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Editorials |

Smoke and MirrorsDangers of Water-Pipe Smoking: The Perils of Water-Pipe Smoking and Implications for Western Countries

Janice M. Leung, MD; Don D. Sin, MD, MPH, FCCP
Author and Funding Information

From the University of British Columbia James Hogg Research Centre (Drs Leung and Sin); and Division of Respirology (Dr Sin), St. Paul’s Hospital.

CORRESPONDENCE TO: Don D. Sin, MD, MPH, FCCP, University of British Columbia James Hogg Research Centre, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada; e-mail: don.sin@hli.ubc.ca


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(4):875-876. doi:10.1378/chest.14-0603
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Nicotine is addictive and dangerous.1 Similar to heroin and cocaine, it possesses both stimulant and relaxant properties and alters mood. When smoked, nicotine reaches the brain within 7 s where it cajoles the midbrain to unleash an army of chemical messengers, such as dopamine and β-endorphins, that induce (pleasant) psychotropic effects.1 With repeated use, there is downregulation of these chemoreceptors, leading to desensitization and habituation and coaxing individuals to smoke increasing numbers of cigarettes to achieve similar central effects. Attempts to quit cause very unpleasant withdrawal symptoms that compel smokers to take up the habit again.1 Globally, cigarette smoking kills 6 million people per year.2 Despite the known health hazards of tobacco, there remain > 1 billion smokers worldwide with one-third living in China.2 In response, governments around the world have implemented various measures to curb smoking rates, including high taxation of cigarettes and smoking bans in indoor workplaces, public transport systems, and shopping centers.2 Although these efforts have been effective in reducing smoking rates in westernized countries, alternative modes of nicotine delivery are rapidly gaining popularity and usurping the vacuum left behind by cigarettes.3 These devices have received far less scientific or regulatory scrutiny and are being promulgated widely to the public on the implicit notion that they are safe.

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smoking ; hookah

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