CAIRO - It is quite lamentable that a hookah, set complete with apple-flavored tobacco, has become compulsory household item for many Egyptians these days. It is also regrettable that the 'hubbly bubbly' addiction has gained ground in Egypt. It is causing growing concern among health experts argue that the waterpipe (shisha) makes for a rather macabre household item and is trying to shatter the harmless image of a habit that has been spreading fast among new categories of the Egyptian society. They say that one hour with a shisha is equivalent to something between 100 and 200 cigarettes. They also agree that a similar nicotine intake a shisha exposes users to more smoke than cigarettes. Moreover, a joint study, conducted by the Ministry of Health and the World Health Organisation (WHO), found that the regular waterpipe smoker is exposed to larger amounts of nicotine, carbon monoxide, and certain other toxins than the typical cigarette smoker. The study pointed out that the force, needed to pull the air through the hose, allows the smoke to reach much deeper into the lungs. Another study also established that waterpipes were largely responsible for reintroducing tuberculosis in Egypt, which is one of the countries that is the most affected by tobacco use. An average of 2.5 per cent of household income is spent on tobacco in Egypt, which is more than on health and leisure, the study found. Health officials admitted that twenty-million cigarettes are smoked every day in Egypt. Although there are no accurate figures for shisha, it is becoming a modern trend among Egyptian youth. The study also pointed out that shisha tobacco, unlike cigarettes, is not covered by any manufacturing regulation, and therefore, no-one knows for sure what people are actually smoking. Over the past 30 years, fashionable shisha bars have mushroomed across Egypt to offer cappuccino or cantaloupe flavored tobacco to every one. Every night, groups of young people leave their homes for these bars, where they sit down on the seats and order tea with mint and a waterpipe, the famous Egyptian smoking device, whose roots go back to Ottoman Empire. Many young people said they like to smoke shisha in a cafe with friends because of the social aspect. In the el-Moez Lidden Allah Street, off el-Hussein Mosque, there are many retail and wholesale shops that sell waterpipes and their accessories. Arab and foreign tourists always prefer to buy elaborate waterpipes and flavoured tobacco including strawberry, cherry, apple and even mango, says Amin Rashid a shop owner. Thirty years ago, waterpipes were always associated with low-class or baladi (local) people, who were uneducated or smoked hashish, Rashid said. But, during the Mubarak era, the shisha made a come back in full force in Egypt, he said. "Now, you can smoke shisha in restaurants, cafés and five-star hotels," he said, adding that he had once catered a dozen of waterpipes to an owner of an internet cafe in Giza. "Can you imagine that college students will be smoking shisha even while they are browsing the internet," he sadly told The Egyptian Gazette.