Waterpipe smoking and risk of coronary artery disease

Research output: Contribution to journalReview articleContributedpeer-review



Purpose of review Smoking tobacco using a water pipe is becoming more prevalent globally, particularly amongst younger populations. In addition to its growing popularity, more evidence is emerging regarding associated harm, and several misconceptions exist concerning the likely adverse health effects of waterpipe smoking (WPS). It is timely, therefore, to examine the body of evidence linking WPS to coronary artery disease (CAD). Here, we review the direct evidence linking WPS to CAD and examine additional, indirect evidence of associated harm. We discuss the clinical and public health implications of the current evidence and provide suggestions for further research. Recent findings A multicentre case-control study in Lebanon has recently demonstrated an association between WPS and CAD. There are few prior studies making this direct link. However, a large body of evidence has emerged showing close similarities between WPS and cigarette smoking with regard to the toxicity of smoke and acute inflammatory and haemodynamic effects following exposure to it. Summary There are consistent similarities between WPS and cigarette smoking in regard to association with CAD, the nature of the smoke produced, and the acute haemodynamic effects and inflammatory responses that follow exposure. These findings justify both public health and clinical interventions to reduce WPS. Further studies are warranted to confirm a causal association between WPS and CAD.


Original languageEnglish
Pages (from-to)545-550
Number of pages6
JournalCurrent Opinion in Cardiology
Issue number5
Publication statusPublished - 1 Sept 2016

External IDs

PubMed 27428005
ORCID /0009-0004-4894-2360/work/142240727


Sustainable Development Goals


  • coronary artery disease, hookah, shisha, waterpipe smoking

Library keywords