Ok, so we all know it is bad, but just how bad? … Dr. Loffredo, you are the Director of the Cancer Genetics and Epidemiology program at Georgetown University Medical Center, and you have been studying tobacco use in Egypt since 1997, surely you can tell us?

People who use these devices don’t realize that they could be inhaling what is believed to be the equivalent of a pack of cigarettes in one typical 30-60 minute session with a waterpipe, because such a large quantity of pure, shredded tobacco is used.

Holy! But … at least the water absorbs the toxins, no?

… that is true to some extent if the toxins are water soluble, but tar isn’t, and tar contains the carcinogens. We believe that, compared to the typical cigarette smoker, waterpipe smokers are exposed to larger total amounts of nicotine, carbon monoxide and certain other toxins. And…

There’s an and?

because the tobacco is burning at a lower temperature, it is more tolerable to inhale deeply, and in fact you need more force to pull air through the high resistance of the water pathway. That means the tobacco smoke can be penetrating deeper in a person’s respiratory tract than cigarette smoke does. The damage could be even worse than seen in cigarette smokers, but we haven’t done studies long enough to quantify the true cancer risk.

Oh, so you haven’t really quantified the risk …

Even so, the incidence of lung cancer is increasing rapidly in Egypt and other Middle Eastern countries, comparable to lung cancer rates in the U.S. after cigarette smoking became newly fashionable

But… but… but… it’s sooo good.