While shisha is often perceived as a less harmful alternative to cigarette smoking, this assumption can be misleading. Many people believe that because the smoke passes through water, it is filtered and thus rendered safer. However, it is important to understand that the water in the hookah does not effectively filter out harmful chemicals such as tar, carbon monoxide, or nicotine. In fact, the cooling effect of the water can mask the harshness of the smoke, allowing users to take deeper inhalations and potentially increase their exposure to these toxic substances.

Nicotine: Despite the belief that shisha is a more social or "light" form of smoking, the nicotine content is still present and can be addictive. Nicotine, the substance responsible for addiction in tobacco products, can lead to dependence on shisha and other forms of tobacco use. Regular shisha smokers may find it difficult to quit, and they may experience withdrawal symptoms similar to those of cigarette smokers.