Birmingham health chiefs have issued a warning about the serious risks associated with shisha pipe smoking following a sevenfold increase in the number of shisha bars across the city.
Figures released show the number of registered premises in Birmingham has increased from just three in 2007 to 21; with many shisha smokers believing it is a healthier or safer option than cigarettes.
* A typical hour-long shisha session can see users inhale the same amount of smoke as from more than 100 cigarettes.
* Shisha tobacco contains over 36 times more tar and twice as much nicotine as cigarette tobacco so it is not only more addictive but carries a far greater risk of causing lung cancer and other respiratory diseases.
* Although the water cools the smoke and makes it feel less 'harsh', the tobacco can still cause ill health, including lung and mouth cancer.
* Because the smoke is cooler, some experts say people inhale it more deeply into their lungs, which increases the risks even further.
* The charcoal - and the smoke it gives off contain additional chemicals and toxins.
Cabinet Member for Health and Wellbeing, Cllr Steve Bedser, said: "Because the tobacco in a shisha pipe is often sweetened and flavoured it's easy to understand why many people are under the impression that it is less harmful than smoking traditional cigarettes.
"But don't be fooled. This is incredibly harmful to people's health. It is a shocking fact that smoking a Shisha pipe for just one hour is equal to smoking 100 cigarettes."
Director of Public Health, Dr Adrian Phillips, added: "There are many misconceptions about shisha, which lead people to believe that it is a healthier alternative to smoking cigarettes.
"In truth, it's linked to the same serious and life-threatening diseases as cigarettes and there are added risks because you often smoke it for far longer than you would a cigarette and you're also exposed to toxins from the wood or charcoal used to burn the tobacco."