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As we celebrate World No Tobacco Day on 31 May, it may come as a surprise to some hubbly bubbly smokers that they cannot plead innocence anymore when answering the question about their smoking habits. While in the past, the underwriting question associated with smoking only asked if one smokes or not, it now specifically asks whether a person smokes cigarettes, e-cigarettes, chewing tobacco or hookah pipe, affectionately known as the hubbly bubbly. So a person who would have answered “no” because they did not consider using hubbly bubbly as traditional smoking, will now not be able to avoid paying the same high premiums as cigarette smokers do.

Dr Pieter Coetzer, chief medical adviser at Sanlam, says while some hubbly bubbly smokers would define themselves as non-smokers, indicating that they simply “enjoy” it on special occasions and when gathering with friends and family, this tobacco product is treated the same as cigarettes as far as risk assessment is concerned.

Dr Coetzer says the South African life insurance industry has always applied the same underwriting yardstick for people smoking water pipes as the one used to rate cigarette smokers for risk purposes. But the industry adapted the question related to smoking as research shows that tobacco used in hubbly bubbly pipes actually poses an increased health risk.

“According to the World Health Organisation (WHO), the smoke from a water pipe contains several toxins known to cause lung cancer, heart disease and other diseases. It delivers the addictive nicotine found in cigarettes, and the charcoal burned in the pipes often produces toxins that are not found in cigarettes – such as high levels of carbon monoxide,” says Dr Coetzer.

The most alarming fact, he says, is that the smoke produced in a typical water pipe smoking session can contain about 36 times more tar than the smoke from a single cigarette. While nicotine is the addictive substance in all tobacco products, tar is the substance that actually causes lung and throat cancer.

“Despite research indicating the risks associated with so-called alternative forms of smoking, people still tend to consider devices such as the hubbly bubbly to be less harmful. But, we know that the hubbly bubbly is actually more toxic than cigarettes, because there are toxins from charcoal that you don’t get from cigarettes.”

According to the Cancer Association of South Africa (CANSA) hubbly bubbly is increasingly becoming a popular activity among young people, because it is seen as a fun way to socialise with friends.

Research conducted by a group of UCT medical students in association with CANSA showed 66% of 228 students surveyed had smoked a hookah pipe, and that most started smoking in high school.

Their smoking sessions on average lasted 30 to 60 minutes and even though 91% indicated that they vaguely knew it was harmful, 84% said they would recommend it.

CANSA says the most worrying trend is that some parents actually buy the hubbly bubbly pipes for their children, hoping that it would deter them from smoking cigarettes!

Dr Coetzer says hubbly bubbly pipes are often a gateway to smoking. “It’s not very portable, so the warning to parents is that they may start their children on a hubbly bubbly – but this is where they will get addicted to nicotine. Once there, they’ll likely switch to cigarettes because it’s portable.”

He says that it is the social and “cultural” status of the hubbly bubbly that makes parents feel comfortable allowing their children to smoke it, but they also do so because they are, sadly, misinformed. Some of these misconceptions are linked to the fact that hubbly bubbly smoke passes through water, so people assume it is therefore less harmful than cigarette smoke. The sweet flavour and pleasant smell make it easier to inhale and also creates an impression that the smoke is cleaner than that of cigarettes.

“Another major problem is that we don’t have control over what people put in the hubbly bubblies, because it is not regulated. It’s like accepting an open drink in a bar where you are at the mercy of the person who gave it to you,” said Dr Coetzer.

  • Footnote:

    Life and critical illness insurance can literally save a family from financial ruin if a breadwinner or family member should die, or be diagnosed with a critical illness like cancer. Medical insurance covers only a very limited range of costs associated with the treatment of critical illnesses such as cancer. Sanlam believes every individual who relies on someone else for financial security or is responsible for another person’s financial security, should obtain good advice and consider risk cover in the form of life and critical illness cover.

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