Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic

Abstract

Context:The global tobacco epidemic may kill 10 million people annually in the next 20–30 years, with 70% of these deaths occurring in developing countries. Current research, treatment, and policy efforts focus on cigarettes, while many people in developing regions (Asia, Indian subcontinent, Eastern Mediterranean) smoke tobacco using waterpipes. Waterpipes are increasing in popularity, and more must be learned about them so that we can understand their effects on public health, curtail their spread, and help their users quit.Objective:To conduct a comprehensive review regarding global waterpipe use, in order to identify current knowledge, guide scientific research, and promote public policy.Data sources:AMedlinesearch using as keywords “waterpipe”, “narghile”, “arghile”, “shisha”, “hookah”, “goza”, “hubble bubble” and variant spellings (for example, “hooka”; “hukka”) was conducted. Resources compiled recently by members of GLOBALink were used.Study selection:Every identified published study related to waterpipe use was included.Data synthesis:Research regarding waterpipe epidemiology and health effects is limited; no published studies address treatment efforts. Waterpipe use is increasing globally, particularly in the Eastern Mediterranean Region, where perceptions regarding health effects and traditional values may facilitate use among women and children. Waterpipe smoke contains harmful constituents and there is preliminary evidence linking waterpipe smoking to a variety of life threatening conditions, including pulmonary disease, coronary heart disease, and pregnancy related complications.Conclusions:More scientific documentation and careful analysis is required before the spread of waterpipe use and its health effects can be understood, and empirically guided treatment and public policy strategies can be implemented.

Why do GDPs fail to recognise oral cancer? The argument for an oral cancer checklist

“…Links have been made to many of the same adverse health effects, including lung, oral and bladder cancer, as well as clogged arteries and heart disease. 7 An analysis of mainstream smoke from waterpipes found that it contains significant amounts of nicotine, tar and heavy metals. 8 A study of nicotine and cotinine (a chemical marker of nicotine exposure) levels in hookah smokers found high amounts of both chemicals after one session of hookah use.…”

“…Shared mouthpieces and the heated, moist smoke may enhance the opportunity for such diseases to spread. 13 Also, although limited research has been done in this area, the secondhand smoke from a waterpipe is potentially dangerous because it contains smoke from the tobacco itself as well as the smoke from the heat source used to burn the tobacco. 14 More investigation is certainly needed to determine the health effects of both long-and shortterm waterpipe use, as well as the relative risk of waterpipe use compared to other forms of tobacco use.…”

Les teneurs en CO dans les bars à chicha : étude de cas à Paris en fonction de la consommation et de la ventilation des locaux

“…Enfin, le CO a été choisi parce que sa mesure avec des capteurs portables est relativement fiable et facile à réaliser. Plusieurs travaux montrent que les teneurs en CO mesurées dans les bars à chicha sont relativement élevées [4,16,17]. Ces études, basées essentiellement sur une comparaison avec les émissions dues aux cigarettes, montrent quelques disparités : d'après l'OMS [4], une séance d'un fumeur de narguilé peut l'exposer à un volume de fumée correspondant à celui émis par un nombre de cigarettes compris entre 40 et 100.…”

“…D'autres mesures montrent que l'augmentation du monoxyde de carbone expiré à la fin d'une session de chicha est équivalente à celle observée lors de la consommation de 30 à 40 cigarettes [17]. Thomas Eissenberg, Professeur de psychologie à l'Université de Virginia Commonwealth, écrit qu'une session durant approximativement 45 minutes délivre 15 fois plus de monoxyde de carbone, qu'une seule cigarette [16]. Au-delà des divergences entre ces résultats, qui traduisent surtout des protocoles de mesure hétérogènes, il apparaît que dans tous les cas la chicha est à l'origine d'une forte pollution au CO. Les vingt « campagnes » de mesures effectuées à Paris montrent des teneurs en CO relativement élevées.…”

“…En effet, selon Hauffmann et Hauffmann [18] [18]. Nous ajoutons qu'une session de chicha, durant approximativement 50 minutes, délivre 36 fois plus de goudron et 70 % de nicotine en plus qu'une seule cigarette [16]. En outre, la fumée du charbon utilisé pour faire brûler le tabac a également un impact sur la santé : les charbons produisent, en plus du CO, des métaux et des substances cancérigènes [4].…”