Burning charcoal is normally placed atop the tobacco to smoke the narghile waterpipe. We investigated the importance of charcoal as a toxicant source in the mainstream smoke, with particular attention to two well-known charcoal emissions: carbon monoxide (CO) and polyaromatic hydrocarbons (PAH). CO and PAH yields were compared when a waterpipe was machine smoked using charcoal and using an electrical heating element. The electrical heating element was designed to produce spatial and temporal temperature distributions similar to those measured using charcoal. With a popular type of ma'assel tobacco mixture, and using a smoking regimen consisting of 105 puffs of 530ml volume spaced 17s apart, it was found that approximately 90% of the CO and 75-92% of the 4- and 5-membered ring PAH compounds originated in the charcoal. Greater than 95% of the benzo(a)pyrene in the smoke was attributable to the charcoal. It was also found that the relative proportions of individual PAH species, the "PAH fingerprint", of the mainstream smoke were highly correlated to those extracted from the unburned charcoal (R(2)>0.94). In contrast, there was no correlation between the PAH fingerprint of the electrically heated and charcoal-heated conditions (R(2)<0.02). In addition to inhaling toxicants transferred from the tobacco, such as nicotine, "tar", and nitrosamines, waterpipe smokers thus also inhale large quantities of combustion-generated toxicants. This explains why, despite the generally low temperatures attained in the narghile tobacco, large quantities of CO and PAH have been found in the smoke.