For a country already facing a heavy burden of cancer, chronic lung disease, heart disease and stroke linked to smoking, the emergence of unregulated products marketed as healthy alternatives could create a new public health challenge
The Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), through its Assembly on Smoking Addiction, has published a series of guidelines and recommendations on how and where to carry out these interventions.6-8 Other Spanish scientific associations have participated in these recommendations or have even produced their own guidelines.8-10 A large number of evidence-based guidelines and recommendations for the clinical treatment of tobacco addiction have been published in other countries.1,11-15 All of these documents propose different kinds of interventions, depending on the greater or lesser motivation of the patient to make a serious attempt to stop smoking, and report on the efficacy and efficiency of different approaches using evidence-based medical criteria
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3,4 Compared to cigarettes, waterpipe users inhale higher carbon monoxide levels and 1.7 times the dose of nicotine
