“…Waterpipe use likely increases the risk of bronchogenic carcinoma (Nafae, Misra, Dhar, & Shah, 1973), as well as lung (Gupta et al, 2001;Rakower & Fatal, 1962), oral (El-Hakim & Uthman, 1999), and bladder (Bedwani et al, 1997;Roohullah, Nusrat, Hamdani, Burdy, & Khurshid, 2001) cancers. Waterpipe use also is associated with decreased pulmonary function (Al-Fayez, Salleh, Ardawi, & Zahran, 1988;Kiter, Ucan, Ceylan, & Kilinc, 2000;Salem & Sami, 1974), markers of atherosclerosis (Ashmawi, 1993) and coronary heart disease (Jabbour, El-Roueiheb, & Sibai, 2003), oral disease (Al-Belasy, 2004;Natto, Baljoon, & Bergstrom, 2005), and low birth weight among infants of women who use it while pregnant (Nuwayhid, Yamout, Azar, & Kambris, 1998). In addition, sharing of waterpipes is associated with the spread of infectious diseases such as Helicobacter pylori (El-Barrawy, Morad, & Gaber, 1997) and tuberculosis (Munckhof et al, 2003;Salem & Sami, 1974); this is especially worrisome given that the vast majority of users in the present study reported usually sharing the same waterpipe with others.…”