Trial reportDrug and alcohol dependence2011
Acute effects of waterpipe tobacco smoking: a double-blind, placebo-control study.
Trial report in Drug and alcohol dependence, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
61 citing papers in PubMed, 1 synthesis or guideline pooled it, 114 citations in OpenAlex.
- Systematic Review and Meta-Analysis of Inhaled Toxicants from Waterpipe and Cigarette Smoking.Public health reports (Washington, D.C. : 1974)Pooled it
- Waterpipe Size Matters: The Effect of Waterpipe Size on Toxicant Exposures and Subjective Experiences.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Trial
- Trial
- Waterpipe Tobacco Warnings: An Experimental Study Among a Nationally Representative Sample of US Young Adults.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2021Trial
- CO exposure and puff topography are associated with Lebanese waterpipe dependence scale score.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2013Trial
- Comparison of effects of charcoal versus electric heating of waterpipe tobacco on carbon monoxide levels: Cardiovascular measures; benzene, pyrene, and nicotine uptake; and subjective reactions.Toxicology reports · 2026Article
- Chronic Exposure to Two Regimens of Waterpipe Smoke Elicits Lung Injury, Genotoxicity, and Mitochondrial Impairment with the Involvement of MAPKs Activation in Mice.International journal of molecular sciences · 2025Article
- Use of Hookah and Age of Asthma Onset Among US Adults.Tobacco use insights · 2025Article
- Study of waterpipe smoking topography in Fars province of Iran.Scientific reports · 2024Article
- Review
- Assessing the risk of cardiovascular diseases in relation to shisha smoking among adults in Qatar: An analytical cross-sectional study.Tobacco induced diseases · 2023Article
- Substance use and substance use disorders in Africa: An epidemiological approach to the review of existing literature.World journal of psychiatry · 2022Review
- The Effect of Perceptions of Hookah Harmfulness and Addictiveness on the Age of Initiation of Hookah Use among Population Assessment of Tobacco and Health (PATH) Youth.International journal of environmental research and public health · 2022Article
- Waterpipe smoking: a review of pulmonary and health effects.European respiratory review : an official journal of the European Respiratory Society · 2021Review
- Comparing Immediate Physiological Responses and Future Intentions of Use between Combustible and Electronic Waterpipe Users.Addictive behaviors · 2021Article
- Article
- Measuring waterpipe tobacco smoking in survey research.Tobacco control · 2020Article
- Relationship among subjective responses, flavor, and chemical composition across more than 800 commercial cannabis varieties.Journal of cannabis research · 2020Article
- Observational
- Short-Term Exposure to Waterpipe/Hookah Smoke Triggers a Hyperactive Platelet Activation State and Increases the Risk of Thrombogenesis.Arteriosclerosis, thrombosis, and vascular biology · 2020Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundWaterpipe tobacco smoking usually involves heating flavored tobacco with charcoal and inhaling the resulting smoke after it has passed through water. Waterpipe tobacco smoking increases heart rate and produces subjective effects similar to those reported by cigarette smokers. These responses are thought to be nicotine-mediated, though no placebo-control studies exist. Accordingly, this double-blind, placebo-control study compared the acute physiological and subjective effects of waterpipe tobacco smoking to those produced when participants used a waterpipe to smoke a flavor-matched, tobacco-free preparation.
methodsOccasional waterpipe tobacco smokers (n = 37; 2-5 monthly smoking episodes for ≥ 6 months) completed two double-blind, counterbalanced sessions that differed by product: preferred brand/flavor of waterpipe tobacco or flavor-matched, tobacco-free preparation. For each 45-min, ad lib smoking episode blood and expired air CO were sampled, cardiovascular and respiratory response were measured, and subjective response was assessed.
resultsWaterpipe tobacco smoking significantly increased mean (± SEM) plasma nicotine concentration (3.6 ± 0.7 ng/ml) and heart rate (8.6 ± 1.4 bpm) while placebo did not (0.1 ± 0.0 ng/ml; 1.3 ± 0.9b pm). For carboxyhemoglobin (COHb) and expired air CO, significant increases were observed for tobacco (3.8 ± 0.4%; 27.9 ± 2.6 ppm) and for placebo (3.9 ± 0.4%; 27.7 ± 3.3 ppm) with no differences across condition. Independent of condition, symptoms of nicotine/tobacco abstinence (e.g., "urges to smoke", "anxious") were reduced and direct effects (e.g., "dizzy", "satisfy") increased. DISCUSSION: These results from the first placebo-control study of waterpipe tobacco smoking demonstrate that waterpipe-induced heart rate increases are almost certainly mediated by nicotine though the subjective effects observed in these occasional smokers were not.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.