Table 4

Toxicant increases in exhaled breath and environmental concentrations in waterpipe café studies compared with a single active smoker in a controlled chamber ventilated at 2.3 hr-1 (this study)

StudyGeographic location (sample size)Boost in exhaled breath (mg/m3)Environmental concentration (mg/m3)
This study*Columbus, Ohio, USA (n=31 waterpipe smokers)27.1±17.20.30–66.2
Hazrati et al 63Ardabil, Iran
(n=81 cafés)
Samarghandi et al 62Hamadan, Iran
(n=25 waterpipe smokers)
This study*Columbus, Ohio, USA (n=33 waterpipe smokers and smoking sessions)59.2±22.816.0–11793.9±50.46.34–234
Zhou 2017§New York City, New York, USA (n=4 cafés;
n=10 non-smoking café workers)
Torrey et al 82Baltimore, Maryland, USA (n=7 cafés)21±262.3–61
Moon82**Istanbul, Turkey
(n=9 cafés)
4.2††1.6 – 23‡‡
Moscow, Russia
(n=17 cafés)
2.9††1.5 - 4.1‡‡
Cairo, Egypt
(n=20 cafés)
27††9.3 – 110‡‡
Zhang 2015§§Toronto, Canada
(n=12 indoor cafés; n=23 non-smoking field staff)
  • *Control configuration; environmental concentration expressed as 1-hour time-weighted average.

  • †Hazrati S, Rostami R, Fazlzadeh M, et al 63

  • ‡Samarghandi M, Mehralipour J, Shabanlo A, et al 62 and personal communication with the author.

  • §Boost estimated from difference between post- and pre-shift average exhaled CO from waterpipe cafe workers working average shift of 10.3 ± 1.4  hours ; Zhou S, Behrooz L, Weitzman M, et al 64

  • ¶Torrey CM, Moon KA, D’Ann LW, et al 82.

  • **Moon KA, Magid H, Torrey C, Rule AM, Ferguson J, Susan J. & Radwan GN. Secondhand smoke in waterpipe tobacco venues in Istanbul, Moscow, and Cairo. Environ Res, 2015;142:568–574.

  • ††Median.

  • ‡‡IQR.

  • §§Boost taken as value for breath sample collected after conducting 2-hour sampling session; Zhang B, Haji F, Kaufman P, et al 65.

  • CO, carbon monoxide; NS, not specified.