Rezk-Hanna M, et al. - Researchers determined the impact of hookah smoking on arterial stiffness in young healthy habitual hookah smokers who do not smoke cigarette smokers. Before and after ad lib hookah smoking, the participants were examined for heart rate, peripheral and central blood pressure, carotid-femoral pulse wave velocity (measure of arterial stiffness), aortic augmentation index (measure of wave reflection), plasma nicotine, and exhaled carbon monoxide (CO). Heart rate and mean brachial arterial pressure were increased with hookah smoking, but for the first time, it was shown that an acute increase in arterial stiffness was detected in young adult hookah smokers after a single hookah smoking session. This increase was comparable to what has been previously reported for cigarettes. These findings argue against effective media marketing of hookah as a safer alternative to cigarettes.