World health experts warned on Thursday that smoking water pipes, long popular in the Middle East and North Africa and with a growing fan base elsewhere, can be more harmful than cigarettes.

“A single puff from a water pipe is nearly equal to the volume of smoke inhaled from an entire cigarette,” said the authors of The Tobacco Atlas, a book about the global impact of smoking that was launched at the World Conference on Tobacco Or Health in Abu Dhabi.

World Health Organization tobacco expert Edouard Tursan d’Espaignet said “one session of shisha (water pipe) can be equal to smoking 20 to 30 cigarettes in one go, which can be very dangerous”.

The water pipe, variously known as a hubbly-bubbly, hookah, shisha or narghile, has become a major worry for anti-tobacco campaigners as it becomes popular across university campuses, overlooked by regulators.

In recent years, its use has spread to the United States, Europe and, to a lesser extent, South America.

Gemma Vestal of the WHO’s Tobacco Free Initiative said that while shishas were previously the domain of older males, “younger people between 18 and 24 years old living in cities and educated” are increasingly smoking them.

Ghazi Zaatari, the chairman of pathology and laboratory medicine at the American University of Beirut, said aromatic flavorings known as maasal added to the tobacco offer younger smokers a “smoother and more tolerated” alternative to the taste of traditional tobacco.

And the “water pipe has an interesting design because it somewhat engages your five senses. You’re holding the hose, there’s something you’re looking at, there is the aroma, there is the sound of the bubbling and there is this kind of sensational thing with the social gathering”.

In social gatherings that last for an average of an hour, the smoker can quickly get “hooked on it because of the nicotine”.

(China Daily 03/21/2015 page11)