This is not just the story of the two but of a huge number of youths who have become addicted to tobacco products like hookah.
What is a matter of serious concern for the youths, parents and law enforcement is that Nepal’s Tobacco Products (Control and Regulatory) Act (2011) has no provision on controlling the import, production and distribution of such products. A team from AMN’s No Tobacco Campaign interviewed some of the regular consumers and visitors of the XYZ restaurant, including students, teachers and corporate to get their perspectives on “hookah, vape and/or e –cigarettes”. Cool or poisonous? Romit (name changed), 23, says he enjoys vaping because his friends also consider it cool and trendy. “Everyone is doing it, so I wanted to give it a try,” he said. “I like different flavors and the fact that it doesn’t smell like cigarettes.” Shreya (name changed), 22, says she too enjoys hookah with friends because it is “a social activity”. “It’s something we can do together and try new flavors,” she said, describing it as a ‘fun thing to do.’ However, not all customers agreed with the two. Sudarshan (name changed), 26, was concerned about the potential health risks associated with hookah, vapes, and e-cigarettes. “I’ve heard that they can cause lung problems and other health issues,” he said. “I’m not sure it’s worth the risk.” Some customers appeared quite cautious about the addictive nature of these products, pointing that they had seen people ‘who can’t go a day without vaping’. Like them, an increasing number of people, including health experts, aware of health risks that these products pose, are raising awareness on the issue. The experts warn that products like e-cigarettes contain harmful chemicals and are addictive. Smoking hookah has been associated with increased risk of lung cancer, heart diseases and other health problems. Findings of a new research from the Nepal Development Research Institute (NDRI) also suggest that increase in hookah use may be behind a growing number of young people in Nepal who are using tobacco products—up from 11.4 percent of 15 to 24-year-olds in 2013 to over 15 percent in 2019. That in turn explains the growing epidemic of smoking-related deaths in Nepal. One in five deaths in the country is attributed to tobacco. Worryingly, the youths account for an increasing number of deaths, including the use of tobacco products, including hookah. Don’t go after flavors Hookah is taxed at a much lower rate than cigarettes, meaning companies are incentivized to invest in promoting it and young people find it more affordable. It does not have to carry visible health warnings on its packaging, meaning many young people are under the mistaken impression that it won’t harm them. And the tobacco firms, of course, know all this. That’s why hookah is marketed as fun, colorful, and cool in a way that’s just not possible with the much more familiar danger of cigarettes. Young people are tempted by flavors, including watermelon, tropical fruit, caramel, chocolate, vanilla, and strawberry. The way we handle hookah in this country is killing young people. The international evidence is clear that hookah can have serious and negative health impacts. In hookah smoke, at least 82 harmful substances and carcinogens have been found. Smoking tobacco with a water pipe for an hour emits the same amount of smoke as 100–200 cigarettes. Studies have shown that users can expose themselves to up to 1.7 times as much nicotine and up to nine times as much carbon monoxide in a normal hookah session as they would in a single cigarette. Hookah smokers are 2.2 times more likely than non-smokers to experience long-term cardiovascular consequences, and it has been shown that hookah smokers are more likely than non-smokers to develop oesophageal cancer. Smoking a hookah is associated with many of the same harmful health effects as smoking cigarettes, including heart disease, lung, bladder, and oral malignancies. Time for urgent action It’s time to end this hookah epidemic and address the wider problem of increasing tobacco use in Nepal, particularly among the youths. NDRI, along with the Nepal Cancer Relief Society, are urging the government to take urgent action to protect the health of Nepal’s youth. They are asking the government to ensure that hookah products are treated with the same level of severity as other tobacco products through measures like these:
- Extending existing tobacco control regulations to explicitly apply to hookah. For example, requiring that hookah products carry health warnings and banning sales to minors.
- Introducing regulations that limit marketing tactics, which specifically target young people.
- Increasing tax on hookah products to help make hookah products less affordable to youth.
