Shisha water does not remove harmful substances; users inhale more smoke – Neurosurgeon warns

Senior neurosurgeon Dr Hadi Mohammed Abdullah has cautioned shisha users against assuming that passing the smoke through water makes it safe, warning that the process cools the smoke and allows them to inhale larger quantities.

He said the flavours added to shisha also create a misleading impression that the product is harmless or does not contain tobacco, exposing users to potentially serious health risks.

Speaking on Joy FM's Super Morning Show on Friday, November 6, during a discussion on “Shisha: Status Symbol or Slow Poison”, Dr Abdullah explained that nicotine in shisha is absorbed through the respiratory system into the bloodstream and can reach the heart and brain within seconds.

He said nicotine stimulates dopamine receptors, which are associated with pleasure and reward, while increasing adrenaline levels. This produces temporary feelings of excitement and pleasure that can encourage repeated use and eventually lead to dependence.

“When you smoke shisha, because of the high nicotine levels, it is absorbed through your respiratory system and then into the bloodstream. And within a matter of a few seconds, it can reach your heart and then your brain,” he explained.

According to him, the stimulation of dopamine receptors creates a feel-good sensation that makes users crave more.

“Because once you stimulate your dopamine receptors, you increase the dopamine level, you feel good, the feel-good factor is there. So you want more,” he said.

Dr Abdullah advised people who were becoming dependent on shisha to acknowledge its health risks and seek professional medical assistance.

Water and flavours create a false sense of safety

The neurosurgeon said the water used in shisha does not eliminate the dangerous substances in the smoke but instead cools it, making it easier for users to inhale larger amounts.

He added that the flavours used in shisha contribute to the misconception that it is less harmful than conventional cigarettes or does not contain tobacco.

“The water cools down the smoke so that you are able to inhale a lot more. And the flavours that they add to it, that is what gives that wrong impression that this is not dangerous and it is not tobacco,” he said.

He maintained that the absence of the harsh sensation associated with cigarette smoking does not mean shisha users are exposed to fewer harmful substances.

“In terms of the substances he mentioned, you are actually taking more of that, and that is what causes the danger,” he added.

Asthmatics urged to avoid shisha, e-cigarettes

Dr Abdullah also warned people living with asthma against using shisha and e-cigarettes, saying some asthmatic patients had developed severe complications after using the products, with some requiring admission to intensive care units.

“If you are asthmatic, try to stay away from shisha and even e-cigarettes because there is evidence to show that some asthmatics have ended up in intensive care unit, by just smoking shisha or taking even e-cigarette,” he cautioned.

E-cigarettes also pose risks to developing brains

Beyond shisha, Dr Abdullah warned young people and pregnant women against using e-cigarettes, citing concerns about metals such as nickel, cadmium and lead found in some products.

He said the long-term effects of e-cigarettes were not yet fully understood and called for caution, particularly because children's brains were still developing.

“E-cigarettes are something new. Yes, it does not contain all the substances that you find in cigarettes or in shisha. But it's something that is new, and it will take a long time for us to really understand its dangers. It's going to take a lot of research,” he said.

He said some children who had undergone autopsies were found to have high levels of metals, including nickel, cadmium and lead, which he linked to materials used in e-cigarette devices.

“When you have a developing brain that is exposed to lead, it is so dangerous. It damages the brain,” he warned.

He further advised pregnant women to avoid exposing their unborn children to shisha, e-cigarettes and other forms of smoking.