Int. J. Environ. Res. Public Health 2009, 6(2), 798-843; doi:10.3390/ijerph6020798
Review

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

Received: 4 January 2009; Accepted: 8 February 2009 / Published: 23 February 2009
(This article belongs to the Special Issue Public Health: Feature Papers)
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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.
Keywords: Hookah; shisha; narghile; tobacco; smoking; environmental tobacco smoke (ETS); particles; public health
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MDPI and ACS Style

Chaouachi, K. Hookah (Shisha, Narghile) Smoking and Environmental Tobacco Smoke (ETS). A Critical Review of the Relevant Literature and the Public Health Consequences. Int. J. Environ. Res. Public Health 2009, 6, 798-843.

AMA Style

Chaouachi K. Hookah (Shisha, Narghile) Smoking and Environmental Tobacco Smoke (ETS). A Critical Review of the Relevant Literature and the Public Health Consequences. International Journal of Environmental Research and Public Health. 2009; 6(2):798-843.

Chicago/Turabian Style

Chaouachi, Kamal. 2009. "Hookah (Shisha, Narghile) Smoking and Environmental Tobacco Smoke (ETS). A Critical Review of the Relevant Literature and the Public Health Consequences." Int. J. Environ. Res. Public Health 6, no. 2: 798-843.


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