Waterpipe smoking as a public health risk: Potential risk for transmission of MERS-CoV

Alagaili, Abdulaziz N.; Briese, Thomas; Amor, Nabil M.S.; Mohammed, Osama B.; Lipkin, W. Ian

Waterpipe smoking is the process of inhaling tobacco smoke, passed through a chilled water chamber, via a hose capped with a plastic mouthpiece. Globally, there are an estimated 100 million (Wolfram et al., 2003) . More recently, demand for the waterpipe smoking has grown in several countries that have no previous tradition of use, including the United States and Saudi Arabia (Maziak et al., 2007) . In the regions where waterpipe smoking is prevalent, it has been linked with numerous smoking-related health problems such as: oral diseases, urinary bladder cancer, cardiovascular disease and pulmonary dysfunction (Al-Belasy, 2004; Bedwani et al., 1997; Jabbour et al., 2003) . The smoke inhaled as a result of waterpipe smoking contains toxic materials similar to those resulting from smoking cigarettes such as carbon monoxide, hydrocarbons, and carcinogenic polycyclic aromatic volatile aldehydes (WHO, 2005; Chaouachi, 2009; Kiter et al., 2000) . Although the average frequency of waterpipe smoking in the United States is lower than that of cigarettes, a single waterpipe session typically lasts for 45 min and may produce 50-100 times the smoke volume inhaled from a single cigarette (Lipkus et al., 2011; Rastam et al., 2011; Primack et al., 2012; Alzoubi et al., 2013; Maziak, 2013) .