Shisha: What you need to know

What is shisha? 

Also known as narghile, argileh, hookah, hubble-bubble, waterpipe and goza, shisha is a water pipe used to smoke heated tobacco, including flavoured tobacco. The smoke bubbles through the water before being smoked through a long pipe.

Shisha is often smoked socially and may seem less harmful than cigarettes, but this is not the case at it still contains tobacco and other harmful substances

It can also be very addictive, due to the nicotine it contains. Even tobacco-free alternatives still contain toxins, so these are not risk-free.

A photo of a shisha pipe

Understanding shisha and health

Shisha smoke can contain: 

  • Nicotine – the highly addictive substance found in cigarettes
  • Tar, carbon monoxide and heavy metals such as lead and arsenic
  • Tobacco juices that can irritate the mouth and throat

These can contribute to health conditions such as: 

  • Mouth, lung, stomach and oesophageal cancers
  • Reduced lung capacity and breathing problems
  • Heart disease and clogged arteries
  • Decreased fertility for men and women

It can also stain your teeth and alter your sense of taste.

How does shisha compare to cigarettes? 

The way shisha is smoked means people often inhale more smoke over a longer period than when smoking a cigarette.

In a typical shisha session: 

  • A World Health Organisation study suggests that someone smoking shisha for one hour can inhale the same amount of smoke as someone smoking between 100 and 200 cigarettes.
  • They may be exposed to up to nine times more carbon monoxide and 1.7 times more nicotine than a single cigarette. 
  • The charcoal, wood or coal used to heat the tobacco can raise health risks as it produces carbon monoxide and cancer-causing chemicals when burning.
  • Second-hand shisha smoke can remain in a room for up to five hours. This can harm people around you, even if you open the windows or smoke in another room.

Keeping safer when using shisha 

Smoking shisha always comes with some health risks, but there are ways you can minimise these.

  • Try tobacco-free shisha: Tobacco-free and nicotine-free alternatives are available. However, the smoke from these can still contain harmful levels of toxins, including carbon monoxide, and other toxins from the charcoal.
  • Use less often: Reducing how often you smoke will lower exposure. 
  • Limit session time: Shorter sessions reduce how much smoke you inhale. 
  • Use your own mouthpiece and hose: Always use a personal, disposable or cleanable mouthpiece to avoid spreading infections. 
  • Ensure good ventilation: Smoke outdoors or in a well-ventilated space. 
  • Avoid mixing substances: Using shisha alongside alcohol, cannabis or other substances can increase longer-term health risks.   
  • Keep shisha away from children and pregnant people. 

How to cut down or stop smoking shisha

If you're looking to reduce the amount you smoke, or quit smoking shisha altogether, there are a few things you can try.

  • Switch to nicotine-free shisha. As nicotine is highly addictive, this means you will be able to start cutting down the amount you smoke.
  • Tell your family and friends you are quitting, so that they can support you. You may even be able to get other friends to quit with you.
  • Be prepared for the cravings. Think of activities you could do to distract yourself until they pass - such as going for a walk, calling a friend, reading a book or magazine, playing a video game, dancing or, anything that will keep your mind off the craving. We've got more suggestions here.
  • Using nicotine replacement therapy, such as patches, gum, lozenges and mouth spray. Your local stop smoking service or pharmacy can give you more information, and help you find the one that works for you.
  • Keep track of the money you’re saving. A single session my not cost much but it will quickly add up, Keeping track of the savings can be a big motivation to stay quit.
  • Avoid places and activities associated with shisha, as these can trigger cravings.

We also recommend getting in touch with your local stop smoking service - they will be able to support you to stop smoking any kind of tobacco, not just cigarettes.

Looking for support around shisha? We’re here to help.

Choosing to make a change, whether it’s cutting down or quitting, is a positive step for your health.

Our stop smoking services will help you to explore your options, understand the facts, and find a plan that works for you. You can also make an appointment with your GP or speak with your local pharmacist about nicotine replacement therapy and other treatments.

Find your local Change Grow Live stop smoking service

Read more about shisha from the British Heart Foundation

See our advice on coping with nicotine cravings