The effect of waterpipe smoking on psychomotor performance required for driving: A quasi-experimental trial

Objective: The main objective of this study was to find out whether there is a causal relationship, beyond statistical association, between waterpipe smoking (WPS) and driving performance. Methods: This quasi-experimental study included 22 male students aged 18-22 years who possessed driving license and had a history of WPS and regularly smoked waterpipe for 1-2 times/week or smoked 2-15 cigarettes per week. Using Vienna Test System (VTS) traffic battery tests, each score was measured four times: 1.1: on the first day without (before) WPS, 1.2: the same day after WPS, 2.1: the second day after WPS and 2.2 the second day without WPS (after the effect of smoking was washed out). IBM SPSS 21, STATA 13.1 and PASS 11 software were used for statistical analysis. Results: WPS significantly improved two hands coordination, attention and concentration, reactive stress tolerance and reaction speed. We did not find any effects on visual observational ability, obtaining an overview, visual orientation ability or speed of perception. Conclusion: The performance-enhancing effects of WPS observed in this study do not justify the use considering the proved long-term health effects. Moreover, our study did not deal with the long term effects of WPS on road traffic injuries. Further studies are necessary to examine if WPS renders drivers to engage in other risk taking activities such as driving in a high speed due to altered cognitive functions.