Evidence map›Paper›PMID 25666550›Full record

ReviewTobacco control2015

Toxicant content, physical properties and biological activity of waterpipe tobacco smoke and its tobacco-free alternatives.

Alan Shihadeh, Jens Schubert, Joanne Klaiany, Marwan El Sabban, Andreas Luch, Najat A Saliba

Registry-linked trialOpen access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Tobacco control, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03625440 (Acute Effects of Waterpipe Smoking on Cognitive Measures and Cardiorespiratory Parameters), which is not on this map. Cited by 107 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
107citing papers in PubMed, 3 pooled it
37.2field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03625440 nacompletednot on this mapstarted 2016, after this paper: background citation

Acute Effects of Waterpipe Smoking on Cognitive Measures and Cardiorespiratory Parameters

TypeinterventionalSponsorRambam Health Care CampusRan2016 to 2017Enrolled55ConditionsWaterpipe SmokingArmsThe Digit span test and PASAT with waterpipe smoking, The Digit span test and PASAT without waterpipe smoking
3 · Its place in the literature

Who cites it

107 citing papers in PubMed, 3 syntheses or guidelines pooled it, 202 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Interventions for waterpipe smoking cessation.The Cochrane database of systematic reviews · 2015
    Pooled it
  4. Visual Attention to Health Warning Labels on Waterpipe Venue Menus in Immersive Virtual Reality.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022
    Trial
  5. 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 · 2021
    Trial
  6. Trial
  7. Concurrent Alcohol Use and Waterpipe Tobacco Smoking: Smoking Topography, Toxicant Exposure, and Abuse Liability.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2020
    Trial
  8. Article
  9. Review
  10. Waterpipe Smoking Among Japanese Teens and Young Adults: an Emerging Public Health Concern.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Smoking and endometriosis: A narrative review.Tobacco induced diseases · 2025
    Review
  19. Toxicity of waterpipe tobacco smoking: the role of flavors, sweeteners, humectants, and charcoal.Toxicological sciences : an official journal of the Society of Toxicology · 2024
    Review
  20. Review

47 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 3 countries.

Alan ShihadehDepartment of Mechanical Engineering, American University of Beirut, Beirut, Lebanon Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.
Jens SchubertDepartment of Safety of Pesticides, German Federal Institute for Risk Assessment, Berlin, Germany.
Joanne KlaianyDepartment of Chemistry, American University of Beirut, Beirut, Lebanon.
Marwan El SabbanDepartment of Human Morphology, American University of Beirut, Beirut, Lebanon.
Andreas LuchDepartment of Chemicals and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany.
Najat A SalibaDepartment of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA Department of Chemistry, American University of Beirut, Beirut, Lebanon.
American University of Beirut · LBFederal Institute for Risk Assessment · DEVirginia Commonwealth University · US

Funding

Training and Education Core p270-287P50DA036105 · NIDA · VIRGINIA COMMONWEALTH UNIVERSITY · PI EISSENBERG, THOMAS EVAN · 2013 to 2017
$19.2M
REALTIME waterpipe tobacco smoke toxicant sampling in the natural environmentR01DA025659 · NIDA · VIRGINIA COMMONWEALTH UNIVERSITY · PI EISSENBERG, THOMAS EVAN, SHIHADEH, ALAN · 2011 to 2015
$1.8M
NIDA NIH HHS P50 DA036105NIDA NIH HHS P50DA036105NIDA NIH HHS R01 DA025659NIDA NIH HHS R01DA025659
6 · The paper itself

Abstract

objectivesWaterpipe smoking using sweetened, flavoured tobacco products has become a widespread global phenomenon. In this paper, we review chemical, physical and biological properties of waterpipe smoke. DATA SOURCES: Peer-reviewed publications indexed in major databases between 1991 and 2014. Search keywords included a combination of: waterpipe, narghile, hookah, shisha along with names of chemical compounds and classes of compounds, in addition to terms commonly used in cellular biology and aerosol sizing. STUDY SELECTION: The search was limited to articles published in English which reported novel data on waterpipe tobacco smoke (WTS) toxicant content, biological activity or particle size and which met various criteria for analytical rigour including: method specificity and selectivity, precision, accuracy and recovery, linearity, range, and stability. DATA EXTRACTION: Multiple researchers reviewed the reports and collectively agreed on which data were pertinent for inclusion. DATA SYNTHESIS: Waterpipe smoke contains significant concentrations of toxicants thought to cause dependence, heart disease, lung disease and cancer in cigarette smokers, and includes 27 known or suspected carcinogens. Waterpipe smoke is a respirable aerosol that induces cellular responses associated with pulmonary and arterial diseases. Except nicotine, smoke generated using tobacco-free preparations marketed for 'health conscious' users contains the same or greater doses of toxicants, with the same cellular effects as conventional products. Toxicant yield data from the analytical laboratory are consistent with studies of exposure biomarkers in waterpipe users.

conclusionsA sufficient evidence base exists to support public health interventions that highlight the fact that WTS presents a serious inhalation hazard.

Indexed as

Hazardous SubstancesHumansNicotianaParticle SizeSmokeTobacco Smoke PollutionWaterHazardous SubstancesSmokeTobacco Smoke PollutionWaterCarcinogensNon-cigarette tobacco productsToxicology

Identifiers

PMID25666550
PMCPMC4345918
OpenAlexW2146243827

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.