Smoking tobacco using the traditional hookah waterpipe has been part of the fabric of life in the Middle East for centuries.
Its documented evolution stretches back to 16
century India where one historian recorded that the waterpipe was invented by a physician during the reign of Emperor Akbar as a less harmful method of tobacco use.
The physician, Hakim Abul Fath, suggested that "tobacco smoke should be first passed through a small receptacle of water so that it would be rendered harmless."
So began a myth that shisha smoking is far less dangerous to health than cigarette and pipe smoking.
This week, the World Health Organisation has quashed that myth, suggesting that smoking a hookah is more dangerous than smoking cigarettes. It also said that more research is needed into the link between the use of the waterpipe and several fatal illnesses.
An advisory note from the WHO says that smoking a hookah may expose the smoker to more smoke over a longer period of time than occurs when smoking cigarettes.
Because smoking a hookah may take up to 80 minutes, the report suggests that the smoker is subjecting himself to as much smoke as somebody dragging on 100 cigarettes.
And the water does not strip out all toxic substances. Some of the nicotine is absorbed, but this leads to people smoking for longer in order to experience the effects of the drug, and therefore inhaling more smoke containing carbon monoxide, heavy metals and other toxic compounds, which leads to heart and respiratory problems.