Waterpipe smoking: A "healthy" alternative to cigarettes or a health hazard in disguise?

Objective: To increase awareness among dental hygienists of the use of waterpipes (WPs) and their associated risks. Methods: A literature search of studies published between 2000 and 2013 that examined the belief that WPs are "harmless," the risks associated with WP use, and the short- term and long-term health effects of WP smoking was conducted. Historical papers and gray literature were also reviewed to confirm the findings. Results and Discussion: The prevalence of WP smoking is on the rise in North America, especially among young adults who may view it as "harmless." WP smokers may be exposed to 3 to 9 times the carbon monoxide and almost 2 times the nicotine of a cigarette after a single 1-hour WP session. Sharing WPs may lead to the transmission of communicable diseases such as herpes, hepatitis, and tuberculosis. WP smoking is also shown to be associated with an increased risk of lung cancer, respiratory illness, and low-birth-weight infants for smokers and may be a gateway to nicotine addiction. The US Food and Drug Administration and the Canadian Food Inspection Agency do not regulate WP packaging, contributing to the lack of standardization of WP contents. Conclusion: Dental hygienists need to be aware of the lack of regulations and how this may lead to public misconceptions about WP smoking as a "safe" or "harmless" activity. There is a significant need for in-depth scientific investigation and dissemination of knowledge concerning WP use in order to understand its health effects, to guide cessation efforts, and to shape public policies. [ABSTRACT FROM AUTHOR]

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