[The narghile and its effects on health. Part I: the narghile, general description and properties]

A narghile is a water-pipe used to smoke a tobacco preparation. As the smoker inhales, the tobacco smoke is sucked down from the bowl and then bubbles up through the water into the air of the smoke chamber and then through the hose to the smoker. Its origins are mysterious and controversial. Nevertheless it remains, under different names, an object used regularly by more than one hundred million people in the world. Since the eighties and especially nineties, its consumption has grown significantly and is now considered to be a worldwide epidemic. However, the knowledge about the effects of narghile smoke on health is partial and sometimes contradictory. Indeed, we are witnessing increasing confusion in biomedical studies and scientific debate about its health impact is unresolved. Given this situation, revealing a serious and profound lack of information about the real nature and toxicity of hookah smoke, the authors conducted this two-part study. The first part presents epidemiological data, describes the narghile and the different types of narghile tobacco and exposes the composition of narghile smoke. The second part highlights the lack of reliable data about the detrimental effects of the narghile pipe on health and especially on the cardiopulmonary function.