Pulmonologist’s warning on water pipes and e-cigarettes 

A perverse belief among some young people that vaping or smoking through a water-filtered hookah pipe is not harmful to their health needs to be urgently corrected.

“There’s a perception that vaping is harmless, but it is harmful and highly addictive. Young people who start using e-cigarettes are more likely to go on to smoking cigarettes,” says Dr Mahomed Seedat, a pulmonologist and specialist physician practising at Netcare Garden City Hospital.

“Previous generations favoured cigarette smoking, but today some young people, including schoolchildren, think it is cool to vape. Many vaping products are available in eye-catching colours and flavours, and this can make them attractive to young people,” Dr Seedat says.

“Vaping is marketed as a lifestyle rather than a habit. In reality, it delivers concentrated nicotine vapour deep into the lungs far more efficiently than cigarettes. As vaping can be virtually odourless, indoor vaping becomes more convenient, and people may develop the habit of vaping almost continuously, thereby amplifying the damage.”

Research has suggested that vaping patterns may lead young people to develop heavier cigarette smoking in future, which is even more cause for concern.

What’s happening in the lungs

Dr Seedat explains that our lungs contain a network of airways, including small airway tubes called bronchi and smaller bronchioles. “Vaping causes irritation and inflammation in the airways, causing them to narrow, which is experienced as coughing or wheezing,” he says.

“The lining of our airways, the bronchial epithelium, contains tiny cells that act as brushes, clearing mucus and other particles from our bronchi. These cells are also damaged by smoking or vaping, causing localised inflammation in the airways, and significantly reducing our bodies’ ability to fight infection in the lungs.

“The tiny air sacs in our lungs, where oxygen and carbon dioxide are exchanged for breathing, are called alveoli. Smoking and vaping can be severely toxic to delicate lung tissue, and there is a higher risk of several forms of pneumonia,” Dr Seedat warns.

Pneumonia can progress to severe lung injury, particularly when the lungs are already damaged by vaping or smoking. In severe cases, it may require mechanical lung ventilation to keep the person alive until they recover. 

“Smoking and vaping can also affect brain function, including focus, concentration, impulse control, mood changes and euphoria. This is not even to mention the risk of cancer, which should be a major concern for young people’s futures,” he says.

Shisha, hookah, hubbly bubbly

Hookah pipes, also known as shisha or hubbly bubbly, which are popular at some bars and parties, are another source of concern for the pulmonary health of people who use them.

“People think the water in shisha pipes filters out the toxins and harmful particles from the smoke, but medical studies have shown the smoke remains highly toxic. Smoking one shisha is estimated to be equivalent to smoking 20 to 30 cigarettes in one sitting.”

In addition, sharing hookah pipes, especially when the mouthpiece is not changed between users, increases the risk of transmitting infectious diseases. Studies have suggested that shared shisha mouthpieces can harbour viruses and bacteria associated with respiratory illnesses, including Mycobacterium tuberculosis, as well as Aspergillus and other spore-producing fungi.

“It’s important for young people to understand the effects of vaping and smoking on their bodies. I would encourage parents to make their children aware that vaping or smoking in any form has real health consequences.

“We only get one set of lungs, and they have to last us for life. If you need help to stop vaping or smoking, speak to your GP. Any persistent cough, wheezing or tight chest should be medically investigated,” Dr Seedat conclude