Opportunistic Insights into Occupational Health Hazards Associated with Waterpipe Tobacco Smoking Premises in the UK

Waterpipe smoking, a tobacco consumption method traditionally associated with the Middle East and South Asia, has increased in prevalence in the last decade in Europe and the US, especially among young people (Amin et al., 2010; Al-Naggar; Saghir, 2011; Martinasek et al., 2011). The waterpipe apparatus consists of a head, body, bowl and hose. The head is loaded with a 10-20 gram of fruit-flavoured tobacco mixture and often covered with perforated aluminium foil. Burning coal is placed on top of this foil, heating the underlying tobacco. When users inhale on the hose, a tobacco and coal smoke mixture passes through water, cooling the smoke before inhalation (Knishkowy and Amitai, 2005). The flavoured and cooled tobacco smoke is one of many explanations for the rise in waterpipe tobacco smoking (Akl et al., 2013). However, studies have shown that waterpipe smokers may be exposed to high levels of toxicants, including nicotine (inducing dependence), tar