Cancer risk in water pipe smokers: a meta-analysis

This is a guest blog post by Ravinder Mamtani, MD. Dr. Mamtani is Professor of Integrative Medicine, Professor of Healthcare Policy and Research and Associate Dean for Global and Public Health at Weill Cornell Medicine-Qatar. His current interests include integrative medicine and lifestyle medicine, public health, and non-communicable diseases such as diabetes, and obesity. Additional information about the author can be found on this page 



The health risks of smoking cigarettes are well known.  Cancer risk is of serious concern.  However, the cancer risk associated with smoking from a water pipe – also known as shisha, hookah and ‘hubble bubble’ – remains poorly understood.

Shisha smoking is popular among the youth today.  Many consider it to be safe. There is a common misconception that the water filters out the toxins present in the smoke.  However, as studies have shown this is not the case. Furthermore, shisha smoking enables longer smoking sessions, larger quantities of smoke being inhaled and the presence of additional toxins such as tar, addictive nicotine and carbon monoxide.  Finally, it is more socially acceptable for women to smoke shisha than cigarettes in the Middle East.

This meta-analysis of 28 studies examined the relationship between water pipe smoking and various forms of cancer, including cancer of the head and neck, esophagus, stomach, lung and bladder. The paper’s findings can be summarized as follows:

  • Water pipe/ shisha smoking is associated with a significantly increased risk of cancer of the head and neck, esophagus, and lung.
  • Increased cancer risk was also observed for stomach, bladder, colorectum, and liver, but paucity of high-quality studies preclude authors from drawing any definite conclusions regarding these cancers.
  • The esophageal and stomach cancer risk of water pipe  smoking  is similar to the risk observed with conventional cigarette smoking.

The study demonstrates the urgency in raising awareness about the dangers of water-pipe smoking. Additional studies are warranted. Controlling the growing epidemic of waterpipe smoking will require enhanced, comprehensive public health and societal efforts.

This study is available to download for free here!


You may also like...

Leave a Reply

Your email address will not be published. Required fields are marked *