The acute effects of waterpipe smoking on lung function and exercise capacity in a pilot study of healthy participants

Feras I. Hawari, Nour A. Obeidat, Hiba Ayub, Iyad Ghonimat, Thomas Eissenberg, Sahar Dawahrah, Hamza Beano

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    27 Scopus citations


    Context: Waterpipe tobacco smoking (WTS) has gained popularity, but its physiologic effects have not been extensively studied: rather, studies have focused on WTS's chronic effects or have evaluated limited respiratory/cardiac parameters. Objective: We sought to characterize in a more detailed manner the acute effects of WTS on lung function and exercise capacity. Method: We recruited 24 healthy WTS males. We used a pilot single-group pre-test (abstained from WTS for ≥48 h) post-test (within 0.5 h of a 45-min WTS session) design. We performed spirometry, diffusing lung capacity and time-limited CPE testing (CPET; cycloergometer; 2-min 20-Watt warm-up and 25-Watt increase every 2-min for 10 min). Results: Mean age was 20.4 years; Post-WTS, the following significant changes were observed: CO level increased from 3.7 ppm to 24.4; oxygen consumption decreased (from 1.86 L/min to 1.7); baseline respiratory rate increased (from 17.7 breath/min to 19.7); forced expiratory flow over the middle half of the forced vital capacity decreased (from 5.51 L to 5.29); and perceived exertion (measured by Borg scale) at mid and peak exercise increased. Baseline resting systolic blood pressure, pulse pressure, and pulse pressure product increased post-WTS (from 118.9 mmHg to 129.2; from 45.3 mmHg to 55.6; and from 9.9 mmHg/min to 11.1 post-WTS, respectively). During exercise, a decrease in oxygen pulse was observed post-WTS (from 10.89 ml/beat to 9.97), while the heart rate-oxygen consumption relationship increased post-WTS (from 3.52 beats/ml/kg to 3.91). Conclusion: Acute WTS appears to induce impairment in lung function and exercise capacity. Larger studies are warranted to further characterize the nature and extent of such impairment.

    Original languageEnglish (US)
    Pages (from-to)492-497
    Number of pages6
    JournalInhalation Toxicology
    Issue number9
    StatePublished - Aug 1 2013



    • Acute effect
    • Exercise testing
    • Lung function
    • Waterpipe

    ASJC Scopus subject areas

    • Toxicology
    • Health, Toxicology and Mutagenesis

    Cite this

    Hawari, F. I., Obeidat, N. A., Ayub, H., Ghonimat, I., Eissenberg, T., Dawahrah, S., & Beano, H. (2013). The acute effects of waterpipe smoking on lung function and exercise capacity in a pilot study of healthy participants. Inhalation Toxicology, 25(9), 492-497.