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Using the participant puffing patterns associated with use of the lower (6 mg/mL) nicotine concentration e-liquid from our previous study 31 , here we demonstrate that significantly more participants increased their daily aerosol yield exposure, formaldehyde exposure and acetaldehyde exposure in both the fixed (F) and adjustable (A) voltage settings

18 , 23 , 32 Cardiovascular disease and metabolic syndrome: Shisha smoking has been shown to increase the heart rate by 613 beats per minute, systolic blood pressure by 316 mm Hg, and diastolic blood pressure by 214 mm Hg in young and healthy individuals post smoking session and reported more coronary artery disease than among non-smokers (odds ratio for association of waterpipe smoking and heart disease was 1.67)

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