Why Rwanda banned smoking of shisha?

Smoking water-pipe tobacco, popularly known as shisha, poses a serious health risk in addition to damaging the social fabric of a community. While there had been multiple complaints about the youth losing track as a result of Shisha, it was until last week, that govnment took a bold decision to ban Shisha. The Ministry of Health directive released on December 14 said the use, advertisement, and import of waterpipe tobacco is banned on Rwandan territory effective from December 15, 2017.

Shisha contains many of the same toxic chemicals found in cigarette smoke although smokers are at a higher risk of suffering the same kinds of diseases caused by cigarette smoking. Rwanda like many other African countries has a growing population of young people. Manufactures of cigarettes and those peddling Shisha look at these young fragile, impressionable and easily manipulable youth as a potential market. Therein lies the problem. There was an aggressive marketing and promotion to young people especially girls and the increasing number of shisha new users in public places has been observed majority of hotels, bars, restaurants and nights clubs. The directive noted that the ban was in line with the World Health Organisation tobacco guidelines pointing to smoking health effects such as being damaging, addictive and dangerous to human lives.

The smoke that emerges from the water-pipe contains numerous toxicants known to cause lung cancer and other heart diseases, according to the ministry of health. The ministry warned that failure to comply with the directive would attract legal punitive measures. Following the ban, Rwanda National Police swung into action. Police officers went to bars and restaurants known for selling Shisha, mainly sensitising them to abide by the ban.

Medical view

Dr. Valens HAFASHIMANA, said shisha is a main cause of lung cancer not only for the smoker but also passive smokers. “Being a vaporised liquid makes it more dangerous than tobacco. Tobacco has nicotine and shisha is made of different substances which may cause cancer,” Francois said. The World Health Organisation warns that water-pipe tobacco smoking contains numerous toxicants known to cause lung cancer, heart disease, among other ailments. Tobacco activists say waterpipe tobacco smoking delivers the addictive drug nicotine as it is the case with other tobacco products.

A cigarette smoker generally takes between 5 to 7 minutes a session and inhales between 0.5 to 0.6 liters of smoke, while water pipe smoke sessions typically last 20 to 80 minutes, during which the smoker may take 50 to 200 puffs which range about 0.15 to 1 liter each, according to the World Health Organisation. The water pipe smoker may, therefore, inhale as much smoke during one session as a cigarette smoker would inhale consuming 100 or more cigarettes, it adds.

While the water does absorb some of the nicotine, waterpipe smokers can be exposed to a sufficient dose of this drug to cause addiction. It is also likely that the reduced concentration of nicotine in the water pipe smoke may result in smokers inhaling higher amounts of smoke and as a result exposing themselves to higher cancer-causing chemicals and hazardous gases.

Following research that was done on waterpipe tobacco smoking, WHO suggests that it should be subjected to the same regulations as cigarettes and other tobacco products. Waterpipes and waterpipe tobacco should also include strong health warnings, they should be included in comprehensive tobacco control efforts, including prevention strategies and cessation interventions, prohibiting them in public places as it is on cigarettes and other forms of tobacco smoking.