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Shisha bar and having a joint

Question
Dear expert team,
many of my friends visit shisha bars. Would smoking with them be harmful for me? It is only water steam and only few tobacco. This is certainly not so dangerous as cigarette smoking? Having a joint , for example, should also relax the airways. Is having a joint better than smoking shisha?
Thank you.
Answer
Dear questioner,
to cut a long story short: shisha as well as having a joint (toking) is already for healthy peolpe harmful and even more for people with chronic lung diseases (e.g. CF).
In order to understand this, one has to know, that when smoking shisha, not only water steam is inhaled, but a so-called water tobacco, which can contain nicotin or be free of nicotin. The question of possibly less danger with alternatives to water tobacco without nicotin can not be answered generally, as there are few studies on the long term effects about these products. However, water tobacco for shisha smoking contains nicotin as well as taste flavours, flavour carriers (so-called molasse, a sugar sirup) and a long-chain alcohol which is necessary for producing the smoke. Due to this substances, there is an increased danger when smoking shisha, as all those substances can be harmful when inhaled. In case of shisha smokers using nicotin-containing water tobacco, the nicotin load is in general higher compared to smoking cigarettes, as a shisha seance leasts in general 20-30 minutes and that is the same as smoking10-20 cigarettes. Via heating of the glycerine the environmental poison propenole (acorelin) is emerging. The shisha smoke bears further dangers: water-cooled smoke can be inhaled more easily, therefore the "smoker career" is coming easily. Due to several people using the same device, there is the danger of transmission of germs and illnesses and the substances damage the bronchial epthelium.

In case of having a joint, ususally cannabis is smoked. This is the most frequent consumed illegal substance in Germany,. Cannabis can cause psychosis and young people can develop long term damages. Cannabis has a meaning in medicine. Due to different effects, drugs based on cannabis are investigated and partly also given in diverse (chronic) illnesses for relieve of symptoms or prevention of worsening of an illness. Examples are epilepsy, multiple sclerosis, depressions, Parkinson or others. A positive effect of cannabis is not proven for CF, a possible anti-inflammatory effect of one substance could until now not be proven. Besides the questionable anti-inflammatory effect the possible positive effect of cannabis on appetite and food intake in CF patients remains speculative.
In summary, we dehort from smoking shisha and having a joint!
Much more healthy and in the long term satisfactory are sportive activities - convince yourself!
Best regards,
Dr. Christina Smaczny
06.10.2017