Key result
Water pipe smoking is linked to increased risk of atherosclerosis, myocardial infarction, and hypertension.
Why the study?
Water pipe smoking is increasingly popular worldwide, especially among adolescents and young adults, and misconceptions about its health risks persist despite growing evidence of harmful cardiovascular effects. Mapping existing literature on public perceptions and cardiovascular implications was needed to inform awareness efforts and policy interventions.
What are the public perceptions, misconceptions, and cardiovascular health implications associated with water pipe smoking?
What are the public perceptions, misconceptions, and cardiovascular health implications associated with water pipe smoking?
This scoping review demonstrates that despite widespread public misconceptions that water pipe smoking is safer than cigarettes, it is associated with significant cardiovascular risks including atherosclerosis, myocardial infarction, and hypertension, underscoring the urgent need for targeted public health campaigns and policy enforcement.
Water pipe use may warrant inclusion in CV risk screening; extends observational literature but leaves open prospective policy evaluations.
Background: Water pipe smoking (hookah, shisha, narghile) is increasingly popular worldwide, particularly among adolescents and young adults. Misconceptions about its health risks persist despite growing evidence of its harmful cardiovascular effects. Objective: This scoping review aims to map the existing literature on public perceptions and misconceptions about water pipe smoking and its cardiovascular health implications, with the goal of informing awareness efforts and policy interventions. Methods: Following the PRISMA-ScR guidelines, we systematically searched, charted, and summarized 96 peer-reviewed studies published between 2000 and 2024 in major databases. Studies were included if they addressed public perception, knowledge, or cardiovascular outcomes related to water pipe use. Data were synthesized descriptively to highlight key themes and evidence gaps. Results: Most included studies (52%) were observational, with a regional focus on Middle Eastern and South Asian populations (67%). Common misconceptions included beliefs that water filtration reduces harm and that water pipe smoking is safer than cigarettes. Evidence shows significant exposure to harmful substances such as carbon monoxide, nicotine, heavy metals, and carcinogens, with reported associations with cardiovascular outcomes including atherosclerosis, myocardial infarction, and hypertension. Social acceptability, flavored tobacco, and weak regulation in low- and middle-income countries further promote its use. Conclusions: Water pipe smoking poses substantial cardiovascular risks that are poorly understood by the public. This scoping review highlights the need for culturally sensitive health education, robust public health campaigns, and stronger policy enforcement. Future research should adopt standardized reporting methods to better characterize long-term cardiovascular impacts, dual tobacco use patterns, and policy effectiveness.
No takes yet. Share an insight, caveat, or question.
Nzeako et al. (2026) conducted a review in Cardiovascular health outcomes and public perceptions related to water pipe smoking. Water pipe smoking (hookah, shisha, narghile) vs. Cigarette smoking or non-use was evaluated on Public perceptions, misconceptions, and cardiovascular outcomes (atherosclerosis, myocardial infarction, and hypertension). Water pipe smoking across 96 reviewed studies was associated with atherosclerosis, myocardial infarction, and hypertension despite widespread public misconceptions of safety.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: