The present study aims to quantify trace metals in different dokha (medwakh) and shisha tobacco products available in local markets. Recent research has shown that these products have higher amounts of nicotine and tar compared to various other tobacco products. No specific data are available on the concentration of trace elements in dokha (medwakh) and shisha tobacco products in the Middle East and North Africa (MENA) region. Harmful health effects due to the toxicity of these elements in tobacco and its smoke have not been adequately emphasized. Concentrations of trace elements were extensively studied using HORIBA XGT-7200 EDXRF fluorescence absorption spectroscopy. The mean concentrations of aluminum, calcium, chromium, copper, iron, magnesium, manganese, nickel, potassium, strontium and zinc in 13 dokha products in μg/g were 406.92 ± 41.72, 14703.27 ± 271.73, 11.73 ± 2.12, 25.58 ± 2.63, 753.85 ± 14.87, 5306.54 ± 134.94, 82.31 ± 4.55, 25.58 ± 2.50, 2212.12 ± 39.04, 816.92 ± 15.26 and 35.96 ± 2.63, respectively; and those in the three shisha products in μg/g were 244.83 ± 25.11, 8235.77 ± 144.51, 3.40 ± 0.38, 22.77 ± 4.50, 569.13 ± 10.22, 2096.20 ± 130.69, 72.13 ± 7.13, 27.67 ± 5.31, 4467.50 ± 168.06, 320.20 ± 6.03 and 36.40 ± 3.57, respectively. In our study, the quantified trace metal concentrations in dokha and shisha tobacco using the EDXRF method were ten times higher than the LODs. The percentage of RSD was <10%, validating the precision of the method. Tobacco smoking is a major source of consumption of toxic elements, not only in the smoker but also in non-smokers through passive smoking. In dokha (medwakh) and shisha tobacco products, compared with cigarettes, Ni levels were significantly higher, Cr, Cu and Zn levels were higher, and Fe levels were similar, while Al and Mn levels were lower. The dokha and shisha tobacco products have no filters; many toxic metals can quickly enter the lungs and cause different pulmonary diseases and oral infections. Tobacco smoking causes lung and oral cancers, chronic obstructive pulmonary disease and cardiovascular diseases.
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