Thomas Oriti reported this story on Monday, May 4, 2015 12:23:00

ELEANOR HALL: Australian doctors have issued a disturbing warning about the dangers of smoking water pipes, dispelling the myth that they're a safer alternative to cigarettes.



Research published in the Medical Journal of Australia concentrates on the case of a young woman who was rushed to hospital with carbon monoxide poisoning.



Cardiologists say it's not an isolated incident and a large number of people could be exposing themselves to long-term health dangers.



Thomas Oriti has our reports.



THOMAS ORITI: The water-pipes are also known as hookah or shisha and for thousands of Australians, using them to smoke is a popular past-time.



LOUIS WANG: Generally, the water-pipe and hookah/shisha preparations have very little tobacco. There are some preparations that don't have tobacco at all.



THOMAS ORITI: Dr Louis Wang is a cardiologist at the Victor Chang Cardiac Research Institute, and Sydney's St Vincent's Hospital.



LOUIS WANG: People think erroneously that water pipe smoking is safer than cigarette smoking. Now, an hour session with a water pipe provides as much smoke inhalation as 50 to 100 cigarettes and so all the long-term consequences of smoking are also present in a water-pipe - you know, the lung disease, the cancer, the cardiovascular disease.



But the additional risk in a water-pipe is the fact that there is a lot of carbon monoxide potentially within that chamber.



THOMAS ORITI: Charcoal heats material at the top of the device, which is then inhaled. But first, it travels through a pipe into a water chamber.



Dr Wang says the process generates harmful carbon monoxide, even more than a cigarette.



LOUIS WANG: The chamber within a water pipe is relatively secluded, relative to the external environment, relative to a smoker who is smoking a cigarette in the open air.



THOMAS ORITI: So what are the consequences?



Dr Wang's research marks the first time Australian doctors have reported a connection between carbon monoxide poisoning and the design of a shisha pipe.



And it comes after a 20-year-old woman who regularly smoked them was rushed to hospital.



LOUIS WANG: She was very lethargic, sleepy, very light-headed. There was a concern, you know, she was in danger of losing consciousness entirely. And then during her observations and monitoring in hospital, she developed profound ECG changes, which were consistent with somebody not having enough oxygen supply to her heart.



THOMAS ORITI: She made a full recovery, but there could be dangers in the years to come.



Carbon monoxide poisoning can lead to irreversible heart damage and long-term mental health consequences.



And a professor of Clinical Pharmacology at the University of New South Wales, Ric Day, says although the research is only based on one patient, he's confident it's not an isolated case.



RIC DAY: The carbon monoxide exposure from water pipes is much greater than from cigarette smoking. It relates to the amount of smoke that you've got to inhale to get the equivalent amount of nicotine through the water pipe. So there's a lot of smoke inhaled so it's fairly easy to extrapolate.



THOMAS ORITI: The warning comes as the health department in New South Wales moves to ban smoking in outdoor dining areas - including water-pipes.



But the manager of the Sahra Restaurant at Parramatta in Sydney's west, Talal Alamein, has already made the move - banning shisha in his outdoor terrace which once attracted crowds of smokers.



He admits his business has taken a hit, but says it's a price he's willing to pay.



TALAL ALAMEIN: I decided not to be a hypocrite. I advise my children not to smoke. I have a grandkid. And there was one woman one night when we were fully booked, and she said 'I didn't know I would be exposed to that'. I'm more happier now that it's going to become a law.



THOMAS ORITI: The changes come into effect in July.



ELEANOR HALL: Thomas Oriti reporting.