Cannabis might be ingested in a number of ways, but the most famous route of administration remains via smoking or inhaling the drug. Cannabis products are usually smoked (with or without tobacco) either through a pipe or in the form of a cigarette (sometimes called a ‘joint’). The pipes come in a vast array of sizes and forms but usually have long stems or add a ‘hookah-type’ water filtration system (i.e., water pipe) and are often known as a ‘bong’. When a water pipe is used, cannabis smoke is cooled by the water in an effort to reduce its harshness and temperature, which may scald the throat (Booth, 2003).

Little research has been conducted in to the specific harms related to smoking cannabis by way of a water pipe or bong. Few studies examining cannabis use, aside from those concerning the medical utilisation of the drug, have differentiated in 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, there has been a resurgence in popularity in using hookahs or ‘shisha’ to Smoketools, particularly flavoured cigarettes and tobacco products. The traditional Middle Eastern water pipe is now widely smoked across the world, particularly by students and teenagers. Because of the utilization of healthy-sounding fruit flavouring as well as the social way it is almost always used (i.e., in restaurants and cafes), it is usually regarded as a ‘safer’ option to cigarettes. As a result of this recent popularity, we have seen an increasing quantity of research conducted examining the harms associated with the aid of the shisha.

This bulletin will examine the foundation in the water pipe and what we should know of the harms connected with smoking cannabis by way of a bong, particularly in comparison with other routes of administration. As the scientific studies are limited in this region, an study of the current evidence concerning the harms related to water pipe cigarette smoking is included in addition to consideration of how this information may be used in cannabis prevention activities.

Origins in the water pipe – Using water in a smoking apparatus is ancient, with Persian hookahs or ‘narghiles’ illustrative examples of early smoking water pipes (Erickson, Jarvie & Miller, 1977). Within their 1997 US patent to have an ‘improved smoking water pipe or bong’, the authors describe the 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 to the mouth of 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 the time of writing, Phillips (1983) hypothesised that cannabis was smoked in water pipes in eastern and southern Africa before the introduction of tobacco. He considered that the invention in Ethiopia water pipe bowls, “definitely related to the smoking of cannabis”, tends bqlsqo confirm speculation of the African origin of the water pipe. Others believe they originated in China or Persia, but in these instances the instruments were believed to be employed to smoke tobacco.

The phrase ‘bong’ is surely an adaptation from the Thai word baung, which identifies a cylindrical pipe or tube cut from bamboo. One of many earliest recorded uses of the word within the West is incorporated in the McFarland Thai-English Dictionary, published in 1944, which describes among the meanings of ‘bong’ in the Thai language as, “a bamboo water pipe for smoking kancha, tree, hashish, or perhaps the hemp-plant.” Erickson and colleagues (1977) believe that it must be this version which includes probably influenced the style of the present day devices that add a “general cylindrical tubular construction”, with tubes of plastic as well as other modern materials replacing the hollow bamboo stem which had been used before. Their description of methods this kind of water pipe works is as follows:

“The oriental bong, further, provides means for using atmospheric air to dilute the smoke before inhalation, as well as provided oxygen for the combustion producing the smoke. Thus, an air admitting orifice has become provided venting the smoke chamber formed in the bamboo stem higher than the water in the bottom of the stem. The orifice is finger controllable, in order that air may on the desire in the smoker be either excluded or admitted straight to the smoke chamber to be able to dilute the smoke therein.”

A bong employed to smoke cannabis is similar to a conventional hookah both in construction and function, except it is usually smaller and much more portable. The hole in the stem described above, also known as the ‘carburator’, ‘shotty’ or just ‘hole’, is usually kept covered during the smoking process, then opened to permit the smoke to be drawn to the respiratory system so as to maximise the impact.