increasing rates and unequitable resources 2 .
Tobacco smoke is the most important human carcinogen and passive and active smoking is among the known risk factors of breast cancer 1 . Although consistent evidence exists for a moderate increase in the risk of breast cancer in women who smoke tobacco 23 , much less is known about potential association between waterpipe smoking and breast cancer risk. Waterpipe (also known as hookah, hubblebubble, narghile, shisha, borry or goza) is a form of tobacco consumption that the smoke bubbles through water before reaching the smoker.
The highest rates of waterpipe use have been reported from the Middle East, Asia and Africa, but it has rapidly become an emerging problem in the United States as well as Europe 4 . The reasons for increasing popularity include misconceptions about safety (in comparison to cigarette smoking) as the smoke passes through water, introduction of flavoured tobacco, social acceptability and lack of waterpipespecific control policy and regulations 56 . Women and young people seem more likely to be choosing waterpipe over cigarettes, with the prevalence surpassing cigarette smoking in some areas 6 . These studies are alarming and call for an urgent need for increasing awareness among women and promoting research in this area.