Water-pipe Tobacco Components and their Association with Oxidative Stress.

Oxidative stress (OS) results from an imbalance between the formation and detoxification of reactive species. Although reactive species at low or moderate levels play numerous physiological roles, high concentrations can lead to disturbances in signaling and metabolic pathways and cause different metabolic, chronic, and age-related disorders. Several endogenous and exogenous processes may lead to the formation of reactive species. The severity of OS can be reduced with the help of antioxidants. Tobacco is one of the most important environmental factors contributing to reactive species production. After cigarette smoking, water-pipe tobacco (WPT) smoking is ranked as the second most popular tobacco product. Its popularity is proliferating due to flavored products, social acceptability, etc. However, studies have shown that WPT smoking is associated with an increased risk of arterial stiffness, ischemic heart disease, and several cancer types. In this study, we aimed to review the most recent evidence on WPT smoking constituents and their association with OS.