Studies have demonstrated that waterpipe tobacco smoking is very harmful!
Effects on the cardiovascular system
Acute cardiovascular effects
- Increases heart rate (HR).
- Increases blood pressure (BP).
- Impaired pulmonary function (PF).
- Coronary artery disease (CAD).
Long-term cardiovascular effects
- Ischemic heart disease or heart failure.
Effects on the respiratory system
Acute respiratory effects
- Increased respiratory rate (RR).
- Carbon monoxide intoxication.
Signs and symptoms of carbon monoxide poisoning may include:
- Dull headache.
- Nausea or vomiting.
- Shortness of breath.
- Blurred vision.
- Loss of consciousness.
- Impaired pulmonary function (PF).
- Decreased exercise capacity.
Long-term respiratory effects
- Chronic obstructive pulmonary disease (COPD).
- Chronic bronchitis.
- Chronic emphysema.
- Asthma.
Association of WPS with cancer
- Lung cancer.
- Oesophageal cancer.
- Gastric cancer.
- Bladder cancer.
Obstetrical and perinatal outcomes
- Low Birth Weight.
- Pulmonary Problems at Birth.
Periodontal and oral disease
- Periodontal disease.
- Larynx and voice changes.
Osteoporosis
- Lower bone density and increased fracture risk.
Infectious disease
Other health outcomes
- Greater BMI and risk for obesity.
- Elevated urine microalbumin.
- Low back pain.
- Increased risk of gastroesophageal reflux.
- Hearing loss.
- Hand eczema.
- Acute eosinophilic pneumoni.
- Lower lip keratoacanthom and ulcerative colitis flare after discontinuing WPS.
- Lower overall health-related quality of life.






Related references
- Advisory note: waterpipe tobacco smoking: health effects, research needs and recommended actions for regulators – 2nd edition
- Fact sheet: waterpipe tobacco smoking & health
- WHO’s work on tobacco product regulation
- Research paper: ‘Herbal’ but potentially hazardous: an analysis of the constituents and smoke emissions of tobacco-free waterpipe products and the air quality in the cafés where they are served
- US Centers for Disease Control and Prevention. Hookahs
- American Lung Association. An Emerging Deadly Trend: Waterpipe Tobacco Use.
- American Lung Association. Hookah Smoking: A Growing Threat to Public Health.
- Akl EA, Gaddam S, Gunukula SK, Honeine R, Jaoude PA, Irani J. The Effects of Waterpipe Tobacco Smoking on Health Outcomes: A Systematic Review. International Journal of Epidemiology 2010;39:834–57
- Cobb CO, Ward KD, Maziak W, Shihadeh AL, Eissenberg T. Waterpipe Tobacco Smoking: An Emerging Health Crisis in the United States . American Journal of Health Behavior 2010;34(3):275–85
- U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 2012
- El-Hakim Ibrahim E, Uthman Mirghani AE. Squamous Cell Carcinoma and Keratoacanthoma of the Lower Lips Associated with “Goza” and “Shisha” Smoking. International Journal of Dermatology 1999;38:108–10
- Nuwayhid, I, Yamout, B., Ghassan, and Kambria, M. Narghile (Hubble-Bubble) Smoking, Low Birth Weight and Other Pregnancy Outcomes . American Journal of Epidemiology 1998;148:375–83
- Cobb CO, Vansickel AR, Blank MD, Jentink K, Travers MJ, Eissenberg T. Indoor Air Quality in Virginia Waterpipe Cafés. Tobacco Control 2012 Mar 24 doi:10.1136/tobaccocontrol-2011-050350
- Shihadeh A, Salman R, Eissenberg T. Does Switching to a Tobacco-Free Waterpipe Product Reduce Toxicant Intake? A Crossover Study Comparing CO, NO, PAH, Volatile Aldehydes, Tar and Nicotine Yields . Food and Chemical Toxicology 2012;50(5):1494–8 [accessed 2015 Sep 14].
- Blank MD, Cobb CO, Kilgalen B, Austin J, Weaver MF, Shihadeh A, Eissenberg T. Acute Effects of Waterpipe Tobacco Smoking: A Double-Blind, Placebo-Control Study. Drug and Alcohol Dependence 2011;116(1–3):102–9