Sweet, fruity – and rather dangerous

Nargila smoking has made a comeback, especially among the young. That may dismay health professionals, but it gladdens the hearts of coffee shop owners like Mahmoud of Makha Hamam.

coffeeshop311 (photo credit: noreen sadik)
(photo credit: noreen sadik)
A sweet, fruity scent of tobacco lingers in the air at Makha Hamam, the cool evening breeze spreading it, enticing people to enter and partake in the camaraderie within. “Ahlan,” says Mahmoud, warmly greeting customers as they enter the popular coffee shop in Taiba. For a moment, he stands outside, and looks pleased as he glances at the cars in front of his shop.
He goes back inside, happy to hear laughter ringing out from a group of teenage boys watching TV. The continuous hum of conversation fills the coffee shop. A patron takes a cup of strong Arab coffee to his table, calling to Mahmoud to bring him a nargila filled with apple-flavored tobacco.
Mahmoud reaches for the tobacco from amongst several flavors. He prepares the nargila and takes it to the customer, who eagerly inhales. Hoops of smoke dance from his lips, slowly becoming larger as they travel around the room.
This scenario is played out in countless coffee shops in Arab towns and villages in Israel, and the lure of the exotic nargila has found its way to the rest of the country, making nargila smoking a very popular pastime.
Coffee shops in the Middle East have been around for hundreds of years and traditionally serve as a place where men can play chess, cards or backgammon, smoke nargilas and drink coffee. However, times have changed since the first coffee shops opened, and the coffee shops of today are a far cry from the sparsely furnished ones of the past.
Mahmoud, owner of Makha Hamam, opened his doors approximately six years ago.
“I was unemployed, and I noticed that there were others in the same situation. They seemed to be going through their days aimlessly with nothing to do. So I decided to open a coffee shop which would serve two purposes: provide a place for unemployed men to go to pass the time, and also to put some money in my pocket,” he explained.
Makha Hamambegan in a small, crowded room decorated with sports memorabilia.
“Coffee, tea, fruit cocktails, sandwiches and nargila were on the menu, and my customers could play chess, cards or backgammon or watch TV,” he says. His business was so lucrative that a year and a half ago he moved to a larger space across the street.
Makha Hamam has an appealing, homey atmosphere, complete with a traditional Arab sitting area, leather sofas and bar stools. The menu has remained the same, as has the entertainment, aside from the addition of five big-screen TVs. And lined up in a corner are nargilas – actually about 100 nargilas.
Mahmoud believes that the “essence and the reason for the popularity of any coffee shop is the nargilas.” He estimates that between 150 and 200 people enter his doors each day.
“Many of them have been coming here for years, mainly because of the nargilas. Take away the nargilas, and I will lose about 60 percent of my business,” he explains.
He points to some regulars. “I do not even need to ask what they want anymore – it’s the same thing every day,” he says.
Some men come here to take a break from home, or rest after a day of work. Here they meet friends over a cup of coffee and a nargila. After a couple of hours they go home. The routine is the same, but they enjoy it.”
Over the past 400 years, nargilas have become especially popular in African, Arab and Asian countries. However, with the increasing influence of Eastern and Middle Eastern cultures around the world, their popularity has been imported to Western countries. A 2005 study by Barry Knishkowy and Yona Amitai estimates that approximately 100 million people worldwide smoke nargilas daily.
A nargila is made up of four parts: the head, which holds the moistened tobacco; the bowl, which is half-filled with water; the body, which is submerged in the water bowl; and the hose and mouthpiece, through which smokers inhale.
Tobacco is put into the head and burning charcoal placed on top of it. Inhaling through the hose pulls air through the charcoal and into the head. The hot air causes the tobacco to evaporate and produce smoke. The smoke goes through the body tube in the water bowl. Bubbles are formed in the water bowl, and, when inhaled, the smoke enters the hose, and goes to the smoker.
In his search for a relatively safe method of tobacco use, Gilani believed that if the tobacco first passed through a receptacle of water, it would become harmless. However, this belief, which has passed down through the centuries, could not be further from the truth.
According to a study by the World Health Organization, during a smoking session lasting 20 to 80 minutes, the smoker takes between 50 and 200 puffs, thus exposing himself to more smoke, over a longer period of time, than during cigarette smoking. The report states that “The water pipe smoker may therefore inhale as much smoke during one session as a cigarette smoker would inhale consuming 100 or more cigarettes.”
Nargila smokers face the same health risks as cigarette smokers: addiction, heart disease, cancer, respiratory disease and problem pregnancies. Shared mouthpieces can cause herpes, TB, mononucleosis and other infectious diseases.
According to Rivka Froehlich Zelcer of the Israel Cancer Association (ICA), additional risks stem from users’ lack of knowledge about where the tobacco is from and the ingredients in it; and the possible addition of marijuana or hashish to the tobacco.
The ICA estimates that in 2006, 23.2 percent of all Israelis smoked cigarettes and nargilas. In spite of the risks, a high majority (60.7% of women, and 53.5% of men) expressed a wish to continue smoking.
A new phenomenon is that Israeli youngsters (Jewish and Arab) are now smoking nargilas, often with their parents’ knowledge. Following a survey of 388 Jewish middle- and high-school students, the ICA estimates that 41% of 7th- to 11th-graders smoke tobacco in some form, and 22% smoke each weekend; however the rate of nargila smoking is three times higher than that of cigarette smoking.
In another study, in 2008 L. Korn and R. Magnezi of Ariel University Center of Samaria interviewed 326 teenagers aged 15-18 from Taiba about their smoking habits. The results revealed that one-third of the interviewees smoked either cigarettes (36.2%) or nargilas (37.1%).
Mahmoud estimates that 40 or 50 teenagers come to Makha Hamam each day. Yousef, 16, who frequently smokes a nargila, said, “I used to prepare my uncle’s nargila, and I took a few puffs once. My friends and I started going to the coffee shop to play cards. The nargilas were there, so we started smoking. My parents know I smoke a nargila, but not cigarettes.”
So taking all this into consideration, what is it that makes coffee shops and nargila smoking so popular? And why do people continue to indulge in behavior so destructive to their health?
Rasheed, 48, who smokes daily, explained: “I have been going to coffee shops for years to meet my friends and to watch the major soccer games. It’s just in the past few years that I started smoking. I know that it is bad for my health, but going to the coffee shop and smoking have become habits. The atmosphere encourages it.”
Although its popularity had faded, the nargila has made a strong comeback around the world, contributing to the high number of tobacco-related deaths. A September 2009 article in the European Journal of Public Health stated that the number of deaths worldwide due to smoking was approximately five million. In Israel in 1999, 9,527 people died from smoking-related illnesses, plus an additional 1,385 from secondhand smoke.
Says Froehlich Zelcer: “We strongly warn people to stay away from nargilas. They are just like cigarettes – even more dangerous. Parents should know the dangers.
“It is important to know that it is all tobacco, all the same killing materials being inhaled. People should not take it lightly.”
Nargilas: Myths and misconceptions
• Myth: One is exposed to less nicotine when smoking nargila than when smoking cigarettes.
• Fact: Nicotine content may be higher in nargila smoke.
• Myth: Toxins in the tobacco are filtered out.
• Fact: Many toxins remain.
• Myth: Nargila smoking is less irritating and less toxic to the respiratory system.
• Fact: The lack of irritation resulting from themoisture in the pipe makes one feel secure about the health effects.
• Myth: Fruit added to the tobacco makes it healthier.
• Fact: The fruit flavor covers the toxicity of the tobacco.