Shisha: A gateway for non-communicable diseases

ZIMBABWE, just like the rest of the world, is making significant strides in fighting noncommunicable diseases which have become a major undoing in the public health sector.

Although the country has realised improvements in service delivery, noncommunicable diseases (NCDs) like cancer, diabetes, hypertension, and depression, the three most common conditions in Zimbabwe, have threatened to derail the achievements made in the public health sector.
It is in this context that some African countries have banned shisha as it has been discovered as one of the major causes of such NCDs.

Shisha is a mixture of tobacco, molasses, glycerine and flavourings, and has become so common in drinking places around the country that some have become addicted and cannot do without it.
Kenya, Tanzania, Rwanda, Cameroon, Ghana and Mali have all banned shisha amid health concerns.
In Zimbabwe, however, shisha, just like tobacco, is freely smoked. According to research, in a shisha session which usually lasts 20-80minutes, a smoker Like cigarette smoking, these toxins from tobacco-based shisha put smokers at risk of developing heart and circulatory diseases.
According to the World Health Organisation, Zimbabwe seems to be facing a double burden of communicable and NCDs, although there are no current statistics on their burden.

“However, evidence from health facility-based surveillance data suggests that NCDs and conditions continue to pose a growing public health challenge. Diabetes, hypertension, cardiovascular conditions, cancers, road traffic injuries and mental health conditions continue to afflict a growing number of Zimbabweans. It is estimated that NCDs account for 31% total deaths in Zimbabwe,” said WHO.
In a statement to commemorate International Youth Day, the African Tobacco Control Alliance (ATCA) said global organisations representing the youth released a statement condemning the tobacco industry’s creation of a new generation of addiction and calling for governments to make tobacco companies pay for past, present and future harms.

ATCA chairperson, Ayong Caleb said the losses caused by tobacco outweigh any economic gains of tobacco industry, costing an estimated US$1,4 trillion annually and urged governments to protect young people. “Tobacco causes 8 million deaths in addition to causing addiction and environmental harm. In Africa 13percent of young adolescent girls use tobacco products. Recent trends show an increase in tobacco use among girls. Recent prevalence rate among girls has become as high as for boys. The single plastics in cigarette packs and butts alone cause at least US$20billion annually in losses,” said Caleb Youth against Alcoholism and Drug Dependency (YADD) Executive Director, Mr
Tungamirai Zimonte said Zimbabwe is affected by a huge NCD burden hence regulating unhealthy commodities that result in the acquisition of NCDs is a priority.
“One of the remedies is increasing excise tax on harmful commodities like tobacco and channel the resources to public health to deal with resultant problems like NCDs,” he said.
Mr Zimonte said the shisha ‘epidemic’ has also become a gateway for drug abuse in Zimbabwe “Shisha has become a gateway for drug abuse as people are now putting other drugs in the shisha pipes. They start by putting tobacco and slowly migrate to other prohibited drugs like marijuana and other toxic drugs. It has become a menace in Zimbabwe and it needs to be controlled as it has become a vector for NCDs,” he said.
Ministry of Health and Child Care public relations manager, Mr Donald Mujiri said they didn’t have any statistics regarding shisha and its association with NCDs but said the country was facing challenges in NCDs.

Medical expert and former health minister, Dr Henry Madzorera gave a medical perspective to the issue.

“Tobacco smoked through pipes that contain water has been around for centuries. The deception around is that the water cleanses the smoke from harmful elements from tobacco. That is extremely deceptive because studies show the smoke contains all the harmful elements found in tobacco like nicotine, carbon monoxide and heavy metals as well as aromatic hydrocarbons which are harmful and cause cancer,” he explained.
“There is no protection that one gets from shisha as it is tantamount to smoking tobacco. In fact, shisha is more harmful than smoking tobacco and this has become a serious public health problem that should be controlled and not allowed to grow. Government has been battling to control the smoking of tobacco and shisha is now threatening to
derail all the efforts and gains and progress so far made in reducing smoking in the
Dr Madzorera said more mitigation measures can be put in place in line with the WHO Framework Convention on Tobacco Control (CTC).

“I cannot say the Government should ban the smoking of shisha before we exhaust all controlling measures as per the CTC. So, I advocate for use of price and tax measures in Zimbabwe given that tobacco and shisha are too cheap in Zimbabwe. Let us also put in a law that protects people from suffering from passive smoking as well as regulate the tobacco industry so that they provide all the contents of shisha and its side effects just like tobacco,” he said.
Dr Madzorera said manufacturers and traders of shisha should register with the Government so that they can be easily monitored.

The United States of America have managed to reduce smoking by about 50 percent while Australia has made significant strides in curtailing smoking by application of the CTC framework guidelines. – @michaelmagoron1.