Speak to an environmental health professional about shisha bars and the word ‘misconception’ comes up regularly.

That, and phrases such as ‘insufficient knowledge’ and ‘lack of understanding.’ An increase in the use of shisha pipes across the Bradford district is causing concern, particularly as it is seen by many as being less harmful than cigarettes. But studies challenge this ‘misconception’.

Research by the World Health Organisation has shown that an hour-long pipe-smoking session is, for one person, the equivalent of smoking between 100 and 200 cigarettes.

“People are always shocked to hear this,” says Joanne Housley, environmental health manager with Bradford Council. “Plus there are risks from secondary smoke inhaled by friends sitting alongside smokers.”

Traditionally smoked in the Middle East and Asia, the smoking of shisha pipes, or water pipes as they are also known, involves a fruit or honey-flavoured tobacco smoked over burning charcoal or wood cinders, then cooled through a glass-based water pipe or ‘hookah’.

It is viewed as an extremely social practice, with multiple users sharing one pipe. A typical session will last up to three hours.

Worryingly, it is seen by many as being safer than smoking cigarettes, but the adverse health effects are believed to be similar, or even more harmful to those for cigarettes.

“There are misconceptions of it being less harmful than traditional tobacco products, or even harmless because it is filtered through water,” says environmental health officer Abdullah Hans. “People don’t class it as smoking.”

He adds: “There is a lack of understanding. We are trying to get the health message across and inform people of the risks.”

The harmful health effects include a carcinogenic potential for the lungs, mouth and bladder, and an increased risk for asthma, cardiovascular disease and other conditions.

Yet many smokers – particularly younger people – remain unaware of this. Research published last year by Harrow NHS on youth attitudes to shisha smoking found that half of the 60 smokers aged between 17 and 25 that they surveyed thought there were health risks, but 30 per cent thought there were not.

Confusion surrounded there being no warnings on tobacco packets, a belief that water strips away toxins and the fact that no-one ever heard of someone dying from shisha. Participants agreed for the need for a health campaign, but warned that it should involve straight facts and statistics, and possibly target 13 and 14-year-olds, before they start.

Referring to the study, Abdullah says: “There is a big gap in the knowledge of people using shisha. A lot of people thought there were no health risks and think of cigarettes as more damaging.”

The fact that they contain fruit flavourings is another reason the dangers are masked, Joanne points out. Adds Abdullah: “It does not make your breath smell in the same way as cigarettes, so people who would not touch cigarettes think nothing of using a shisha pipe.”

Across the country, the number of shisha bars, or lounges as they are commonly known, has risen, particularly since the smoke-free legislation was implemented four years ago.

Five years ago, the Council’s environmental health team knew of three, now they are aware of four times that figure. “But they are the ones we know about,” says Joanne, “There may be others of which we are unaware.”

Such bars come to light when officers come across them on visits to other premises, or they may be alerted by members of the public.

There is no legislation covering registration of shisha bars, and existing restaurants or cafes can create them. “Some people say they have a licence, but there is no such thing,” says Abdullah. But the same no-smoking legislation applies and if those rules are broken, the team can carry out enforcement action.

The former Markaz shisha lounge in Bradford city centre was taken to court three times in 18 months and fined almost £16,000 by magistrates for breaching the smoking ban.

Education is the way forward, and work is being done to this end by the Council and West Yorkshire Trading Standards Service.

Councillor Ghazanfer Khaliq, Bradford Council’s executive member for environment and sport, said: “People have to realise that smoking tobacco through a shisha pipe is every bit as dangerous as smoking it any other way.

“Some young people subscribe to the false notion that shisha smoking does not carry with it the associated health risks of lung disease, cancer and heart disease, but nothing could be further from the truth.

“It is just as harmful as smoking cigarettes and second-hand shisha smoke is as dangerous as second-hand cigarette smoke. That is why it is illegal to smoke shisha indoors in public premises.”