Background and Aim : Water pipe smoking has become a public health hazard. The aim of this study was to measure and compare the concentration of salivary cotinine in cigarette smokers, water pipe smokers and nonsmokers .

  Materials and Methods : Forty-eight volunteers (16 cigarette smokers, 16 water pipe smokers and 16 nonsmokers) participated in this cross-sectional study. High sensitivity Salivary Cotinine Quantitative enzyme immunoassay kit was used to measure the salivary cotinine concentration. Non-parametric Kruskal Wallis test, Pearson’s correlation coefficient and linear regression were used to determine the correlation between number of cigarettes smoked and concentration of cotinine .

  Results : The mean concentration of salivary cotinine was 223.74(±181.56) ng/ml (the highest) in cigarette smokers, 106.24 (±135.23) ng/ml in water pipe smokers and 0.73(±1.24) ng/ml in nonsmokers. The difference in this respect among the 3 groups was statistically significant (P<0.0001). In smokers, the level of salivary cotinine increased by 1.84 ng/ml per each time of cigarette smoking per week. This increase was 14.57 ng/ml per each time of water pipe consumption per week .

  Conclusion : The mean concentration of salivary cotinine was significantly higher among cigarette smokers compared to water pipe smokers and nonsmokers. However, one time consumption of water pipe caused a greater rise in salivary cotinine level compared to cigarette smoking .