Daily shisha use: the tobacco control niche that’s not so niche any more

Between 1.8% and 3.6% of smokers use shisha daily across Australia, up from 1% just three years ago.

That’s the shocking result from the 2022-2023 National Drug Strategy Household Survey that was released Wednesday. It deals with a range of alcohol and other drug use, but I was interested in the data on tobacco use. In particular, what’s been happening with shisha use.

The 2022-3 survey results show a dramatic increase in the daily use of shisha in Australia over the COVID-19 period from 1% of smokers in 2019 to 2.7% only three years later.

A graph showing daily shisha use has increased form 0.8% of smokers in 2016 to 2.7% of smokers in 2022.

Keep in mind that this is daily use. 45 minutes of shisha use equates with more than 100 cigarettes, so this represents a marked increase in overall tobacco consumption for people in this group.

We can be fairly confident this increase is real and that the rate is between 1.8% and 3.6%. The 95% confidence intervals for the 2022-3 survey are 0.9% and the rate of standard error is 17.7% (RSE, generally <25% is considered reliable for most practical purposes).

This challenges assumptions made by many working in tobacco control and public health that shisha use is infrequent.

We also know that use isn’t distributed evenly. 2.7% of all smokers may seem like a small proportion, but this increase disproportionately affects Arabic speaking communities and populations, people living in cities and regional centres, and other migrant groups.

A young man with tongs kindles the coal while using a shisha.

This is also consistent with focus groups that Dr Lilian Chan and I conducted for the Shisha No Thanks project in 2022. People who used shisha told us that their use had intensified through the COVID lockdowns, but that this increase had continued afterwards and was increasingly complemented with e-cigarettes use.

We need to increase our focus on:

  • increasing awareness of the harms of water pipe use (this remains low)
  • providing avenues for quitting that are tailored to shisha users
  • making sure use at food venues complies with existing laws
  • enforcing and retail and import conditions more consistently.


AIHW. (2024). National Drug Strategy Household Survey 2022–2023. Australian Institute of Health and Welfare. https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey/contents/technical-notes