coronary artery disease due to the nicotine and tar content. 3
Healthcare providers should document shisha use when taking tobacco histories, as it represents real tobacco exposure that affects morbidity and mortality. 1