Waterpipe Smoking: Challenges and Opportunities for More Effective Regulations

Waterpipe smoking (WPS), also known as hookah, is a popular social phenomenon among youth and young adults worldwide. They come in various sizes, shapes, and styles, with the highest prevalence observed in the Middle East and North Africa. Several factors contribute to their popularity, including appealing flavors, perceived accessibility, affordability, as well as the fact that smoking bars are underregulated in many countries. Although there has been a decrease in tobacco use overall because of global efforts, waterpipe smoking has become more common over time, particularly in Eastern Mediterranean countries. This is also fueled by the misconception by tobacco companies that these products are less harmful than cigarettes. This perspective review will focus on the current epidemiological data on waterpipe smoking, the impact of waterpipe smoking, the challenges of measuring waterpipe prevalence, and put forward recommendations to strengthen waterpipe smoking regulations.