KUALA LUMPUR: An oncologist has called on the authorities to strictly enforce the ban on smoking in public places immediately and warned about the widespread ignorance involved in smoking shisha, with even medical students being unaware of its dangers.

National Cancer Society managing director Dr Murallitharan Munisamy said a study carried out by the Management and Science University (MSU) in Shah Alam found that one-third of its students surveyed had smoked shisha, with 20% of them being medical students.

He said in a typical one-hour shisha smoking session, users may inhale 100 to 200 times the amount of smoke produced from a single cigarette.

“In a single water pipe session, users are exposed to up to nine times the carbon monoxide and 1.7 times the nicotine of a single cigarette. The amount of smoke inhaled during a typical shisha session is about 90,000ml, compared with 500 to 600ml inhaled when smoking a cigarette.

“Going by this calculation, a typical shisha session is equivalent to smoking 180 sticks of cigarettes, which translates to nine 20-stick packets of cigarettes.”

Murallitharan said many of the health risks associated with smoking shisha are similar to those from cigarettes.

“However, because of the way shisha is used, people who smoke it will absorb more of the toxic substances that are found in tobacco smoke. These toxic chemicals, like formaldehyde, acetaldehyde and acrolein, have been linked to various respiratory diseases and pose a real cardiovascular risk for people who consume them.”

He said flavoured shisha has the potential to render additional health risks because heat stimulates the ingredients to produce more toxic chemicals.

Murallitharan added that just like conventional and e-cigarettes, second-hand smoke from shisha is harmful to non-smokers as well.

“Non-smokers can experience serious respiratory issues such as coughing and shortness of breath, among others.

“Long exposure can cause cardiovascular issues like increased blood pressure and development of heart diseases. Second-hand exposure to shisha smoke could also lead to cancer cells forming. Many tend to forget this,” he said, adding that the public has a perception that shisha is less harmful than other forms of tobacco consumption.

“A study in Saudi Arabia found that 50% of students thought smoking shisha was less harmful than smoking cigarettes.

“Just as bad, 61% of them even thought the harmful substances in shisha would be purified by the water filtration system that the smoke goes through.”