Comparing Immediate Physiological Responses and Future Intentions of Use between Combustible and Electronic Waterpipe Users.

•First known study comparing health effects of combustible and noncombustible waterpipe smoking.•Significantly larger increases in carbon monoxide and heart rate after smoking TWP compared to EWP.•FEV1 levels did not significantly change after smoking TWP or EWP.•69.4% felt positive about smoking EWP and believed EWP was safer and less addictive than TWP.•This study was not able to conclude that EWP is a safer alternative to TWP as it is perceived to be.