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Hookah (Shisha, Narghile) Smoking and Environmental Tobacco Smoke (ETS). A Critical Review of the Relevant Literature and the Public Health Consequences

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  • Kamal Chaouachi

    (DIU Tabacologie, Université Paris XI / Paris, France)

Abstract

Hookah (narghile, shisha, “water-pipe”) smoking is now seen by public health officials as a global tobacco epidemic. Cigarette Environmental Tobacco Smoke (ETS) is classically understood as a combination of Side-Stream Smoke (SSS) and Exhaled Main-Stream Smoke (EMSS), both diluted and aged. Some of the corresponding cigarette studies have served as the scientific basis for stringent legislation on indoor smoking across the world. Interestingly, one of the distinctive traits of the hookah device is that it generates almost no SSS. Indeed, its ETS is made up almost exclusively by the smoke exhaled by the smoker (EMSS), i.e. which has been filtered by the hookah at the level of the bowl, inside the water, along the hose and then by the smoker’s respiratory tract itself. The present paper reviews the sparse and scattered scientific evidence available about hookah EMSS and the corresponding inferences that can be drawn from the composition of cigarette EMSS. The reviewed literature shows that most of hookah ETS is made up of EMSS and that the latter qualitatively differs from MSS. Keeping in mind that the first victim of passive smoking is the active smoker her/himself, the toxicity of hookah ETS for non-smokers should not be overestimated and hyped in an unscientific way.

Suggested Citation

  • Kamal Chaouachi, 2009. "Hookah (Shisha, Narghile) Smoking and Environmental Tobacco Smoke (ETS). A Critical Review of the Relevant Literature and the Public Health Consequences," IJERPH, MDPI, vol. 6(2), pages 1-46, February.
    • Handle: RePEc:gam:jijerp:v:6:y:2009:i:2:p:798-843:d:4076
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    References listed on IDEAS

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    1. Schick, Suzaynn & Glantz, Stanton A. Ph.D., 2005. "Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke," University of California at San Francisco, Center for Tobacco Control Research and Education qt54b9m1sb, Center for Tobacco Control Research and Education, UC San Francisco.
    2. Sargent, R P & Shepard, R M & Glantz, Stanton A. Ph.D., 2004. "Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study," University of California at San Francisco, Center for Tobacco Control Research and Education qt3276d6r6, Center for Tobacco Control Research and Education, UC San Francisco.
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    Cited by:

    1. Li Ping Wong & Haridah Alias & Nasrin Aghamohammadi & Sima Aghazadeh & Victor Chee Wai Hoe, 2016. "Shisha Smoking Practices, Use Reasons, Attitudes, Health Effects and Intentions to Quit among Shisha Smokers in Malaysia," IJERPH, MDPI, vol. 13(7), pages 1-14, July.
    2. Linda Haddad & Omar El-Shahawy & Roula Ghadban & Tracey E. Barnett & Emily Johnson, 2015. "Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature," IJERPH, MDPI, vol. 12(6), pages 1-21, May.

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