Chami HA, et al. - Researchers examined a community-based sample including 175 exclusive water-pipe smokers and 170 nonsmokers, ≥ 35 years of age, to study the association of water-pipe smoking with coronary artery calcium (CAC, a marker of coronary heart disease [CHD] risk), by using regression analyses adjusted for CHD risk factors. The participants were recruited from the community in Lebanon and Qatar. A validated questionnaire was used to determine water-pipe smoking. Via multidetector CT scan, they evaluated CAC score. While accounting for other risk factors, they found the association of exclusive water-pipe smoking with the presence and extent of CAC, with twice the risk of having CAC and three times the risk of being in the high CHD risk category.