The growing epidemic of water pipe smoking: Health effects and future needs

Abstract

Water pipe smoking (WPS), an old method of tobacco smoking, is re-gaining widespread popularity all over the world and among various populations. Smoking machine studies have shown that the water pipe (WP) mainstream smoke (MSS) contains a wide array of chemical substances, many of which are highly toxic and carcinogenic for humans. The concentrations of some substances exceed those present in MSS of cigarettes. Despite being of low grade, current evidence indicates that WPS is associated with different adverse health effects, not only on the respiratory system but also on the cardiovascular, hematological, and reproductive systems, including pregnancy outcomes. In addition, association between WPS and malignancies, such as lung, oral and nasopharyngeal cancer, has been suggested in different studies and systematic reviews. Despite its long standing history, WPS research still harbors a lot of deficiencies. The magnitude of toxicants and carcinogen exposures, effects on human health, as well as the addiction and dependence potentials associated with WPS need to be studied in well-designed prospective trials. Unfortunately, many of the tobacco control and clean indoor policies have exempted water pipes. World wide awareness among the public, smokers, and policymakers about the potential health effects of WPS is urgently required. Furthermore, stringent policies and laws that control and ban WPS in public places, similar to those applied on cigarettes smoking need to be implemented.

Waterpipe tobacco smoking among sexual minorities in the United States: Evidence from the National Adult Tobacco Survey (2012-2014)

“…Novel biomedical research has revealed that WTS may result in worse lung functioning as a result from longer sustained volumes of inhaled smoke during a WTS session exposing individuals to similar types of carcinogens and toxic heavy metals found in cigarette smoke (Akl et al, 2010). Along with WTS demonstrating similar health risks as cigarette use, (Bou Fakhreddine, Kanj, & Kanj, 2014) WTS has also been linked to nicotine dependence (Cobb, Ward, Maziak, Shihadeh, & Eissenberg, 2010). Although evidence highlights the negative health effects of WTS, the general perception of WTS is that it is less harmful than cigarettes (Rezk-Hanna, Macabasco-O’Connell, & Woo, 2014).…”

Correlates of other tobacco use in a community sample of young adults

“…First, most ANTPs appear to have adverse health effects, including increasing users’ risk of cardiovascular and respiratory disease as well as cancer [14–17]. An additional concern is the potential impact of ANTP use on cigarette smoking.…”

Young low and middle-income country (LMIC) smokers—implications for global tobacco control

“…Using the sale of cigarettes as an example, there is abundant evidence that cigarettes sold singly are affordable to children (16) and that proximity of tobacco vendors close to school grounds may influence tobacco use (17). Cultural factors may play a part: in some countries it remains appropriate to give and receive tobacco as part of business transactions (18); other forms of tobacco, such as the water pipe, enjoy social acceptability that is difficult to tackle (19). Adolescents are vulnerable to targeted marketing strategies by the tobacco industry.…”