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 Beyond the flavours: the hidden dangers of shisha smoking

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 On a hot Sunday afternoon, the Labadi beach or other leading beaches are filled with people from all walks of life, both foreigners and Ghanaians alike.

Children are seen playing in the sand while adults enjoy some food and drinks or bath in the sea amidst loud music.

Traders, horse riders and pub own­ers would also cash in, pitching their business to revellers at the beach.

As dusk settles in, some people would leave while others troop in, with the place becoming livelier as the beach is filled with a lot more people.

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The atmosphere is choked with an unusual smell of smoke; a smoke emanating from random tables on the beach.

It is usually from a flavoured water pipe popularly known as shisha, sitting on the tables and used mostly by women who shared the same tube with friends on the same table.

This is often the sight at most beaches on holidays or weekends.

An attendant at the Labadi beach, told this writer that, shisha was mostly taken by women and the price ranges from GH¢50 to GH¢70 at the beach.

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She also said the price is higher at other places saying “you can also get it from GH¢100 to GH¢200.

This mirrors what happens at other beaches, clubs, pubs and social gatherings across the capital and the country at large.

Shisha, also known as hookah or water pipe, is another form of com­bustible smoking of tobacco, where flavoured tobacco is burned with charcoal, while the smoke is guided through water via tube before it is inhaled by the smoker.

The intention behind the passage of tobacco smoke through water is to filter the smoke to make it safer. Also, the added flavour, mostly fruity, is to enhance the packaging and im­prove desirability.

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This type of smoking was invented in ancient India, and it has remained a tradition to the Middle East, and a common practice for hundreds of years.

It is estimated that, globally, about 100 million people smoke shisha on a daily basis and most of these are adolescents, high school students, and university students.

Shisha smoking has become a com­mon practice in social gatherings, generally shared in a group of four and five individuals and usually lasts from 20 to 80 minutes with 50–200 puffs per session.

The use of Shisha with tobacco products leads to particulate matter such as nicotine, carbon monoxide, and nitrogen oxide. The presence of nicotine in smoke is the primary cause of dependence on tobacco-re­lated products, hence its addiction.

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The Ghanaian Times newspaper reported on November 6, 2024 that a new survey by the World Health Organisation (WHO) has revealed that more young women in the country were engaged in various forms of smoking on a daily basis than their male counterparts, resulting in can­cer, heart and lung-related diseases in recent times.

It said WHO noted that while traditional cigarette smoking may be on the low, ‘Shisha,’ was rife partic­ularly among persons 18 to 29 years, across the country.

“More than half of current tobacco smokers report smoking on a daily basis. Among daily smokers, 73.6 per cent smoked manufactured cigarette with individuals consuming three sticks of manufactured cigarettes per day on the average.

Among daily smokers, younger persons began smoking at an earlier age compared to their older coun­terparts. The proportion of current smokers who smoke shisha is 7.8 per cent, which is more prevalent among age group 18 to 29 years and highest among women,” it revealed.

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Principal Investigator and Deputy Director of Disease Surveillance at the Ghana Health Service (GHS), Dr Dennis Laryea, expressed concern over the increasing rate of females smoking shisha in the country which holds dire consequences for the future.

“Once females take up something, it’s easier to drag the males along. And once we’re seeing this in young­er women, it also means that they are likely to grow up with it and that is a potential risk for our develop­ment,” he stated.

Dr Laryea disclosed that while ‘Shi­sha’ may be portrayed as a trendy, favourable substance, it was highly harmful as it contained chemical which could be more dangerous to one’s health due to the longer smok­ing sessions. In an interview with the Principal Regulatory Officer with the Tobacco Products Department of the Food and Drugs Authority (FDA), Mavis Danso on Friday, she said Shisha is legal because it is a tobacco product but its smoking is not allowed in public areas.

She explained that smoking of shisha is only allowed in designated areas, adding that it is so because tobacco products are scientifically known to cause a lot of illnesses which includes Non-Communicable Diseases (NCDs).

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“Once you smoke as an individu­al, you put yourself at risk and also endanger the people around you who also inhale your smoke which is called second-hand smoke,” she stated.

She again explained that the smoke coming out of the nostrils of the one smoking and also from the end of the cigarette or from the Shisha device, inhaled by those around is known as secondary smoking and also endan­gers the lives of the latter.

So in order for government to protect its citizenry, there is a law on ban of smoking at public places except in designated smoking area saying “you are not supposed to endanger other people once you are smoking.”

Ms Danso said, the department often engage in routine monitoring which includes at night as well as public education to ensure enforce­ment of the law

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She mentioned that, her de­partment also relies on voluntary complains from the public, stating that, citizens were expected to be enforcers of the law by reporting to the FDA or question the owner of the place.

She was optimistic of Ghana be­coming a Shisha free country but said it will not only depend on enforcers but also on facility owners and vigi­lant individuals who ensure that the right thing was done.

Ms Danso said there was a high prevalence of shisha smoking among women as well as a misconception that shisha was better than smoking, a notion she described as untrue.

She mentioned that an hour use of shisha was equivalent to smoking 200 sticks of cigarettes.

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Ms Danso also mentioned that the idea that it passes through water and the contaminants remained in the water was false and that once the substance is taken, it affects the entire body.

According to her, there was the tendency of it being additive due to nicotine found in it and also has risk factors such as heart and lung dis­eases and also cancers, adding that “there is no safe form of tobacco, whether smoked, inhaled or what­ever forms it comes in, it is harmful and can cause serious health implica­tions to the body.”

According to the World Health Organisation (WHO), shisha also known as water pipe tobacco smok­ing was probably associated with oral, oesophageal and lung cancers and possibly with gastric and bladder cancers.

It said, shisha has also been associated with respiratory disease, cardiovascular disease, periodontal disease, low birth weight, perennial rhinitis, male infertility, gastro-oe­sophageal reflux disease and impair­ment of mental health.

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With women, shisha can cause higher risk of preterm menstrual pause, reduced bone mineral density, infertility, and ectopic pregnancy; it is also associated with a higher rate of infant mortality and can lead to intrauterine growth restriction and the rise of certain chromosomal anomalies.

The Sustainable Development Goal (SDG) three which states “good health and well-being” targets reduc­tion in the global maternal mortality ratio to less than 70 per 100,000 live births, reduce by one third prema­ture mortality from non-communi­cable diseases through prevention and treatment and promote mental health and well-being by 2030.

This can be achieved when gov­ernment and its health agencies, non-governmental organisations and individuals help enforce existing laws on shisha smoking.

Also, workshops, seminars should be organised by various stakehold­ers for young women focusing on the dangers of shisha, utilise social media platforms to raise awareness about risks of Shisha while sharing engaging content and personal sto­ries and also create safe space and engaging recreational spaces for young women offering alternatives to shisha cafes and bars.

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More so, it is important for facility owners to obey the laws on shisha smoking while the citizenry reports offenders to the FDA for appropriate punishments.

 By Jemima Esinam Kuatsinu

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Gender

Motherhood in the Fields: The Unseen Health Toll on Women Farmers

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A woman working on a farm with baby strapped at her back
A woman working on a farm with baby strapped at her back

Across many farming communities in Northern Ghana, women routinely carry their infants on their backs while engaging in strenuous farm labour. This practice, though rooted in necessity and resilience, exposes both mothers and their babies to significant health risks, particularly musculoskeletal strain and developmental concerns.

For these women, the decision to take babies to the farm is rarely optional. It reflects the absence of affordable childcare, entrenched gender roles, and persistent economic pressures that compel women to combine farming, childcare, and household duties simultaneously.


Everyday Reality

In many rural communities in Northern Ghana, women begin their day before sunrise, balancing farm work with domestic responsibilities such as fetching water and firewood, cooking, and caring for children. Carrying infants on their backs, strapped with cloth, enables them to breastfeed and monitor their babies while going about their farming activities.

The use of outdated tools increases the risk of sprains and strains. Exposure to pesticides, extreme heat, and zoonotic infections further endanger women, especially those who are pregnant or breastfeeding.


Effects on Mothers

Dr. Enoch Harvoh, a Senior Medical Doctor at the Tamale Teaching Hospital, explained in an interview with GNA that the primary health risks stem from prolonged physical strain. He identified several key concerns, including musculoskeletal pain, postural changes, chronic fatigue, injury risk, and other hazards such women face.

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Dr. Harvoh explained that musculoskeletal issues such as chronic lower back, upper back, neck, and shoulder pain are common among women who farm with babies on their backs. He added that back-carrying alters spinal alignment, increasing pelvic tilt and causing abnormal curvature of the spine, medically described as cervokypholordotic posture.

The combination of farming, domestic work, and childcare leads to severe physical exhaustion and stress, while frequent bending, squatting, and lifting further contribute to physical strain.


Effects on Infants

While back-carrying supports bonding and infant safety, prolonged exposure in farm environments presents risks to infants. These include:

  • Lower limb development concerns
  • Restricted movement and visual stimulation
  • Potentially affected sensorimotor development
  • Exposure to farm hazards including chemicals, machinery, and excessive heat

According to Dr. Harvoh, some studies link extended back-carrying to changes in leg alignment, such as genu valgum (knock-knees), though these are often within normal clinical limits.


Labour and Time Constraints

Women face chronic labour shortages, especially during peak farming seasons. Combined with unpaid domestic work and childcare, this creates extreme physical and mental strain.

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Madam Saada Abdul, a farmer from Kpadjai in the Kpandai District, told GNA that she regularly carries her baby while weeding, harvesting, transporting crops, and cooking. “The work is very hard, and the baby’s weight adds to the pain in my back and waist. I hardly get time to rest compared to my husband,” she said.

Similarly, Madam Ramatu Iddris from the Nawuri community explained that women often prioritise labour on their husbands’ farms, reducing productivity on their own plots. Limited access to tractors, credit, extension services, and market information forces many women to rely on manual labour while carrying their babies.

These compounded challenges heighten women’s vulnerability to climate shocks such as drought, erratic rainfall, and economic downturns.


Intersecting Challenges

The practice of carrying babies to farms is embedded within broader structural inequalities. Customary inheritance systems largely favour men, leaving women with limited access to land. Many women farm on their husbands’ plots or borrow small, less fertile parcels of land, discouraging long-term investment and access to credit or extension services.

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Women account for more than half of Ghana’s agricultural labour force, particularly in subsistence farming in the Northern Sector, yet much of their work remains informal and undervalued, with limited recognition in economic planning and policy frameworks.


Resilience and Coping Strategies

Despite these hardships, Northern women farmers demonstrate remarkable resilience. Common coping mechanisms include forming women’s farming groups to access training, credit, and inputs. Livelihood diversification, such as engaging in shea butter processing, poultry rearing, petty trading, charcoal production, and seasonal migration, can help supplement income.


Recommendations

Stakeholders in agriculture, health, and local governance must prioritise targeted interventions to reduce the physical burden on women farmers. Key recommendations include:

  • Establishing community-based childcare centres to reduce the need to carry babies to farms
  • Providing practical ergonomic training on safe lifting, posture, and culturally appropriate baby-carrying techniques
  • Improving access to appropriate farm tools and small-scale mechanisation
  • Strengthening workplace protections through rest breaks, access to potable water, and protective equipment
  • Formally recognising women’s unpaid care and agricultural labour in national and district development planning

Health professionals also recommend targeted strengthening and stretching exercises for the lower back and pelvic muscles to mitigate long-term physical strain associated with combined farming and childcare responsibilities.


Conclusion

Women farmers are indispensable to Ghana’s food security and rural livelihoods. Yet their contributions come at a high personal cost due to systemic inequities, limited support services, and entrenched gender roles.

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Addressing the health and productivity challenges faced by women who farm with babies on their backs is not only a matter of equity but a critical investment in national development, public health, and future generations.

—GNA

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Gender

Workshop to deepen coverage of gender-based issues held in Accra

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A training and capacity-building workshop was held on Thursday for the media to intensify coverage on gender-based issues to support women’s participation in leadership and governance in Accra.

The workshop, held under the theme ‘Strengthening Advocacy for the Implementation of Ghana’s Affirmative Action (Equity) Law, 2024 – The Case of the Media’, brought together journalists from selected media houses.

The Convener of the Affirmative Action (AA) Law Coalition, Ms Sheila Minka-Premo (Esq.), stressed that the media has a critical responsibility to educate the public on the importance of the Affirmative Action Act, noting that sustained and informed reporting would strengthen advocacy and support the effective implementation of the law.

While commending both the Legislature and the Executive for the passage and presidential assent of the Affirmative Action Bill into law, the AA Law Coalition Convener appealed to government to address existing gaps. These include the constitutional provision of 30 per cent women’s representation in politics, inadequate policy frameworks to advance affirmative action, and weak compliance by state institutions.

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She charged the media to highlight and promote the role of women in leadership and to actively support a smooth and effective implementation process of the Act.

In her welcome address, Executive Director of ABANTU for Development, Dr Rose Mensah-Kutin, said the training sought to strengthen journalists’ advocacy skills to enable them to educate the public on the provisions and significance of the law.

Dr Mensah-Kutin commended ActionAid Ghana for supporting the advocacy efforts, urging the media to prioritise the law to ensure its sustainability.

The Affirmative Action (Gender Equity) Act, 2024 (Act 1121) was passed by Parliament in July 2024 and received presidential assent in September 2024, following years of sustained advocacy by women’s rights organisations, gender activists, and other stakeholders.

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By Linda Abrefi Wadie

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