In the summer of 2009, the FDA obtained authority to regulate the manufacturing, distribution, and marketing of cigarettes and smokeless tobacco products. The Family Smoking Prevention and Tobacco Control Act was passed to reduce the trend of new users forming an addiction to tobacco before they were of the age to have an understanding of the toxic and even deadly consequences. However, non-conventional tobacco products, such as hookah tobacco, e-cigarettes, and other modified tobacco or tobacco-free alternatives are currently not regulated. On April 24th, 2014, the FDA announced they were planning on extending the agency's tobacco authority to cover additional tobacco products. Yet, not much is known about the hazards of these tobacco and potentially reduced exposure products (PREPs).Steam Stones are one alterative tobacco product where no quantitative information is available. These small pebble-like rocks contain no tobacco or nicotine and are coated in a viscous flavored fluid formulation consisting of glycerin, and are placed in a hookah head as an alternative to hookah tobacco. A total metal analysis with ICP–MS/MS was performed on the two originally marketed brands, Mya and Shiazo. The coatings of the stones underwent an initial hot water extraction for the purposes of determining the stones' metal composition for 26 metal targets. The toxic metals detected in both the Mya and Shiazo stones included trace levels of Cr, Ni, Cu, As, and Pb. This led to analyzing the toxic metals a smoker could potentially be exposed to during a 30minute smoking session using both brands of steam stones and two different types of traditional smoldering charcoal. It was found that a smoker could inhale statistically similar quantities of Cr (between 12.2±9.91ng per smoking session to 1130±776ng per smoking session) and As (between 191±30.1ng per smoking session to 246±101ng per smoking session) when smoking one of four hookah head scenarios (scenario 1: Mya stones and Coco Nara charcoal, scenario 2: Mya stones and Fantasia charcoal, scenario 3: Shiazo stones and Coco Nara charcoal, and scenario 4: Shiazo stones and Fantasia charcoal).Although steam stones are marketed as free of nicotine, tar, carcinogens, and carbon monoxide, the use of traditional smoldering charcoal still exposes a user to these toxicants, including unacceptable amounts of harmful metals, such as Cr and As, despite the use of an alternative tobacco product. Notably, the use of electronic charcoal decreased the amount of toxic metals present in the smoke. Therefore, the smoke still contained relatively high levels of toxic metals, likely due to the use of traditional charcoal, which was previously quantified by ICP–MS/MS in our earlier paper [40].