Waterpipes and ElectronicCigarettes: Increasing Prevalenceand Expanding Science.

Theprevalence of noncigarette tobacco product use is on the riseacross the globe, especially for waterpipes (also known as hookah,narghile, and shisha) and electronic cigarettes (e-cigarettes). Thescientific literature reveals that waterpipe tobacco smoking is associatedwith exposure to a variety of toxicants that can cause short- andlong-term adverse health events. In contrast, there is far less evidenceof health harms related to e-cigarette use, although the variety ofproducts in this category makes it difficult to generalize. We searchedthe PubMed database for all publications on waterpipes and e-cigarettesfrom January 2000 to March 2014. The number of publications on waterpipesrose in a slow, linear pattern during this time, while the numberof publications on e-cigarettes showed exponential growth. The differenttrends suggest there may be more interest in studying a novel nicotineproduct (the e-cigarette) over a traditional tobacco product (thewaterpipe). We posit that, although the specific research needs forthese products are different, public health would be served best bya more equitable research approach. Scientists should continue todevote attention to understanding the unknown long-term health effectsof e-cigarettes and their potential to serve as harm reduction orsmoking cessation tools while simultaneously investigating how toreduce waterpipe smoking given that it exposes users to toxicantsknown to cause harm to health. Recent regulatory action in the UnitedStates, which proposes to include waterpipes and e-cigarettes undersome of the same regulations as tobacco cigarettes, makes such researchparticularly timely. [ABSTRACT FROM AUTHOR]