The shisha pipe at a Middle Eastern family gathering is Australia's beer at a barbeque, but health authorities in Western Sydney want shisha smoking phased out over fears it causes cancer.

Key points: Shisha is an ancient practice still common in Middle Eastern communities

Shisha is an ancient practice still common in Middle Eastern communities The Shisha, No Thanks campaign is the result of three years of research and community surveys

The Shisha, No Thanks campaign is the result of three years of research and community surveys The New South Wales Multicultural Health Communication Service has enlisted the help of the Lebanese Muslim Association to disseminate the health message

Health authorities say research shows 45 minutes of smoking flavoured tobacco from a water pipe is the equivalent of smoking 100 cigarettes and can cause cancer and lung disease.

But the Shisha, No Thanks campaign targeted at Western Sydney families has been met with distaste from many in the community.

Shisha or "hookah" is an ancient practice still common in Middle Eastern communities, which involves smoking tobacco — often with fruity flavouring — that has been heated with charcoal and sucked through a water pipe.

The water pipe is thought to have been invented in 16th-century Persia and is common in Middle Eastern family homes and in Lebanese-style cafes and restaurants in Western cultures.

In the Western Sydney hub of Parramatta, shisha is popular with young people like Sarah Byers, who has made friends with other smokers in Sydney.

The water pipe is thought to have been invented in 16th-century Persia. ( ABC News: Dariya Salmin )

"I love shisha. I smoke it like three times a day. When you want to chill out from a busy day at work or something, it's good to have it just to relax a little bit," she said.

Sarah's husband, Allan Byers, also smokes shisha and said he was not too concerned about health warnings.

"You haven't really heard of anyone dying yet from smoking shisha," he said.

"I just do it now and then."

'It's seen as safer than cigarettes'

The Shisha, No Thanks campaign is the result of three years of research and community surveys by the New South Wales Multicultural Health Communication Service, the Sydney, south-eastern Sydney and south-western Sydney local health districts, and backed by the Lebanese Muslim Association.

"Shisha smoking does lead to cancer, and a range of cancers including lung cancer, head and neck cancer, oesophageal cancer and it also has an impact on cardiovascular systems," Lisa Woodland, the director of the New South Wales Multicultural Health Communication Service, said.

"It actually impacts on the whole body. We also know it has an impact on pregnant women on the health of their unborn baby."

The health service has enlisted the help of the Lebanese Muslim Association to disseminate the message among the Arabic-speaking community, where shisha smoking is most common.

Ahmad Malas, from the organisation, said he understood the cultural significance of shisha but added it was important people knew the health effects.

"I know there are teenagers that are doing shisha. That's because family members see it as the lesser of two evils. It's seen as safer than cigarettes," he said.

In 2015, a World Health Organisation report found while there is sparse research into the effects of shisha smoking, studies show waterpipe tobacco contains enough toxins known to cause diseases similar to cigarette smoking, and that shisha smoking should be limited.

'It has a very rich heritage and it won't stop'

Wal Eade owns a shisha pipe business and runs several shisha events in Sydney.

He denies that shisha pipes contain the same chemicals as those found in cigarettes.

"Shisha is made of fruit-flavoured tobacco," he said.

Shisha business owner Wal Eade disagrees with the campaign's main slogan. ( ABC News: Isobel Roe )

"That tobacco content is between 15 to 18 per cent. The rest is the molasses and the colours and the flavours and the glycerine and everything else that goes in there."

He believed few people in the community would heed the local health authority's message.

"They will keep going. The way the prices are, they may cut back, but it has a very rich heritage in our culture and it won't stop," he said.

And he disagreed with the campaign's main slogan — that 45 minutes of smoking shisha was the equivalent of 100 cigarettes.

"If you take a puff of a shisha, a cloud can fill a room. So yes, 100 cigarettes may be the equivalent in volume of smoke, but not necessarily the harmful effects that are in that smoke," Mr Eade said.

It is legal to buy and smoke shisha tobacco in Australia if you are over 18, but shisha smokers must abide by the same laws as cigarette smokers in public.