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Shisha smoking could carry similar risk of cardiovascular disease as cigarettes

People who smoke shisha regularly could have a significantly increased risk of developing long-term high blood pressure, which increases the risk of a heart attack or stroke. New research, published by JRSM Open, the open access companion publication of the Journal of the Royal Society of Medicine, shows that heart rate, blood pressure and carbon monoxide levels rise significantly immediately after smoking shisha. While previous studies have identified a number of health complications associated with shisha smoking such as mouth and lung cancers, this is the first study to review the acute cardiovascular effects.

The culture of shisha smoking in the UK is increasing at an exponential rate and since the smoking ban in 2007 the number of shisha cafés has increased by 210%. There is a common misconception that passing the smoke through water removes it of all harmful substances.

Professor Brendan Madden of St. George’s, University of London, who supervised the research, said: “There is minimum public awareness of the health risks of shisha smoking and a lack of scientific interest. This research shows that the elevation in heart rate witnessed after smoking shisha may, like smoking cigarettes, act as a marker of cardiovascular morbidity and mortality.”

The study was carried out in 2012 in six London shisha cafés where participants smoked shisha for a period between 45 and 90 minutes, the routine period offered by shisha cafés.

“Further research is needed to verify the results of this research and to investigate the wider effects of smoking shisha”, added Prof Madden. “If future studies note the same effects of this research then the public should be made aware of the health effects of shisha smoking. This would include mandatory labelling of shisha tobacco packs and apparatus with ‘smoking kills’, which to date is not enforced at shisha cafés.”


Measuring the acute cardiovascular effects of shisha smoking: a cross-sectional study, Murtaza Kadhum, Ali Jaffery, Adnaan Haq, Jenny Bacon and Brendan Madden, JRSM Open, DOI: 10.1177/2054270414531127, published online 6 June 2014.

The Royal Society of Medicine