Many people treat shisha as a casual, social activity, often failing to realize it poses risks just as severe as traditional cigarettes. Medical professionals in the UAE are raising the alarm, noting that a single hour-long shisha session can be equivalent to smoking 40 cigarettes. The common misconception that the water filter makes the smoke "cleaner" or safer has no scientific foundation, as users are still inhaling high levels of carbon monoxide, tar, and other toxic substances. Alarmingly, many individuals who smoke shisha, midwakh, or vapes do not even classify themselves as smokers, which complicates medical diagnosis and prevents people from seeking necessary help.

Experts emphasize that doctors need to change how they approach patient screenings by asking more specific questions about tobacco habits. Because many smokers normalize persistent symptoms like a chronic cough, wheezing, or breathlessness, they often delay seeking treatment for conditions like chronic obstructive pulmonary disease (COPD). Experts urge that cessation support should be integrated into primary healthcare, offering non-judgmental guidance and medical intervention. Ultimately, the message is clear: shisha is not a harmless alternative, and any respiratory symptoms should be treated as a serious warning sign that requires professional attention.