The Problem of Tobacco

South Asian Awareness Month

Smokeless tobacco and Shisha are both cultural traditions in South Asian communities that have a negative impact on anyone using them.

As part of South Asian Awareness Month, we want to highlight the health implications of smokeless tobacco use, as well as smoking Shisha.

What is smokeless tobacco?

Smokeless tobacco refers to a flavoured tobacco product that is not burnt. It involves chewing, sniffing or placing the product between the gum, cheek or lip. Smokeless tobacco is consumed by up to 300 million people worldwide. South Asian countries consuming the highest amount. ASH (Action on Smoking and Health) found that smokeless tobacco is most consumed in the UK by South Asians of Bangladeshi, Indian and Pakistani origin.

South Asian Smokeless Tobacco

Smokeless tobacco comes in many different forms.
Mishri and Qiwam – tobacco with flavours and sweeteners
Khaini, Naswar and Gul – tobacco with alkaline modifiers – these modifiers increase how much nicotine is absorbed and adds to the addictiveness.
Gutka, Zarda and Mawa – Tobacco with areca nut (also called betel nut) and slaked lime – areca is a common ingredient in smokeless tobacco and is a stimulant and recognised carcinogen in its own right.

Global evidence on smokeless tobacco suggests strong associations with oral and pharyngeal cancers, heart disease and stroke. It can also be harmful for pregnant people. Add to this the fact that some types of smokeless tobacco may contain tobacco species with higher levels of nicotine, making it even more addictive.

Shisha

Shisha is a type of pipe used for burning tobacco, where smoke passes through a container of water before it is breathed in. This means that larger amounts of smoke can be inhaled in one go, which can be a big problem.
It’s also known as hookah, water pipe, nargile or hubble bubble.

It can be used to smoke other substances – for example, herbal shisha. There is a common belief that Shisha is less harmful and less addictive than smoking. This is not the case. Instead, shisha is associated with many of the same risks as smoking.

South Asians in the UK are more likely to use shisha, according to ASH YouGov Research: 28% of South Asians in their study reporting they have tried shisha, compared to 12% of White people in their study.

When you smoke shisha you end up inhaling more smoke in a session compared to smoking cigarettes, as you take deeper breaths and smoke for longer. According to a British Heart Foundation:

• In an average shisha session (between 20-80 minutes) you can inhale the same amount of smoke as a cigarette smoker having between 100 and 200 cigarettes.
• 2-3 times the amount of nicotine.
• About 10 times the amount of carbon monoxide.
• 25 times the amount of tar.
• Up to 50 times the amount of lead (besmokefree.com.au)
• Second-hand shisha also causes harm, with a one-hour shisha session having as much carbon monoxide as 20 cigarettes.

And finally…
Overall, shisha and smokeless tobacco products have a huge impact on an individual’s health. Smoking and smoking-related behaviours are found to be a big source of health inequalities in ethnic minorities. Addressing this problem and reducing smoking behaviour is one way of tackling these health inequalities.

If you need advice on this topic, we offer lots of useful information about stopping smoking which can also be applied to preventing the use of shisha and smokeless tobacco products.

Feel Good Suffolk can also offer you extra support around stopping smoking, which can be accessed through our Find Support section here.

As always if you have any questions, queries or suggestions about this or any of our work and would like to get in touch we’d be delighted to hear from you.