Return of the hookah traverse from village gatherings to enticing in lavish joints in metros, the hookah in social space is raising a health alarm. But its return has sparked concern among cancer experts who say Indian youth are getting addicted to the hubble-bubble in the mistaken belief that it is a healthy alternative to cigarettes.
According to the Global Adults Tobacco Survey (GATS) 2009-10, India accounts for over seven million hookah users among a total of 274.9 million tobacco users. While tobacco is the leading cause of cancer deaths in India, experts say hookah smokers are prone to lung cancer, oral cancer, heart diseases and respiratory disorders.
"Over the last two years, hookahs have penetrated urban space and gained enormous popularity among youngsters. Without knowing the harmful effects, youth are addicted to the hookah because of a fashion quotient associated with it," said Dhirendra N. Sinha, regional advisor, Surveillance (Tobacco Control) at the World Health Organisation (WHO), Southeast Asia.
"Making hookah smoking seem fashionable is an innovative approach of the tobacco industry to make the youth population addicted to tobacco," Sinha told IANS.
Experts attribute the impressive return of the hookah to hookah parlours that have been positioned as 'hangout zones of the elite'. The Arab-lounge like ambience at such bars - dimly lit corners, reclining couch, soothing music and exotic flavours - have helped the hookah grip metropolitan residents.
"In cities, hookah parlours have become symbols of socio-economic prosperity. They are easily available and being at a hookah parlour looks cool to youngsters and urban rich," P.K. Julka, professor of clinical oncology at the All India Institute of Medical Sciences (AIIMS), told IANS.
While Bangalore, Rajasthan, Punjab and Haryana have banned hookah parlours under the Cigarettes and Other Tobacco Products (Prevention) Act 2003, Delhi is yet to take any action to curb hookah smoking or mushrooming hookah parlours.
Hookah or waterpipe smoking uses a technique where specially-made tobacco is heated, and the smoke passes through water to be drawn through a mouthpiece. Experts say the tobacco in a hookah pipe is no less toxic, and the water in the hookah does not filter out the toxic ingredients in the tobacco smoke.
"While we also get cancer patients from rural areas, the young hookah-related cancer patients coming to us have a myth. They think hookah is less harmful than cigarettes due to its water base," informed Julka.
An evening spent at a popular hookah bar in south Delhi's Defence Colony makes the picture clear. Faint candlelight coupled with woodworked interiors, the bar is abuzz with the young and hip waiting for hookah sessions. Each session ranges from an hour to two hours.
On a couch tucked away in a corner sits a group passing the mouthpiece for their favourite flavour 'treasure trail' - an alcoholic hookah. For an hourly session starting at Rs.250, hookah or sheesha comes in different flavours mixed with bases of alcohol, juice or water.
But the hookah smokers seem oblivious to the harm while they sift through the menu card to try more "thrilling flavours". It is a preferred way to unwind after work, says 24-year old Asmita Marwah as she puffed away smoke from her fruity hookah.
"Well, I think it's better than puffing away 20 cigarettes at work. I always hang out with my colleagues at this hookah parlour to relax after a long day of work," Marwah, a public relations executive, told IANS. Her colleagues nod in agreement.
According to WHO, a hookah smoker may inhale as much smoke per session as a cigarette smoker would inhale from over 100 cigarettes. Sharing the same mouthpiece for smoking can also cause serious communicable diseases such as tuberculosis and hepatitis, the global health body informs.
Occasionally, hookah laced with alcohol or marijuana is also ordered.
"Hookah smoke is already full of addictive nicotine and toxic compounds that affect the lungs and the body. But alcohol with tobacco is a deadly combination," Julka said.
At hookah joints teeming with youngsters, people exposed to secondhand hookah smoke are at equal risk.
Experts feel there is more needed than just a ban.
"Banning hookah bars is an incomplete solution as anyone can buy a hookah, a pipe, flavours and tobacco from a paan shop. What we need is awareness and of course stricter norms," said Bhawna Sirohi, head of medical oncology at Artemis hospital, Gurgaon.