‘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

Abstract

'Herbal' shisha products tested contained toxic trace metals and PAHs levels equivalent to, or in excess of, that found in cigarettes. Their mainstream and sidestream smoke emissions contained carcinogens equivalent to, or in excess of, those of tobacco products. The content of the air in the waterpipe cafés tested was potentially hazardous. These data, in aggregate, suggest that smoking 'herbal' shisha may well be dangerous to health.

Graphic health warnings and their best position on waterpipes: A cross-sectional survey of expert and public opinion

“…The adverse health effects are similar to those of cigarette smoking 7 , and include respiratory illnesses, various cancers, mouth and throat diseases, cardiovascular disease, and low birth weight [10][11][12] . Some waterpipe smokers use herbal products instead of tobacco 13,14 . Irrespective of what is smoked, harmful chemicals, such as carbon monoxide, toxic trace metals, polyaromatic hydrocarbons, and carcinogens are released posing health risks like heart and lung diseases 7,11,13,15 .…”

“…Some waterpipe smokers use herbal products instead of tobacco 13,14 . Irrespective of what is smoked, harmful chemicals, such as carbon monoxide, toxic trace metals, polyaromatic hydrocarbons, and carcinogens are released posing health risks like heart and lung diseases 7,11,13,15 . Occasional WPS may not be less harmful than regular WPS 15,16 .…”

A review of the health effects of smoking shisha

“…11 The presence of volatile aldehydes has also been reported in shisha smoke, including formaldehyde, acetaldehyde, acrolein, propionaldehyde and methacrolein. 12 These chemicals have been correlated with various respiratory disorders, respiratory tract irritation, chronic obstructive pulmonary disease and lung cancer. 12 Specifi cally, formaldehyde and acrolein are both potent carcinogens that may promote the development of leukaemia.…”

“…12 These chemicals have been correlated with various respiratory disorders, respiratory tract irritation, chronic obstructive pulmonary disease and lung cancer. 12 Specifi cally, formaldehyde and acrolein are both potent carcinogens that may promote the development of leukaemia. 12 The approximate levels of volatile aldehydes in shisha smoke have been found to be signifi cantly higher than in cigarettes, highlighting that shisha may result in a higher incidence of aldehyde-associated diseases.…”

“…12 Specifi cally, formaldehyde and acrolein are both potent carcinogens that may promote the development of leukaemia. 12 The approximate levels of volatile aldehydes in shisha smoke have been found to be signifi cantly higher than in cigarettes, highlighting that shisha may result in a higher incidence of aldehyde-associated diseases. 12 In addition, CO levels have been observed to signifi cantly increase after shisha smoking.…”