Options for waterpipe product regulation: A systematic
review on product characteristics that affect attractiveness,
addictiveness and toxicity of waterpipe use
Abstract:In this paper, we will refer to 'waterpipe product' as a collective term that includes tobacco and flavored herbs, with or without nicotine. We will refer to the act of waterpipe smoking as 'waterpipe product smoking' (WPS). In line with this, 'waterpipe product' and 'waterpipe product smoke' will refer to ABSTRACT INTRODUCTION Despite its known adverse effects on human health, waterpipe smoking is increasing in popularity worldwide. However, compared to cigarettes, regulation of waterpipe product smoking lags… Show more
“…Flavor was by far the most mentioned attractive aspect of e-cigarettes. Flavor has also been cited as the most appealing aspect of waterpipe use among youths [22] as well as flavored or menthol cigarettes sold in the US [23].…”
In line with the global trends, electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs) have found their way to the Lebanese market. The present study aims to explore the determinants of e-cigarette and HTP use among young adults in Lebanon. Convenience and snowball sampling were used to recruit participants aged 18–30 residing in Lebanon, who were familiar with e-cigarettes products. Twenty-one consenting participants were interviewed via Zoom and the verbatim transcriptions were analyzed thematically. The outcome expectancy theory was used to categorize the results into determinants and deterrents of use. HTPs were viewed by participants as another mode of smoking. The results showed that most participants perceived e-cigarettes and HTPs to be healthier alternatives to cigarettes/waterpipes and to be used as smoking cessation tools. Both e-cigarettes and HTPs were found to be easily accessible in Lebanon; although, in the recent economic crisis, e-cigarettes have become unaffordable. More research is needed to investigate the motivations and behaviors of e-cigarette and HTP users if effective policies and regulations are to be developed and enforced. Furthermore, greater public health efforts need to be made to increase awareness of the harmful impacts of e-cigarettes and HTPs and to implement evidence-based cessation programs tailored to those modes of smoking.
“…Flavor was by far the most mentioned attractive aspect of e-cigarettes. Flavor has also been cited as the most appealing aspect of waterpipe use among youths [22] as well as flavored or menthol cigarettes sold in the US [23].…”
In line with the global trends, electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs) have found their way to the Lebanese market. The present study aims to explore the determinants of e-cigarette and HTP use among young adults in Lebanon. Convenience and snowball sampling were used to recruit participants aged 18–30 residing in Lebanon, who were familiar with e-cigarettes products. Twenty-one consenting participants were interviewed via Zoom and the verbatim transcriptions were analyzed thematically. The outcome expectancy theory was used to categorize the results into determinants and deterrents of use. HTPs were viewed by participants as another mode of smoking. The results showed that most participants perceived e-cigarettes and HTPs to be healthier alternatives to cigarettes/waterpipes and to be used as smoking cessation tools. Both e-cigarettes and HTPs were found to be easily accessible in Lebanon; although, in the recent economic crisis, e-cigarettes have become unaffordable. More research is needed to investigate the motivations and behaviors of e-cigarette and HTP users if effective policies and regulations are to be developed and enforced. Furthermore, greater public health efforts need to be made to increase awareness of the harmful impacts of e-cigarettes and HTPs and to implement evidence-based cessation programs tailored to those modes of smoking.
“…In Deutschland darf der Gehalt an Feuchthaltemittel Feuchthaltemittel entsprechend der Tabakverordnung maximal 5 % bezogen auf die Trockenmasse betragen [ 17 ]. Die große Vielfalt zugesetzter Aromen Aroma macht dieses Produkt v. a. für junge Menschen attraktiv und suggeriert unschädliches Rauchen [ 18 , 19 ]. Neben Tabak werden beim Shisharauchen immer häufiger „steam stones“ „Steam stones“ (Dampfsteine) aus mit Glyzerin oder Propylenglykol sowie Aromen getränktem porösem anorganischem Trägermaterial oder Shishapasten Shishapaste aus Glyzerin, Diatomeenerde, Aroma- und Farbstoffen eingesetzt [ 20 ].…”
Der Konsum inhalativer psychotroper Substanzen ist in unserer Gesellschaft weit verbreitet. Neben der Vielzahl an tabakhaltigen Rauchwaren werden E‑Zigaretten, Cannabis, Schnüffelstoffe sowie Kokain und Heroin inhalativ konsumiert. Die schädigenden pulmonalen Auswirkungen sind zwar für die meisten tabakhaltigen Rauchwaren hinreichend erforscht, für viele andere inhalativ konsumierte Substanzen mangelt es jedoch noch an wissenschaftlich fundierten Erkenntnissen. Insbesondere für die neuartigen Produkte wie E‑Zigaretten und Tabakerhitzer fehlen unabhängige standardisierte Daten, die ein suggeriertes geringeres gesundheitliches Risiko im Vergleich zu herkömmlichen Zigaretten belegen. Auch bezüglich langfristiger Folgen von Cannabiskonsum auf Lunge und Atemwege sind eindeutige Schlussfolgerungen derzeit nicht ausreichend möglich. Für den inhalativen Gebrauch von Kokain und Heroin hingegen wurden insbesondere bei ausgiebigem und chronischem Konsum erhebliche Schädigungen der Lunge belegt.
“…In their review paper, KIENHUIS et al [63] recommended including all waterpipe products in tobacco-product regulations and smoking bans in order to ban waterpipe molasses, mandate dissemination of information on all waterpipe tobacco elements to the national regulator, and prescribe testing to regulate contents of waterpipe smoking products and heating sources. In addition, the World Health Organization (WHO) recommends reinforcing the need for proper regulation and documentation of effective practices [64].…”
Section: Legalisation and Regulation Of Waterpipementioning
confidence: 99%
“…Thus many aspects of waterpipe smoking require further research, as recommended by WHO [63], including but not limited to: the types and patterns of smoking across regions and countries, the pharmacology and toxicology in laboratory and in real-world use, the epidemiology of waterpipe smoking and associated risks of disease, and prevention and cessation strategies.…”
Waterpipe smoking is an old form of tobacco smoking, originating in Persia and the Middle East. The popularity of the waterpipe is increasing worldwide, particularly among young adults, and there are widespread misconceptions regarding its negative health effects. The inhaled smoke of the waterpipe contain several toxic and hazardous materials including nicotine, tar, polyaromatic hydrocarbons and heavy metals, all of which are proven to be related to lung diseases and cancer. Regular waterpipe smoking is associated with respiratory symptoms, a decrease in pulmonary function and increased risk for lung disease such as COPD. Additional negative health effects include increased risk for arterial stiffness, ischaemic heart disease and several cancer types including lung cancer. This review summarises the negative health effects of waterpipe smoking, with emphasis on cardiorespiratory complications. Increased awareness and knowledge amongst healthcare professionals will hopefully help identify waterpipe smokers and promote patient education. Applying World Health Organization (WHO) regulations will provide a synergistic effect in reducing waterpipe use and associated disease.
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