The Association between Waterpipe Smoking and Metabolic Syndrome: A Cross-Sectional Study of the Bus

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Waterpipe (WP), a less common method of tobacco smoking than cigarette smoking (CS), has become increasingly popular over the last decade. Contrary to popular belief, WP smoking is far from harmless and has multiple health risks similar to, or even exceeding, those seen in CS[1,2]. It has been shown that a WP smoking session lasting about 45 minutes can expose the body to several times as many cardiorespiratory toxins as a CS[1], which further highlights the importance of studying WP. A pooled analysis of national surveys from 2006 to 2009 showed that Bushehr Province, Iran, has the highest prevalence of WP smoking among men (10.0%) and the second-highest among women (14.8%)[3]. Thus, this region is suitable for an evaluation of the chronic impacts of WP smoking on the cardiovascular system.
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