A method for cancer elemental risk assessments in hookah: An example in two common types of traditional and flavored tobaccos in Iran

Aim: This study aimed to compare the elemental composition of traditional and flavored hookah tobacco, with a focus on heavy metals. Methods: We used inductively coupled plasma mass spectrometry (ICP-MS) to analyze the concentrations of 29 elements in the raw tobacco, tobacco ash, hookah water after smoking, and tobacco smoke. Results: The results showed that the traditional tobacco had significantly higher metal concentrations than the flavored tobacco in all samples. Most of the toxic metals (more than 98 %) remained in the smoke of both types of tobacco. The tobacco and hookah smoke contained high levels of harmful metals that can pose health risks to hookah users. • ICP-MS provides a comprehensive analysis of multiple elements simultaneously and it allows for precise quantification of metal concentrations in different samples. • ICP-MS requires specialized equipment and trained personnel and it may not detect elements present in extremely low concentrations.