WTS database

Title	Pub Year	Author Sort descending	SearchLink
Gender and smoking status-based analysis of views regarding waterpipe and cigarette smoking in Aleppo, Syria	2004	Maziak, W., Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Preventive medicine Periodical, Abbrev. Prev.Med. Pub Date Free Form / Volume 38 Issue 4 Start Page 479 Other Pages 484 Notes Place of Publication ISSN/ISBN 0091-7435 Accession Number Language SubFile DOI Output Language Unknown(0) PMID Abstract Background. Narghile (waterpipe) smoking is increasing across the Eastern Mediterranean region (EMR), though little is known about the social attitudes and perceptions related to this method of tobacco use, and how those attitudes and perceptions are influenced by gender. Methods. Data from two cross-sectional surveys conducted in 2003 in Aleppo, Syria, were used to examine these issues. Overall, 855 participants were included (439 men, 416 women; mean age, 24.4Â±7.1 years; response rate, 97%). The current analysis focuses on responses to four similar nine-item questions tapping perceptions related to narghile smoking by women or men, and cigarette smoking by women or men. Scores on the nine items were summed to yield a total score to gauge participants' perceptions about narghile and cigarette. Results. Generally, participants were less positive about women smoking relative to men smoking, and cigarette smoking relative to narghile smoking. Cigarette smoking by women was the behavior least associated with positive perceptions. Individuals who resided in the city, were economically better-off, and were Christian, had higher perception scores (i.e., more positive attitudes) toward all forms of smoking, whereas older and married participants had higher perception scores for narghile only. Smoking status of participants, especially narghile smoking, was also associated with more positive perceptions toward smoking in general. Conclusions. We conclude that preliminary analysis shows that views on different forms of smoking in Syria differ by gender and smoking status. Â© 2003 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved. Descriptors adult, article, smoking, controlled study, female, gender, health behavior, health survey, human, interview, male, narghile smoking, normal human, perception, priority journal, questionnaire, sex difference, smoking habit, social behavior, Syrian Arab Republic Links Book Title Database Embase; MEDLINE Publisher Data Source Embase Authors Maziak,W., Rastam,S., Eissenberg,T., Asfar,T., Hammal,F., Bachir,M. E., Fouad,M. F., Ward,K. D. Original/Translated Title URL Date of Electronic PMCID Editors
Standardizing questionnaire items for the assessment of waterpipe tobacco use in epidemiological studies	2005	Maziak, W., Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Public health Periodical, Abbrev. Public Health Pub Date Free Form / Volume 119 Issue 5 Start Page 400 Other Pages 404 Notes Place of Publication ISSN/ISBN 0033-3506 Accession Number Language SubFile DOI Output Language Unknown(0) PMID Abstract Lessons from surveillance of the smoking epidemic show that the lack of adequate attention to standardizing measures and instruments for epidemiological studies has negatively influenced our ability to assess spatial and secular trends in smoking worldwide. Waterpipe smoking, another hazardous form of tobacco use, is gaining popularity worldwide, with societies in the Eastern Mediterranean region (EMR) being most affected. Several research groups are currently investigating the epidemiology of waterpipe smoking among various populations in the EMR. Initial evidence shows that in contrast to usage patterns observed in adult cigarette smoking, waterpipe smoking is characterized mainly by intermittent and social use. As such, many measures that have been traditionally used for the study of usage patterns and dependence among adult cigarette smokers are uninformative for waterpipe smoking. Thus, the need to develop standardized measures and terminology for assessment of the epidemiology of waterpipe smoking in different populations is of paramount importance. As the monitoring of waterpipe smoking is in its infancy, the development of consensus measures should facilitate the initiation of effective surveillance that can guide public health response to this emerging epidemic. Â© 2004 The Royal Institute of Health. Published by Elsevier Ltd. All rights reserved. Descriptors article, smoking, consensus, epidemic, health hazard, health survey, human, medical research, monitoring, nomenclature, population research, public health service, questionnaire, social aspect, society, Southern Europe, standardization Links Book Title Database Embase; MEDLINE Publisher Data Source Embase Authors Maziak,W., Ward,K. D., Afifi Soweid,R. A., Eissenberg,T. Original/Translated Title URL Date of Electronic PMCID Editors
Factors related to frequency of narghile (waterpipe) use: The first insights on tobacco dependence in narghile users	2004	Maziak, W., Syrian Center for Tobacco Studies, P.O. Box 16542, Aleppo, Syrian Arab Republic	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Drug and alcohol dependence Periodical, Abbrev. Drug Alcohol Depend. Pub Date Free Form 2004/10 Volume 76 Issue 1 Start Page 101 Other Pages 106 Notes Place of Publication ISSN/ISBN 0376-8716 Accession Number Language SubFile DOI Output Language Unknown(0) PMID Abstract Aims: To evaluate factors related to level of narghile (waterpipe) use as a first step towards modeling tobacco dependence among narghile users. Design: Cross sectional survey done in 2003 using interviewer-administered anonymous questionnaires. Setting: Cafes/restaurants serving narghiles in Aleppo, Syria. Participants: Narghile smokers (161 men and 107 women; mean age, 30.1 Â± 10.2, 161; age range, 18-68 years; response rate, 95.3%) randomly selected from the 17 cafes/restaurants sampled. Measurements: Frequency of narghile use (daily, weekly, monthly) was assessed as a function of several factors potentially indicative of dependence, including situational characteristics (where, when, and with whom smoking occurs; seasonality of use, and sharing of narghile), attitudes, and experience with quitting narghile use, escalation of use over time, future intentions regarding use, perception of being "hooked" on narghile, and cognitions/behaviors engaged in to support use (carrying one's own narghile; think of narghile when it is not available; considering narghile for selection of cafes/restaurants). Findings: Frequency of narghile use was strongly correlated with participant's subjective judgment of how hooked they are on narghile (coefficient, 0.5). Predictors of narghile use frequency according to multinomial logistic regression were: male gender, smoking mainly alone versus with others; smoking mainly at home versus outside; smoking more frequently since initiation, being hooked on narghile, carrying narghile, and considering it for cafe/restaurant choice. Conclusions: Our data reveal two main domains of a tobacco dependence syndrome likely to be relevant to narghile; the first reflects the effects of nicotine contained in narghile tobacco, and is not very different from what is seen with other tobacco products, and the second is unique to narghile and is related mainly to its social dimension, with more intensive smokers showing an increasingly individual pattern of narghile smoking. Â© 2004 Elsevier Ireland Ltd. All rights reserved. Descriptors adult, aged, article, behavior, catering service, cognition, correlation analysis, female, human, logistic regression analysis, male, prevalence, priority journal, questionnaire, smoking, Syrian Arab Republic, tobacco dependence, tube Links Book Title Database Embase; MEDLINE Publisher Data Source Embase Authors Maziak,W., Ward,K. D., Eissenberg,T. Original/Translated Title URL Date of Electronic PMCID Editors
Comparison of CO, PAH, Nicotine, and Aldehyde Emissions in Waterpipe Tobacco Smoke Generated Using Electrical and Charcoal Heating Methods	2019	Mechanical Engineering Department , American University of Beirut , Beirut 1107 2020 , Lebanon.; Mechanical Engineering Department , American University of Beirut , Beirut 1107 2020 , Lebanon.; Mechanical Engineering Department , American Univer(TRUNCATED	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Chemical research in toxicology Periodical, Abbrev. Chem.Res.Toxicol. Pub Date Free Form 6-May Volume Issue Start Page Other Pages Notes LR: 20190506; JID: 8807448; 2019/05/01 06:00 [pubmed]; 2019/05/01 06:00 [medline]; 2019/05/01 06:00 [entrez]; aheadofprint Place of Publication United States ISSN/ISBN 1520-5010; 0893-228X Accession Number PMID: 31038931 Language eng SubFile Journal Article DOI 10.1021/acs.chemrestox.9b00045 [doi] Output Language Unknown(0) PMID 31038931 Abstract Waterpipe tobacco smoking (WTS) has been characterized as a global epidemic. Waterpipe smoke has been shown to contain and deliver significant doses of many of the toxicants known to cause cancer, respiratory, and cardiovascular diseases in cigarette smokers. It has also been shown that the charcoal used to heat the tobacco contributes most of the polycyclic aromatic hydrocarbons (PAHs) and carbon monoxide (CO) found in the smoke, two major causative agents in smoking-related lung cancer and heart disease, respectively. Possibly as a result of growing awareness of charcoal as a toxicant source, electrical heating elements (EHEs) are being marketed for waterpipe use as reduced harm charcoal substitutes. We measured thermal performance characteristics (tobacco burned, total aerosolized particulate matter) and toxicant emissions in WTS generated using three commercially available waterpipe EHEs and charcoal to examine the hypothesis that EHEs can function similarly to charcoal while presenting a reduced toxicant profile. Toxicants quantified included total particulate matter, nicotine, PAHs, CO, and volatile aldehydes delivered at the mouthpiece when the waterpipe was machine smoked using a standard protocol. We found that while EHEs involved an 80% reduction in total PAH and a 90% reduction in CO emissions, they also resulted in a several-fold increase in the potent respiratory toxicant acrolein. These mixed findings underscore the complexity of toxicant reduction by product manipulation and suggest that marketing EHEs as reduced harm products may be misleading. Descriptors Links Book Title Database Publisher Data Source Authors El Hourani,M., Talih,S., Salman,R., Karaoghlanian,N., Karam,E., El Hage,R., Saliba,N.A., Shihadeh,A. Original/Translated Title URL Date of Electronic 20190506 PMCID Editors
Comparison of CO, PAH, Nicotine, and Aldehyde Emissions in Waterpipe Tobacco Smoke Generated Using Electrical and Charcoal Heating Methods	2019	Mechanical Engineering Department , American University of Beirut , Beirut 1107 2020 , Lebanon.; Mechanical Engineering Department , American University of Beirut , Beirut 1107 2020 , Lebanon.; Mechanical Engineering Department , American Univer(TRUNCATED	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Chemical research in toxicology Periodical, Abbrev. Chem.Res.Toxicol. Pub Date Free Form 6-May Volume Issue Start Page Other Pages Notes LR: 20190506; JID: 8807448; 2019/05/01 06:00 [pubmed]; 2019/05/01 06:00 [medline]; 2019/05/01 06:00 [entrez]; aheadofprint Place of Publication United States ISSN/ISBN 1520-5010; 0893-228X Accession Number PMID: 31038931 Language eng SubFile Journal Article DOI 10.1021/acs.chemrestox.9b00045 [doi] Output Language Unknown(0) PMID 31038931 Abstract Waterpipe tobacco smoking (WTS) has been characterized as a global epidemic. Waterpipe smoke has been shown to contain and deliver significant doses of many of the toxicants known to cause cancer, respiratory, and cardiovascular diseases in cigarette smokers. It has also been shown that the charcoal used to heat the tobacco contributes most of the polycyclic aromatic hydrocarbons (PAHs) and carbon monoxide (CO) found in the smoke, two major causative agents in smoking-related lung cancer and heart disease, respectively. Possibly as a result of growing awareness of charcoal as a toxicant source, electrical heating elements (EHEs) are being marketed for waterpipe use as reduced harm charcoal substitutes. We measured thermal performance characteristics (tobacco burned, total aerosolized particulate matter) and toxicant emissions in WTS generated using three commercially available waterpipe EHEs and charcoal to examine the hypothesis that EHEs can function similarly to charcoal while presenting a reduced toxicant profile. Toxicants quantified included total particulate matter, nicotine, PAHs, CO, and volatile aldehydes delivered at the mouthpiece when the waterpipe was machine smoked using a standard protocol. We found that while EHEs involved an 80% reduction in total PAH and a 90% reduction in CO emissions, they also resulted in a several-fold increase in the potent respiratory toxicant acrolein. These mixed findings underscore the complexity of toxicant reduction by product manipulation and suggest that marketing EHEs as reduced harm products may be misleading. Descriptors Links Book Title Database Publisher Data Source Authors El Hourani,M., Talih,S., Salman,R., Karaoghlanian,N., Karam,E., El Hage,R., Saliba,N.A., Shihadeh,A. Original/Translated Title URL Date of Electronic 20190506 PMCID Editors
Does switching to a tobacco-free waterpipe product reduce toxicant intake? A crossover study comparing CO, NO, PAH, volatile aldehydes, "tar" and nicotine yields	2012	Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon. as20@aub.edu.lb	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association Periodical, Abbrev. Food Chem.Toxicol. Pub Date Free Form May Volume 50 Issue 5 Start Page 1494 Other Pages 1498 Notes LR: 20151119; CI: Copyright (c) 2012; GR: F31 DA028102/DA/NIDA NIH HHS/United States; GR: F31DA028102/DA/NIDA NIH HHS/United States; GR: R01 CA120142/CA/NCI NIH HHS/United States; GR: R01 DA024876/DA/NIDA NIH HHS/United States; GR: R01CA120142/CA/NCI NIH Place of Publication England ISSN/ISBN 1873-6351; 0278-6915 Accession Number PMID: 22406330 Language eng SubFile Comparative Study; Journal Article; Research Support, N.I.H., Extramural; IM DOI 10.1016/j.fct.2012.02.041 [doi] Output Language Unknown(0) PMID 22406330 Abstract Waterpipe (hookah, narghile, shisha) use has become a global phenomenon, with numerous product variations. One variation is a class of products marketed as "tobacco-free" alternatives for the "health conscious user". In this study toxicant yields from waterpipes smoked using conventional tobacco-based and tobacco-free preparations were compared. A human-mimic waterpipe smoking machine was used to replicate the puffing sequences of 31 human participants who completed two double-blind ad libitum smoking sessions in a controlled clinical setting: once with a tobacco-based product of their choosing and once with a flavor-matched tobacco-free product. Outcome measures included yields of carbon monoxide, nitric oxide, volatile aldehydes, nicotine, tar, and polycyclic aromatic hydrocarbons. Smoke from both waterpipe preparations contained substantial quantities of toxicants. Nicotine yield was the only outcome that differed significantly between preparations. These findings contradict advertising messages that "herbal" waterpipe products are a healthy alternative to tobacco products. Descriptors Links Book Title Database Publisher Elsevier Ltd Data Source Authors Shihadeh,A., Salman,R., Jaroudi,E., Saliba,N., Sepetdjian,E., Blank,M.D., Cobb,C.O., Eissenberg,T. Original/Translated Title URL Date of Electronic 20120301 PMCID PMC3407543 Editors
A review of air quality, biological indicators and health effects of second-hand waterpipe smoke exposure	2015	New York University School of Medicine, New York, New York, USA.; New York University School of Medicine, New York, New York, USA.; Departments of Pediatrics and Environmental Medicine, New York University School of Medicine, New York University, New York	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Tobacco control Periodical, Abbrev. Tob.Control Pub Date Free Form Mar Volume 24 Suppl 1 Issue Start Page i54 Other Pages i59 Notes LR: 20151119; CI: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.; JID: 9209612; 0 (Biomarkers); 0 (Particulate Matter); Place of Publication England ISSN/ISBN 1468-3318; 0964-4563 Accession Number PMID: 25480544 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; Review; IM DOI 10.1136/tobaccocontrol-2014-052038 [doi] Output Language Unknown(0) PMID 25480544 Abstract OBJECTIVE: There has been a rapid increase in the use of waterpipe tobacco and non-tobacco based shisha in many countries. Understanding the impact and effects of second-hand smoke (SHS) from cigarette was a crucial factor in reducing cigarette use, leading to clean indoor air laws and smoking bans. This article reviews what is known about the effects of SHS exposure from waterpipes. DATA SOURCES: We used PubMed and EMBASE to review the literature. Articles were grouped into quantitative measures of air quality and biological markers, health effects, exposure across different settings, different types of shisha and use in different countries. STUDY SELECTION: Criteria for study selection were based on the key words related to SHS: waterpipe, hookah, shisha and third-hand smoke. DATA EXTRACTION: Independent extraction with two reviewers was performed with inclusion criteria applied to articles on SHS and waterpipe/hookah/shisha. We excluded articles related to pregnancy or prenatal exposure to SHS, animal studies, and non-specific source of exposure as well as articles not written in English. DATA SYNTHESIS: A primary literature search yielded 54 articles, of which only 11 were included based on relevance to SHS from a waterpipe/hookah/shisha. CONCLUSIONS: The negative health consequences of second-hand waterpipe exposure have major implications for clean indoor air laws and for occupational safety. There exists an urgent need for public health campaigns about the effects on children and household members from smoking waterpipe at home, and for further development and implementation of regulations to protect the health of the public from this rapidly emerging threat. Descriptors Links Book Title Database Publisher Data Source Authors Kumar,S.R., Davies,S., Weitzman,M., Sherman,S. Original/Translated Title URL Date of Electronic 20141205 PMCID PMC4345792 Editors
Cross-country comparison of waterpipe use: nationally representative data from 13 low and middle-income countries from the Global Adult Tobacco Survey (GATS)	2014	Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; World Health Organization Regional Office for the Eastern M	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Tobacco control Periodical, Abbrev. Tob.Control Pub Date Free Form Sep Volume 23 Issue 5 Start Page 419 Other Pages 427 Notes LR: 20151119; CI: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.; JID: 9209612; 059QF0KO0R (Water); OID: NLM: PMC414541 Place of Publication England ISSN/ISBN 1468-3318; 0964-4563 Accession Number PMID: 23760609 Language eng SubFile Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; IM DOI 10.1136/tobaccocontrol-2012-050841 [doi] Output Language Unknown(0) PMID 23760609 Abstract OBJECTIVE: Evidence shows that smoking tobacco using a waterpipe is significantly associated with diseases. Despite this, waterpipe use seems to be increasing worldwide, though nationally representative data are not widely available. The Global Adult Tobacco Survey (GATS) provides an opportunity to measure various indicators of waterpipe use from nationally representative surveys. METHODS: Data were obtained for adults 15 years of age or older from 13 countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam) who completed GATS from 2008-2010. The GATS questionnaire collected data on current waterpipe use, including daily/less than daily prevalence and number of sessions per day/week. An optional waterpipe module measured former use, age of initiation, and level of consumption during a session. RESULTS: GATS was successful in producing nationally representative data on waterpipe use from 13 countries, many of which for the first time. The prevalence of waterpipe use among men was highest in Vietnam (13.0%) and Egypt (6.2%); among women, waterpipe use was highest in Russia (3.2%) and Ukraine (1.1%). While over 90% of adults in Ukraine thought smoking tobacco causes serious illness, only 31.4% thought smoking tobacco using a waterpipe causes serious illness. CONCLUSIONS: GATS data provide the ability to analyse waterpipe use within a country and across countries. Monitoring of waterpipe use at a national level will better enable countries to target tobacco control interventions such as education campaigns about the negative health effects of waterpipe use. Descriptors Links Book Title Database Publisher Data Source Authors Morton,J., Song,Y., Fouad,H., Awa,F.E., Abou El Naga,R., Zhao,L., Palipudi,K., Asma,S., GATS Collaborative Group Original/Translated Title URL Date of Electronic 20130611 PMCID PMC4145417 Editors
Comparison of a preferred versus non-preferred waterpipe tobacco flavour: subjective experience, smoking behaviour and toxicant exposure	2018	Oklahoma Tobacco Research Center, Oklahoma City, Oklahoma, USA.; Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA.; Oklahoma Tobacco Research Center, Oklahoma City, Oklahoma, USA.; Department of Pediatrics, Universi(TRUNCATED	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Tobacco control Periodical, Abbrev. Tob.Control Pub Date Free Form May Volume 27 Issue 3 Start Page 319 Other Pages 324 Notes LR: 20190114; CI: (c) Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018; GR: R03 DA041928/DA/NIDA NIH HHS/United States; GR: P50 DA036105/DA/NIDA NIH HHS/United States; JID: 9209612; 0 (Flavoring Agents); 6M3 Place of Publication England ISSN/ISBN 1468-3318; 0964-4563 Accession Number PMID: 28381414 Language eng SubFile Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.; IM DOI 10.1136/tobaccocontrol-2016-053344 [doi] Output Language Unknown(0) PMID 28381414 Abstract INTRODUCTION: One possible reason for the rapid proliferation of waterpipe (WP) smoking is the pervasive use of flavoured WP tobacco. To begin to understand the impact of WP tobacco flavours, the current study examined the impact of a preferred WP tobacco flavour compared with a non-preferred tobacco flavoured control on user's smoking behaviour, toxicant exposure and subjective smoking experience. METHOD: Thirty-six current WP smokers completed two, 45-minute ad libitum smoking sessions (preferred flavour vs non-preferred tobacco flavour control) in a randomised cross-over design. Participants completed survey questionnaires assessing subjective smoking experience, exhaled carbon monoxide (eCO) testing, and provided blood samples for monitoring plasma nicotine. WP smoking topography was measured continuously throughout the smoking session. RESULTS: While participants reported an enhanced subjective smoking experience including greater interest in continued use, greater pleasure derived from smoking, increased liking and enjoyment, and willingness to continue use after smoking their preferred WP tobacco flavour (p values Descriptors Links Book Title Database Publisher Data Source Authors Leavens,E.L., Driskill,L.M., Molina,N., Eissenberg,T., Shihadeh,A., Brett,E.I., Floyd,E., Wagener,T.L. Original/Translated Title URL Date of Electronic 20170405 PMCID Editors
'Enter at your own risk': a multimethod study of air quality and biological measures in Canadian waterpipe cafes	2015	Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.; Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.; Ontario Tobacco Research Unit, Dalla La	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Tobacco control Periodical, Abbrev. Tob.Control Pub Date Free Form Mar Volume 24 Issue 2 Start Page 175 Other Pages 181 Notes CI: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.; JID: 9209612; 0 (Air Pollutants); 0 (Particulate Matter); 0 (Tobacc Place of Publication England ISSN/ISBN 1468-3318; 0964-4563 Accession Number PMID: 24161999 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; IM DOI 10.1136/tobaccocontrol-2013-051180 [doi] Output Language Unknown(0) PMID 24161999 Abstract BACKGROUND: Tobacco and non-tobacco-based waterpipe smoking has increased exponentially in many countries in recent decades, particularly among youth and young adults. Although tobacco smoking is banned in many indoor public places, waterpipe smoking, ostensibly non-tobacco, continues in Ontario and other jurisdictions where only tobacco smoking is prohibited. This study assessed air quality and exposure in waterpipe cafes using multiple methods and markers. METHODS: Indoor (n=12) and outdoor (n=5) air quality was assessed in Toronto, Canada waterpipe cafes from 30 August to 11 October 2012. Real-time measurements of air nicotine, fine particulate matter less than 2.5 microns in diameter (PM2.5) and ambient carbon monoxide (CO) were collected in 2 h sessions. Levels of CO in breath were collected in non-smoking field staff before entering and upon leaving venues. Observations of occupant behaviour, environmental changes and venue characteristics were also recorded. RESULTS: In indoor venues, mean values were 1419 microg/m(3) for PM2.5, 17.7 ppm for ambient CO, and 3.3 microg/m(3) for air nicotine. Levels increased with increasing number of active waterpipes. On outdoor patios, mean values were 80.5 microg/m(3) for PM2.5, 0.5 ppm for ambient CO, and 0.6 microg/m(3) for air nicotine. Air quality levels in indoor waterpipe cafes are hazardous for human health. Outdoor waterpipe cafes showed less harmful particulate levels than indoors, but mean PM2.5 levels (80.5 microg/m(3)) were still 'poor'. CONCLUSIONS: Staff and patrons of waterpipe cafes are exposed to air quality levels considered hazardous to human health. Results support eliminating waterpipe smoking in hospitality venues indoors and out. Descriptors Links Book Title Database Publisher Data Source Authors Zhang,B., Haji,F., Kaufman,P., Muir,S., Ferrence,R. Original/Translated Title URL Date of Electronic 20131025 PMCID Editors

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