Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature

Int J Environ Res Public Health. 2015 May 29;12(6):6115-35. doi: 10.3390/ijerph120606115.


Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation.

Methods: Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library.

Results: To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers.

Conclusion: Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States.

Keywords: hookah; policy; regulation; waterpipe.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Government Regulation*
  • Health Policy
  • Humans
  • Male
  • Prevalence
  • Smoking / epidemiology*
  • Smoking / legislation & jurisprudence*
  • Surveys and Questionnaires
  • Tobacco
  • United States / epidemiology
  • Water*
  • Young Adult


  • Water