Abstract
The perception that water pipe smoking (WPS) is safe mode of smoking is biased; the purpose of this study was to review literature for genotoxic effects of WPS and associated vital organ damage. The amount of nicotine, polycyclic aromatic hydrocarbons, carbon monoxide, tar, and heavy metals delineated after prolonged exposure to WPS exceeds that reported for cigarette smoking (CS). WPS is related to diverse adverse health consequences on cardiovascular, respiratory, hematological, and reproductive systems without sparing infants who are reported to born with reduced birth weight and length from exposed mothers. WPS causes significant reduction in mRNA expression levels of DNA repair genes (OGG1 and XRCC1) compared to CS and predisposes to heightened risk of developing bladder cancer, lung cancer, prostate cancer, and pancreatic cancers. Education about the harmfulness of WPS and policies to limit its use should be implemented, particularly in females (Graphical Abstract). [INLINE:1] Graphical Abstract
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