Background:
The evidence demonstrating the adverse health effects of shisha smoking is accumulating, however, data on the effect of shisha smoking on obesity and lipid profile arte still sparse.

Objective:
The present study investigated the relationship of shisha smoking with obesity and lipids.

Methods:
Body weight, BMI, total cholesterol (Tch), LDL, HDL, Tch/HDL, LDL/HDL, and triglycerides (Tri) were measured in 147 shisha smokers and 144 non-smokers. The smokers were subdivided according to smoking duration, those who smoked <10 years (shisha1), smoked 10–20 years (shisha2), and those who smoked >20 years (shisha3).

Results:
The ANCOVA demonstrated elevated obesity and lipid profile measures in shisha smokers versus non-smokers (p<0.01). Further comparisons showed greater (p<0.05) weight and BMI in the women who smoked for longer time, but not the men. Furthermore, Tch, LDL, Tch/HDL and LDL/HDL levels were elevated (p<0.05) in the men with longer smoking history, but not the women.

Conclusions:
The results demonstrate that gender and smoking duration impact the relationship of shisha smoking with obesity and lipid profile. The findings are unique and indicate that gender and smoking duration should be considered when designing cessation programs for shisha smoking. Moreover, the adverse health effects of shisha smoking are further confirmed.