Dokha

[1] Unlike hookah tobacco preparations (usually called "shisha" or "mu'assel"), dokha is dry and does not contain molasses or water.

[2] Dokha has a higher concentration of nicotine compared to other forms of tobacco,[3] and can thus cause brief periods of euphoria, relaxation or lightheadedness in some users.

[4] As using the midwakh also reportedly leaves fewer lingering smells, and requires less tobacco to be used at a time, it can be used discreetly, which has made it popular among student populations and young adults.

[5][6] The product is popular in the United Arab Emirates (UAE), Oman, Qatar, Saudi Arabia, Yemen, Bahrain, Jordan, and other Middle Eastern countries.

[11] Notable concern in the UAE over the spreading popularity of dokha among teenagers and young adults has led to multiple tobacco control efforts to curb its use.

[citation needed] In many countries where dokha is used, there are a number of available tobacco strengths (typically described in Arabic as "hot", "warm" or "cold"), which indicate the harshness of a particular blend.

[14] Dokha use has seen some emergence in the Western world, and some health officials speculate this may be due to immigration, globalized commerce, and internet sales, but such a trend has not been definitively studied or proven.

[25] In October 2015, the Dubai Municipality issued warnings to 40 dokha shops to obtain certificates of conformity from the UAE Authority for Standardization and Metrology.

[26] Despite these efforts, there were still concerns from local leaders and health officials over shopkeepers illegally selling dokha and midwakh pipes to underage customers, and teenage use of tobacco continued to rise.

Anecdotal evidence from chronic users suggests that long-term use may cause them to feel out of breath after strenuous activity, and they report difficulty quitting.

[15] Some of the health risks of tobacco smoking in general, that have been identified, are: A February 2018 study called for further research into the harmful effects of dokha smoke after it found that three different types of dokha tested from the Middle East and North Africa region contained toxic metals comprising "22 irritants, 3 known carcinogens, 5 central nervous system depressants, in addition to several other compounds with miscellaneous effects".

Traces of aluminum, calcium, chromium, copper, iron, magnesium, manganese, nickel, potassium, strontium and zinc were detected in both product types.