Health effects associated with waterpipe smoking

Abstract

ObjectiveIt is widely held that waterpipe smoking (WPS) is not associated with health hazards. However, several studies have documented the uptake of several toxicants and carcinogens during WPS that is strongly associated with harmful health effects. This paper reviews the literature on the health effects of WPS.Data sourcesThree databases-PubMed, MEDLINE and EMBASE-were searched until August 2014 for the acute and long-term health effects of WPS using the terms ‘waterpipe’ and its synonyms (hookah, shisha, goza, narghileh, arghileh and hubble-bubble) in various spellings.Study selectionWe included original clinical studies, case reports and systematic reviews and focused on clinical human studies. ∼10% of the identified studies met the selection criteria.Data extractionData were abstracted by all three authors and summarised into tables. Abstracted data included study type, results and methodological limitations and were analysed jointly by all three authors.Data synthesisWPS acutely leads to increased heart rate, blood pressure, impaired pulmonary function and carbon monoxide intoxication. Chronic bronchitis, emphysema and coronary artery disease are serious complications of long-term use. Lung, gastric and oesophageal cancer are associated with WPS as well as periodontal disease, obstetrical complications, osteoporosis and mental health problems.ConclusionsContrary to the widely held misconception, WPS is associated with a variety of adverse short-term and long-term health effects that should reinforce the need for stronger regulation. In addition, this review highlights the limitations of the published work, which is mostly cross-sectional or retrospective. Prospective studies should be undertaken to assess the full spectrum of health effects of WPS, particularly in view of its growing popularity and attractiveness to youth.

Graphic health warnings and their best position on waterpipes: A cross-sectional survey of expert and public opinion

“…WPS poses risks to health because of the smoker's prolonged exposure to toxins while smoking 7 . The adverse health effects are similar to those of cigarette smoking 7 , and include respiratory illnesses, various cancers, mouth and throat diseases, cardiovascular disease, and low birth weight [10][11][12] . Some waterpipe smokers use herbal products instead of tobacco 13,14 .…”

Increasing hookah use among adolescent females in the US: analyses from the 2011-2014 National Youth Tobacco Survey (NYTS)

“…A small but increasing research literature suggests that hookah use may be asaddictive 8 and more harmful 9,10 than cigarettes. Hookah smoking has been associated with an increased risk of many diseases, ranging from lung cancer to periodontal disease 11 . The World Health Organization states that one hookah smoking session may be equivalent to inhaling as much smoke as using 5 packs of cigarettes 12 .…”

Water Pipe Tobacco Smoking among Females: A Middle Eastern or a Global Epidemic?

“…Moreover, a prevalence of WTS reaching 25% and 16% among 11-15 year old school male and female students, respectively in Estonia is worrying [14]. With the success of tobacco control efforts that mainly targeted cigarette smoking and the increase of evidence on the health effects of WTS [15], immediate action should be taken to curb the WTS epidemic globally and from Arab countries in particular. Special attention should be given to Arab women and youth who are the most vulnerable.…”