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Tob Control. 2015 Sep;24(5):509-13. doi: 10.1136/tobaccocontrol-2014-051675. Epub 2014 Jul 22.

How popular is waterpipe tobacco smoking? Findings from internet search queries.

Author information

  • 1Department of Health Services Policy and Management, Arnold School of Public Health University of South Carolina, Columbia, South Carolina, USA.
  • 2Department of Health Promotion, Education, and Behavior, Arnold School of Public Health University of South Carolina, Columbia, South Carolina, USA.
  • 3Department of Epidemiology, Stempel College of Public Health and Social Work Florida International University, Miami, Florida, USA Syrian Center for Tobacco Studies, Aleppo, Syria.



Waterpipe tobacco smoking (WTS), a traditional tobacco consumption practice in the Middle East, is gaining popularity worldwide. Estimates of population-level interest in WTS over time are not documented. We assessed the popularity of WTS using World Wide Web search query results across four English-speaking countries.


We analysed trends in Google search queries related to WTS, comparing these trends with those for electronic cigarettes between 2004 and 2013 in Australia, Canada, the UK and the USA. Weekly search volumes were reported as percentages relative to the week with the highest volume of searches.


Web-based searches for WTS have increased steadily since 2004 in all four countries. Search volume for WTS was higher than for e-cigarettes in three of the four nations, with the highest volume in the USA. Online searches were primarily targeted at WTS products for home use, followed by searches for WTS caf├ęs/lounges.


Online demand for information on WTS-related products and venues is large and increasing. Given the rise in WTS popularity, increasing evidence of exposure-related harms, and relatively lax government regulation, WTS is a serious public health concern and could reach epidemic levels in Western societies.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to


Global health; Non-cigarette tobacco products; Surveillance and monitoring

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