- Page navigation anchor for The hidden shisha smoking history: A London medical student perspectiveThe hidden shisha smoking history: A London medical student perspectiveWe read with great interest about the increasingly urgent need for GPs to elicit the “hidden shisha history”. The authors of this editorial1 have suggested an equivalence of 10 cigarettes to a 45-minute shisha session for the ease of allowing clinicians to quantify the pack years. Albeit acknowledging its imprecision, the potential of underestimation in suggesting quantification without methodology may discredit the true harmful effects of shisha smoking. This number may be used by lay readers and propagated without proper context. Moreover, the lack of consensus on the exact harmful effects of shisha remains a significant limitation towards the development of shisha history guidance and its application.2From the perspective of London medical students, there has been no such inclusion of shisha in smoking histories thus far by the MBBS curriculum. This is despite the recent light that has been shed on the potential hidden harms of shisha smoking and its increasing popularity.3 Furthermore, it would be interesting to see if medical students were aware of the harmful effects of shisha, especially those who specifically smoke shisha, and whether they consider asking specifically about its use when taking a smoking history.References1. Jawad M, Khaki H, Hamilton F. Shisha guidance for GPs. Eliciting the hidden history. Br J Gen Pract...Show MoreCompeting Interests: None declared.