Public health

waterpipe introduction

By : Ali toffaha

Out line-Terminology & history-Anatomy of waterpipe

-Forms of nargile & tobacco types-Comparison

-Some facts

Waterpipe terminology can depend upon region, and includes names such as

shisha,goza>>Egypt & Saudirabianarghile >> palestine & jordan & syria hookah >>Africa & Indian

History of nargile:

-waterpipe was invented in India as a purportedly less harmful method of tobacco use. The physician Hakim Abul Fatli suggested that tobacco “smoke should be first passed through a small receptacle of water so that it would be rendered harmless” Thus. a widespread but unsubstantiated belief held by many waterpipe users today— that the practice is relatively safe — is as old as the waterpipe itself.

-Then in Turkey the nargile completed its revolution

Its spread due to: (1 )The wrong idea that toxins in argileh are

filtered out by water in the water jar(2 )the belief that because argileh is fruit-

flavored, it is a harmless substance that is acceptable for children

( 3 )the idea & labels of its tobacco that it contains

“0.5% nicotine and 0 tar.”

anatomy hookah is usually made of five components, four of which are essential for its operation -The bowl Also known as the head of the hookah, the bowl is a container, usually made out of clay, that holds the tobacco and coal during the smoking session.

-Body, Gasket, Valve The body of the hookah is a hollow tube with a gasket at its bottom. The gasket itself has at least one opening for the hose. The gasket seals the connection of the body of the hookah with the water jar. The gasket may have one more opening with a valve in it for clearing the smoke from the water jar not via the hose.

(tray)

Cont.-Hose The hose is a slender tube that allows the smoke

to be drawn. The end is typically fitted with a metal or wooden mouthpiece.

-Water jar  Placed at the bottom of the hookah, the water jar

is a container which the smoke from the tobacco passes through before it reaches the hose. By passing through water, the smoke

gains moisture. This makes inhaling the smoke of the hookah easier than a cigarette's.

Typestwo main smoking mixtures have been clearly

identified :-Moassel:The most popular type of tobacco

used in waterpipes. It is a mixture of crude tobacco fermented with molasses (black honey) Different fruit flavours are added to it (apple, strawberry, etc.)Consist of <water , glycerole , glucose ,

tobacco> -tumbak (ajami)

Some formes-gouza: the oldest form of waterpipe. It has a

small water container that is made of metal has a water container made of brass :-bouri

-shisha: larger and more decorated form of waterpipe, usually with a glass water container. However, it is common to see shisha water containers made of ceramics

Cont. -Ice waterpipe : This unique hookah has a built

in ice chamber right under the tray. The ice chamber’s purpose is to give you a cooler and smoother smoke each and every time. Putting ice in the chamber is optional

-Other people enjoyed adding pomegranate juice or rose oil to their water for added flavor

Comparison : cigarettes VS argeleh*accurate numbers about nargele smokers are

made hard because: -Most of studies are done on cigarette

-Many types of tobacco & types of hookah it self

-Many methods & habits of its smoking -Duration of each (ras) & # of puffs

Cont. ISO norms suggest the “waterpipe” used in

the laboratory was based on 171 steady puffs drawn every 17 seconds, i.e for one full hour, with the charcoal (heating source) on the same point over the smoking mixture .

Cont.- The average nicotine content in each waterpipe

head (20 g) of unflavoured tobacco found to be 713 mg/head and flavoured tobacco 166 mg/head. using this average of 8.3 mg nicotine/g tobacco, which should be 10 times that of the American cigarette

- compared to cigarette smoking, waterpipe smoking is characterized by less frequent exposure (one to four sessions per day) but with a much more intense exposure per session which varies between 15 and 90 minute

Cont.- The uptake of tobacco nicotine is equivalent

to 2–12 cigarettes per head-waterpipe smoking produces more smoke than

cigarette smoking and it has been estimated that smoke exposure could be as much as 100-200 cigarettes per session

Cont.-Middle East researchers have subsequently

estimated the overall shisha water-filtration rate to be 38%, and concluded that shisha smoke, with only 142 compounds detected in a pipe filled with jurak (a mixture of 15% of tobacco leaves and 47% carbohydrates (glucose)), is actually far less complex than cigarette smoke .This figure can be compared with the 4,700 substances identified so far in cigarette smoke

Cont.-in contrast with cigarettes a hookah does not

generate such a side-stream smoke, but still the large amount of EMSS is problem for SHS.

Cont.-Special health concerns that distinguish

waterpipe smoking from cigarette smoking include the possibility that waterpipe users are prone to infections due to the habit of sharing waterpipes without changing the mouthpiece.

Some facts about nargile-smokers mistakenly believe that argileh is less

harmful than other methods of tobacco use. For example, in a recent study of Israeli school children, 50% of the participants believed that argileh was less harmful than cigarettes, and 25% had smoked a hookah pipe with their parents.

Cont.

-a great part of the smoke is made up of water and glycerol when moassel is used

-Water of hookah , if not changed after each session will be rich in microorganisms

Cont.-Hookahs can also be smoked with herbal

flavours. These contain Sugar Cane Bagassewith

no tobacco, nicotine or tar.“a standard waterpipe session”, a series of

toxicant yields (nicotine, heavy metals, “tar”) are doses actually inhaled by smokers in the real world

TANK YOU.…