Waterpipe tobacco smoking, otherwise known as 'hookah' or 'shisha,' is becoming increasingly popular worldwide, especially among youth. Traditional hookahs burn charcoal as a heat source, but recently, electrical heating elements (EHEs) have been introduced to the market. Reinforced by product advertising and package labeling, many hookah smokers believe that EHEs are less harmful than charcoal. Now, researchers report that although EHEs reduce some toxicants, they increase others.