TABLE 1.

Concentration and health effects of major hazardous and toxic compounds of waterpipe smoke compared with cigarettes

Compound/toxin	Cigarette concentration	Waterpipe concentration	Health effect/risk
Nicotine mg	0.1–3	>0.01–9.29	Tobacco dependence
Tar mg	1–27	242–2350	CVD, COPD, lung cancer
Carbon monoxide mg	12–23	5.7–367	CVD
Polycyclic aromatic hydrocarbons ng			Lung, larynx and oral cavity cancer
Naphthalene	360.8	30–3860
Fluoranthene	52.7	354–2380
Carbonylic compounds			COPD, lung and larynx cancer
Formaldehyde μg	20–100	36–630
Acetaldehyde μg	400–1400	120–2520
Tobacco-specific nitrosamines ng			Lung, larynx, oral cavity, oesophageal and bladder cancer
NNK	80–770	Limit of detection – 46.4
NAB	120–3700	34.3
Heavy metals			Lung inflammation, COPD
Lead ng	34–85	200–6870
Nickel ng	Not detected – 600	300–900

CVD: cardiovascular disease; NNK: nicotine-derived nitrosamine ketone; NAB: N′-nitrosoanabasine. Reproduced and modified from [7] with permission.