Narghile known in different names as shisha, hookah, hubble-bubble, waterpipe has been smoked widely in Middle East countries traditionally and recently began to spread to European countries and USA. Narghile is consumed particularly by university youth in cafes as a social activity in Turkey. We report a case series of five patients presented with narghile induced carbon monoxide (CO) poisoning. We believe that this problem might be overlooked and underreported. We want to emphasize that, in the differential diagnosis of nonspecific neurological complaints (especially headache, nausea, vomiting and vertigo) CO poisoning must be considered and patient must be questioned about the usage of narghile smoking especially in areas popular of it.
WHO Study Group on Tobacco Product Regulation.TobReg advisory note: Waterpipe tobacco smoking: health effects, research needs and recommended actions by regulators.Geneva: World Health Organization Press, 2005.
2.
SubaşιN., BilirN., İlhanE., AvlukA., BavlιG., BitekerM.Nargile içenlerin nargile içme konusundaki bilgi, tutum ve davranιşlarι. Türk Toraks Dergisi2005; 6(2): 137–43.
KnishkowyB., AmitaiY.Water-pipe (narghile) smoking: an emerging health risk behavior. Pediatrics2005; 116(1): e113–9.
5.
ChaouachiK.Hookah (Shisha, Narghile) Smoking and Environmental Tobacco Smoke (ETS). A critical review of the relevant literature and the public health consequences. Int J Environ Res Public Health2009; 6(2): 798–843.
6.
PoyrazoğluS., SarliS., GencerZ., GünayO.Waterpipe (narghile) smoking among medical and non-medical university students in Turkey. Ups J Med Sci2010; 115(3): 210–6.
7.
UyanikB., ArslanE.D., AkayH., ErcelikE., TezM.Narghile (hookah) smoking and carboxyhemoglobin levels. J Emerg Med2009 (Epub ahead of print).
8.
LimB.L., LimG.H., SeowE.Case of carbon monoxide poisoning after smoking shisha. Int J Emerg Med2009; 2(2): 121–2.
9.
Al-MoamaryM.S., Al-ShammaryA.S., Al-ShimemeriA.A., AliM.M., Al-JahdaliH.H., AwadaA.A.Complications of carbon monoxide poisoning. Saudi Med J2000; 21(4): 361–3.
10.
CavusU.Y., RehberZ.H., OzekeO., IlkayE.Carbon monoxide poisoning associated with narghile use. Emerg Med J2010; 27(5): 406.
11.
MaloneyG.Carbon Monoxide. In: TintinalliStapczynski, MaCline, CydulkaMeckler, editors. Tintinalli's Emergency Medicine, 7th ed. The McGraw-Hill Companies, Inc: 2010: p. 1410–3.
12.
ChaouachiK.The medical consequences of narghile (hookah, shisha) use in the world. Rev Epidemiol Sante Publique2007; 55(3); 165–70.
13.
World Health Organization Regional Office for the Eastern Mediterranean.The health hazards of smoking shisha.2006.
14.
TamimH., MusharrafiehU., El RoueihebZ., YunisK., AlmawiW.Y.Exposure of children to environmental tobacco smoke (ETS) and its association with respiratory ailments. J Asthma2003; 40(5): 571–6.
15.
ShafagojY.A., MohammedF.I., HadidiK.A.Hubble-bubble (waterpipe) smoking: levels of nicotine and cotinine in plasma, saliva and urine. Int J Clin Pharmacol Ther2002; 40(6): 249–55.
16.
SerotaJ.A.A pack in 30 minutes. J Pediatr Health Care2007; 21(3); 180–1.
17.
ChaouachiK.Prevention and sporadic carbon monoxide poisoning related to shisha (hookah, narghile) tobacco smoking. J Emerg Med2010 (Epub ahead of print).
