BACKGROUND: Studies on the submaximal aerobic capacity of exclusive narghile smokers (ENS) seem necessary in view of effective prevention of cardiorespiratory diseases. The goal of the study was to assess, by 6-min walk test (6MWT) data, the submaximal aerobic capacity of ENS, to identify factors influencing their 6-min walk distance (6MWD), and to compare their data with those of a healthy non-smoker (HNS) group. METHODS: Seventy 20 -60-y-old male ENS were included. Narghile use (narghile-years) and anthropometric, clinical, spirometric, and 6MWT data were collected. Univariate and multivariate analyses were used to identify factors influencing 6MWD. Data of a subgroup of 40 -60-y-old ENS (n ؍ 25) were compared with those of an age-matched HNS group (n ؍ 53). RESULTS: The median (first to third quartile) for age and narghile use were 32 (26 -43) and 17 (8 -32) narghile-years, respectively. The profile of ENS performing the 6MWT was as follows: at the end of the 6MWT, 34% and 9% had a low heart rate (< 60% of maximum predicted) and high dyspnea scores (> 5/10, visual analog scale), respectively; 3% had an oxyhemoglobin saturation decrease of > 5 points during the test; and 20% had an abnormal 6MWD (less than the lower limit of the normal range). The factors that significantly influenced the 6MWD, explaining 38% of its variability,