Akl et al. BMC Public Health 2011, 11:244 http://www.biomedcentral.com/1471-2458/11/244 and RH contributed to screening. JI contributed to drafting the protocol and designing the search strategy. All authors revised the article critically for important intellectual content and approved its final version. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. EAA is the guarantor. All authors read and approved the final draft. Competing interests The authors declare that they have no competing interests. Received: 11 August 2010 Accepted: 19 April 2011 Published: 19 April 2011 References 1. Chaouachi K: The medical consequences of narghile (hookah, shisha) use in the world. Revue d Epidemiologie et de Sante Publique 2007, 55:165-170. 2. An Emerging Deadly Trend: Waterpipe Tobacco Use. American Lung Association; 2007. 3. 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