We hypothesize that WPS is associated with increased risk of vascular impairment. Tonometry and digital thermal monitoring (DTM) are non-invasive tests used to assess arterial stiffness and vascular function respectively. Impulse oscillometry (IOS) is used to assess pulmonary resilience/reactance. We proposed to conduct an experimental study on 60 waterpipe smokers (30 daily and 30 occasional) and 30 non-smokers from the young community (age 18-30 years old) in Beirut. Participants will be invited to AUBMC where WPS will be assessed using a standardized questionnaire. Height, weight, heart rate, blood pressure, tonometry, DTM, IOS and exhaled CO will be measured. Waterpipe smokers will be asked to smoke a waterpipe for 30 minutes in a nearby café using a “smart mabsam” to record their number of puffs and duration while never smokers will be invited to sit in the same environment with the smoker to evaluate the effect of second hand exposure to WPS for the same duration. Blood pressure, tonometry, DTM, IOS and exhaled CO will be reassessed after this session for all participants at AUBMC. Comparisons between before and after waterpipe exposure for all assessed measures will be done among each group. Analysis will also include comparisons between the three groups using their baseline measures.

 This study includes 90 healthy young adults aging between18 and 30 years old from Beirut split equally into three different groups who differ in their waterpipe smoking patterns: 30 never smokers (waterpipe/ cigarette/ cigar), 30 occasional waterpipe smokers (excluding cigarette and cigar smokers), 30 daily waterpipe smokers (excluding cigarette and cigar smokers) who have been smoking for more than a year.