Plan to limit nicotine and tar in medwakh and shisha could backfire, doctors warn

Although it would help to reduce some of the harmful effects of tobacco, it could also make users smoke more, increasing the amount of tar taken into their lungs, they say.

Some doctors believe that a reduction in nicotine and tar in dokha tobacco could also make users smoke more as they seek out a stronger hit. Jeff Topping / The National

AJMAN // Limiting the amount of nicotine and tar in the tobacco used in traditional medwakh pipes and shisha could push smokers to increase their habits, doctors warned.

Although the reduction would help to reduce some of the harmful effects of tobacco, it could also lead users to smoke more, increasing the amount of tar taken into their lungs, said Dr Bassam Mahboub, a pulmonologist, allergy specialist and head of the Emirates Respiratory Society.

“Smokers will not feel the percentage of nicotine and it may push them to smoke more to compensate,” he said.

Rather than trying to make tobacco safer, he said, a better idea would be to impose higher taxes to deter use. This money could be used to fund anti-smoking programmes. Dr Mahboub also suggested reducing the number of shisha cafes.

Medwakh is the pipe used to smoke dokha, a highly concentrated tobacco that is usually mixed with herbs and spices. It is predominately smoked in the UAE and Oman. Its name is Arabic for “dizziness”.

A move to set limits on nicotine and tar, reported last week, came about because medwakh was linked to oral, lip and tongue cancers.

The move is part of a GCC initiative, said Dr Wedad Al Maidoor, head of the national tobacco control committee at the Ministry of Health.

According to Dr Al Maidoor, an awareness campaign on the dangers of smoking shisha and medwakh is due to run in conjunction with World No Tobacco Day on May 31.

A 2011 study of smokers’ habits in Abu Dhabi found that while the medwakh bowl is smaller than other pipes, the tobacco used has a high nicotine level.

Out of more than 9,000 people who took part in the survey, about 11 per cent said they smoked cigarettes, while 5.9 per cent said they smoked medwakh and 4.8 per cent shisha. About 2.5 per cent said they smoked a combination of the three.

UAE nationals had the highest prevalence for smoking medwakh, at 16.1 per cent. Among those aged between 20 and 29, the prevalence was 17.3 per cent.

Women were found to be much less likely than men to smoke the pipe. Only 0.1 per cent reported that they used it, compared with 11.5 per cent of men.

Reem Mohamad, a 21-year-old Lebanese business student who smokes shisha four times a week, said any move to make smoking safer and less addictive was a good idea.

“I agree with determining the percentage of nicotine in shisha because I smoke it for fun. I am not addicted to it and that will make me comfortable while smoking because of its lower risks on my health,” she said.

But Mohammad Saif, an Emirati businessman who smokes a medwakh pipe once an hour, did not agree with reducing the level of nicotine because, he said, it would not give the same effect and would lead him to smoke more.

Rules regarding medwakh are similar to those for cigarettes, with the pipes banned from restaurants and public places.

The UAE has strict laws regarding shisha. In Dubai, it is illegal for shisha to be sold to pregnant women or if a child under the age of 18 is present, while in UAQ, Fujairah and Abu Dhabi, cafes have been forced to move from residential areas.

Dr Naglaa Rizk, a consultant gynaecologist at Al Zahra Hospital in Dubai, said smoking decreases fertility in women because it affects the cilia, the small hairs in the fallopian tubes, and the same in men’s tubes that transport sperm.

“None of those hairs will work properly in men or women who smoke, or who are around smoke. It is an issue for passive smokers and young people who socialise around shisha cafes,” the doctor said.

“I would support any plan for a reduction in tobacco use in both sexes because it has a major affect on fertility.”