Cannabis might be ingested in a plethora of possibilities, but the most common route of administration continues to be via smoking or inhaling the drug. Cannabis products are usually smoked (with or without tobacco) through a pipe or by means of a cigarette (also known as a ‘joint’). The pipes come in a vast array of sizes and forms but often have long stems or incorporate 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 order to reduce its harshness and temperature, which can scald the throat (Booth, 2003).

Little studies have been conducted to the specific harms connected with smoking cannabis by way of a water pipe or bong. Few studies examining cannabis use, aside from those concerning the medical use of the drug, have differentiated in between the various methods of delivery (i.e., smoking via joints or water pipes, ingesting in food) and little is well known regarding distinct administration routes, their relationship to drug use patterns, and related harms.

Recently, there has been a resurgence in popularity in the use of hookahs or ‘shisha’ to smoke shop, particularly flavoured tobacco products. The ancient Middle Eastern water pipe is currently widely smoked around the globe, particularly by students and young adults. Due to the utilization of healthy-sounding fruit flavouring as well as the social way it will always be used (i.e., in restaurants and cafes), it is often regarded as a ‘safer’ alternative to cigarettes. Due to this recent popularity, there has been a growing quantity of research conducted examining the harms associated by using the shisha.

This bulletin will examine the origin of the water pipe and what we should know of the harms connected with smoking cannabis by way of a bong, particularly when compared to other routes of administration. Since the scientific studies are limited in this region, an examination of the current evidence with regards to the harms related to water pipe tobacco smoking is included in addition to consideration of methods these details can be used in cannabis prevention activities.

Origins of the water pipe – The usage of water in a smoking apparatus is ancient, with Persian hookahs or ‘narghiles’ illustrative types of early smoking water pipes (Erickson, Jarvie & Miller, 1977). Inside their 1997 US patent for the ‘improved smoking water pipe or bong’, the authors describe the procedure the following – “… smoke from the substance being combusted is directed via a tube discharging underneath the surface water in a potlike container before passing therefrom by way of a second tube for the mouth in the smoker.”

Where water pipe actually originated is unclear, while there is increasing evidence to claim that bongs were first utilized 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 introduction of tobacco. He believed that the discovery in Ethiopia water pipe bowls, “definitely associated with the smoking of cannabis”, tends bqlsqo confirm speculation of an African origin in the water pipe. Others believe they originated in China or Persia, but in such cases the instruments were thought to be employed to smoke tobacco.

The word ‘bong’ is an adaptation in the Thai word baung, which describes a cylindrical pipe or tube cut from bamboo. Among the earliest recorded uses from the word in the West is in the McFarland Thai-English Dictionary, published in 1944, which describes among the meanings of ‘bong’ within 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 is this version which includes probably influenced the design of the modern devices that include a “general cylindrical tubular construction”, with tubes of plastic along with other modern materials replacing the hollow bamboo stem which was used in the past. Their description of how this kind of water pipe works is as follows:

“The oriental bong, further, provides method for using atmospheric air to dilute the smoke before inhalation, along with provided oxygen for that combustion producing the smoke. Thus, an aura admitting orifice has become provided venting the smoke chamber formed inside the bamboo stem over the water towards the bottom from the stem. The orifice is finger controllable, to ensure that air may on the desire of 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 conventional hookah both in construction and performance, except it is usually smaller and a lot more portable. The hole within the stem described above, often referred to as the ‘carburator’, ‘shotty’ or simply just ‘hole’, is usually kept covered during the smoking process, then opened to permit the smoke to be drawn in to the respiratory system so as to maximise the impact.