Cannabis might be ingested in a number of ways, but the most common route of administration continues to be via smoking or inhaling the drug. Cannabis items are usually smoked (with or without tobacco) either through a pipe or as a cigarette (also known as a ‘joint’). The pipes come in a huge selection of sizes and forms but usually have long stems or include a ‘hookah-type’ water filtration system (i.e., water pipe) and are referred to as a ‘bong’. When a water pipe is used, cannabis smoke is cooled by the water in an attempt to reduce its harshness and temperature, which can scald the throat (Booth, 2003).
Little reports have been conducted into the specific harms related to smoking cannabis via a water pipe or bong. Few studies examining cannabis use, besides those relating to the medical use of the drug, have differentiated between the various strategies for delivery (i.e., smoking via joints or water pipes, ingesting in food) and little is known regarding distinct administration routes, their relationship to drug use patterns, and related harms.
Recently, we have seen a resurgence in popularity in using hookahs or ‘shisha’ to smoke shop, particularly flavoured cigarettes and tobacco products. The traditional Middle Eastern water pipe is currently widely smoked around the globe, particularly by students and teenagers. Due to the usage of healthy-sounding fruit flavouring and also the social way it is almost always used (i.e., in restaurants and cafes), it is often thought to be a ‘safer’ alternative to cigarettes. Because of this recent popularity, there has been a growing amount of research conducted examining the harms associated with the aid of the shisha.
This bulletin will examine the origin in the water pipe and what we understand about the harms connected with smoking cannabis via a bong, particularly in comparison to other routes of administration. As the research is limited in this region, an examination of the existing evidence regarding the harms associated with water pipe tobacco smoking is included in addition to consideration of methods this info can be used in cannabis prevention activities.
Origins in the water pipe – The usage of water in a smoking apparatus is ancient, with Persian hookahs or ‘narghiles’ illustrative examples of early smoking water pipes (Erickson, Jarvie & Miller, 1977). In their 1997 US patent for the ‘improved smoking water pipe or bong’, the authors describe this process as follows – “… smoke through the substance being combusted is directed via a tube discharging beneath the surface of water in a potlike container before passing therefrom via a second tube towards the mouth in the smoker.”
Where the water pipe actually originated is unclear, while there is increasing evidence to advise that bongs were first used to smoke cannabis in Africa. Based on the archaeological evidence available during writing, Phillips (1983) hypothesised that cannabis was smoked in water pipes in eastern and southern Africa before the creation of tobacco. He believed that the discovery in Ethiopia of water pipe bowls, “definitely related to the smoking of cannabis”, tends bqlsqo confirm speculation of the African origin from the water pipe. Others believe they originated in China or Persia, but in these cases the instruments were believed to be used to smoke tobacco.
The word ‘bong’ is definitely an adaptation in the Thai word baung, which describes a cylindrical pipe or tube cut from bamboo. One of many earliest recorded uses of the word within the West is within the McFarland Thai-English Dictionary, published in 1944, which describes one of many meanings of ‘bong’ in the Thai language as, “a bamboo water pipe for smoking kancha, tree, hashish, or even the hemp-plant.” Erickson and colleagues (1977) believe that it is this version that has probably influenced the style of the current devices that incorporate a “general cylindrical tubular construction”, with tubes of plastic as well as other modern materials replacing the hollow bamboo stem which was used before. Their description of methods this type of water pipe works is just as follows:
“The oriental bong, further, provides path for using atmospheric air to dilute the smoke before inhalation, in addition to provided oxygen for the combustion producing the smoke. Thus, an aura admitting orifice has been provided venting the smoke chamber formed within the bamboo stem above the water in the bottom from the stem. The orifice is finger controllable, so that air may on the desire from the smoker be either excluded or admitted right to the smoke chamber in order to dilute the smoke therein.”
A bong employed to smoke cannabis is similar to a traditional hookah within both construction and function, except it is almost always smaller and a lot more portable. The hole within the stem described above, often referred to as the ‘carburator’, ‘shotty’ or simply ‘hole’, is normally kept covered throughout the smoking process, then opened to enable the smoke to become drawn into the respiratory system so as to maximise the impact.