FRIDAY, March 8, 2019 — Smoking a water pipe is addictive and can increase the risk for initiating cigarette smoking, according to a scientific statement from the American Heart Association published online March 8 in Circulation.

Aruni Bhatnagar, Ph.D., from the University of Louisville in Kentucky, and colleagues examined the design and operation of water pipes and their use patterns to identify harmful and potentially harmful constituents in water pipe smoke.

The authors note that water pipe tobacco smoking is prevalent worldwide. Sweetened and flavored water pipe tobacco, social media, and misperceptions about the addictive potential and adverse health effects of water pipe smoking promote its use. Most users believe that water pipe smoking is less harmful than cigarette smoking and that the probability of addiction is low, according to the statement. However, the risk for cigarette-smoking initiation is higher among water pipe smokers than never smokers. Water pipe tobacco smokers are exposed to a level of nicotine that is physiologically active in the short term, and with repeat exposure, it can produce dependence. A single session of water pipe smoking typically results in more exposure to carbon monoxide than smoking a single cigarette and exposes smokers to higher levels of heavier and more toxic polycyclic aromatic hydrocarbons and cardiorespiratory toxicants.

The statement authors encourage health care providers to ask users about water pipe use, advise them to quit, and “assist water pipe smokers to quit by providing cessation counseling, including setting a quit date and providing social support and coping assistance.”

One author disclosed financial ties to the pharmaceutical industry.

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Posted: March 2019

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