Smoking tobacco is the second most common cause of death worldwide and is among the leading serious risk factors for disease. Among the forms of tobacco smoking, the two most common can be specifi ed: cigarette smoking and smoking through a hookah. Cigarette use is related to approximately 450,000 premature death cases in the US each year. Compared to the extensive knowledge regarding the damages caused by smoking cigarettes, scientifi c data on the damages of hookah smoking has accumulated only in recent years. The sources for fi nding articles were "Pubmed" and "Google scholar", using the search terms 'Water pipe tobacco', 'Hookah'and 'Nargileh', including results in English only. Hookah smoking has been linked to various types of cancer, respiratory diseases, coronary heart diseases, lung diseases, infertility problems, dental problems, etc. Nevertheless, Hookah smoking is on the rise, and is now the second most popular form of smoking in the United States. Due to this growing popularity, it seems that the health implications are pushed aside, in light of the following reasons-exposure to fl avored hookah, social nature of hookah smoking, the internet and the mass media, the unharmful perception of smoking hookah. There is an urgent need for developing policies targeted towards hookah smoking on multiple levels, including-raising public awareness through health education guidance and educational programs; legislation regarding public smoking prohibitions, warning labels, taxing regulations and production standards; eff ective and uncompromising enforcement.