Multi-Cultural Medicine: A Series in the British Medical Journal

Abstract

Hooka — The hooka is a smoking apparatus: a flask half filled with water is connected through a pipe to an earthenware funnel containing tobacco paste, which is covered with a stone disc over which there are lighted coals; another pipe from the side of the flask above the water level is connected to a mouthpiece. As with the chestpiece of a stethoscope, this mouthpiece is never sterilised. One person inhales the smoke that originates from the tobacco paste filtered through the water through the mouthpiece, and then it is passed to the next person and so on among the family, relatives, and visitors, who sit around in a circle most evenings after dinner for a ‘pow-wow’. This custom is popular not only in the Asian subcontinent but also with Arabs, Iranians, Chinese, and south east Asians. This was a sight familiar to British Army personnel when visiting these areas. This form of smoking is as dangerous as any other and its use should be elicited through direct questioning. The Sikh religion, however, forbids smoking, and to a devout Sikh this would be an offensive question. Therefore an indirect approach is more tactful.