title: Is Smoking Shisha Safer than Cigarettes: Comparison of Health Effects of Shisha and Cigarette Smoking among Young Adults in Kuwait.
abstract: OBJECTIVE
  The aim of this study was to compare the health effects of shisha smoking with cigarette smoking among male college students in Kuwait.
  
  
  METHODS
  This cross-sectional study was conducted on 525 male students in Kuwait from September to October 2013. A pretested questionnaire was used for information on demographics and health complaints. Peak expiratory flow rate (PEFR) was measured using a portable peak flow meter. The outcome variables of health status were compared between smoking shisha, cigarettes, or both, and nonsmoking.
  
  
  RESULTS
  The prevalence of current smoking was 243 of the 525 students (46%); of them, 52 (10%) were shisha smokers, 69 were (13%) cigarette smokers and 122 (23%) were both shisha and cigarette smokers. There were significantly fewer shisha smokers than cigarette smokers with symptoms of persistent cough (4 vs. 13% or 2/52 vs. 15/69; p = 0.007), chest pain (4 vs. 23% or 2/52 vs. 16/69; p = 0.004) and rapid heart rate (12 vs. 28% or 6/52 vs. 19/69; p = 0.04). Other complaints, including asthma, respiratory infections, shortness of breath, high blood pressure, increased blood sugar levels and sleep disturbances were similar in the 2 groups. Values of PEFR for shisha smokers and cigarette smokers were not significantly different.
  
  
  CONCLUSIONS
  This study produced evidence suggesting that shisha smoking is not safer than cigarette smoking except with regard to complaints such as cough, chest pain and rapid heart rate, and that people who smoke both experience worse health effects in terms of frequent symptoms of respiratory infections, persistent cough, rapid heartbeat and sleep disturbances.
authors.affiliation: Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
authors.forename: Hamid
authors.initials: H
authors.lastname: Husain
authors.forename: Fahed
authors.initials: F
authors.lastname: Al-Fadhli
authors.forename: Fatima
authors.initials: F
authors.lastname: Al-Olaimi
authors.forename: Alshouq
authors.initials: A
authors.lastname: Al-Duraie
authors.forename: Ammar
authors.initials: A
authors.lastname: Qureshi
authors.forename: Waleed
authors.initials: W
authors.lastname: Al-Kandari
authors.forename: Amal K
authors.initials: AK
authors.lastname: Mitra
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D015438:Health Behavior; D006801:Humans; D007730:Kuwait; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D055815:Young Adult