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Although the AHA has published policy statements on smokeless tobacco and e-cigarettes, to date, no AHA scientific statement has addressed the cardiovascular impact of water pipe tobacco smoking, Bhatnagar, the professor of medicine and the director of the Diabetes and Obesity Center at the University of Louisville School of Medicine, and colleagues wrote in the statement

The chance of people who smoke one cigarette a day of developing coronary heart disease and stroke is around half that of smokers who puff 20 a day, the researchers concluded

If we then have physiological evidence to show how smoking might cause the disease, then this adds up to strong evidence that smoking does indeed cause the disease

Of course, this is far from everything you may need or want to know but it's a start