Chemical characterization and safety assessment of dokha: An emerging alternative tobacco product

Elsayed, Yehya; Dalibalta, Sarah; Kouche, Maissam El

doi:10.1016/j.scitotenv.2017.09.255

Cited by 20 publications

(32 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Daily e-cigarette users were able to list reasons for liking and not liking e-cigarettes, including significant health effects in the latter category 21. Despite these effects, participants still tended to erroneously5 7 24 perceive midwakh smoking as a healthier alternative to cigarettes.…”

Section: Discussionmentioning

confidence: 99%

“…While cigarettes are the most common type of tobacco used,2 other forms are on the rise 3 4. Dokha, a form of dried tobacco leaves smoked in a pipe called a midwakh, is increasing in popularity in the Arab world 5. Research on the epidemiology, determinants and health effects of midwakh use is nascent, but provides evidence that midwakh smokers may be at risk of tobacco-related diseases comparable to that of cigarette smoking 4 6 7.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

‘When I smoked it, it was like a slap in the face but it felt really good’: exploring determinants of midwakh use among young adults in Lebanon

2020

View full text Add to dashboard Cite

BackgroundDokha (‘dizziness’ in English) is a type of alternative tobacco product (ATP) increasing in popularity in the Arab world; and smoked in a pipe called a midwakh. Midwakh use is common among nationals in the United Arab Emirates (UAE); yet, evidence indicates its spread among expats in the UAE as well as beyond the UAE. Research on midwakh use is nascent, and no qualitative research has been published. This paper explored the context and determinants of midwakh use among young adults in Lebanon using qualitative methods.MethodsWe conducted four focus group discussions with 18 midwakh ever smokers aged 18–25 years in Lebanon. Discussions were recorded, transcribed and thematically analysed using the Pragmatics, Attraction, Communication, Expectations framework.Results‘Pragmatics’ was evident in participants’ comments about availability of a supply of dokha. For ‘attraction’, participants described why they prefer midwakh smoking and compared it to other ATPs. Regarding communication, participants shared terms used to describe their use of midwakh (eg, ‘buzz’/taking a hit). Participants also described expectations from smoking midwakh, including stress relief.ConclusionMidwakh smoking is appealing to young adults due to factors such as the ‘buzz’, perceived harm reduction, stress relief and its ability to satisfy nicotine craving with small amounts of tobacco. As a result, despite experiencing negative effects on first use, young adults choose to continue to use midwakh, and find it hard to quit. These results have implications for prevention and control of midwakh smoking among young adults. Framework Convention on Tobacco Control guidance documents to address ATPs are critically needed to prevent the global spread of yet another tobacco product.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

‘When I smoked it, it was like a slap in the face but it felt really good’: exploring determinants of midwakh use among young adults in Lebanon

2020

View full text Add to dashboard Cite

show abstract

“…Three different dokha samples were collected from North Africa and the Middle East. The analysis of these samples revealed many toxic metals, 22 different irritants, three carcinogenic compounds, 5 CNS depressants, and other numerous harmful compounds with various effects (5).…”

Section: Discussionmentioning

confidence: 99%

“…While there is scant evidence regarding the impact dokha has on a person's health, health officials are nonetheless concerned about dokha as a praised, better alternative to cigarettes (4). Also, preliminary studies discovered high concentrations of tar and nicotine in dokha; moreover, the initial analysis of dokha smoke has detected high toxins levels (5). However, the effects of midwakh on the central nervous system (CNS) are still ambiguous and require further research.…”

Section: Introductionmentioning

confidence: 99%

Midwakh (pipe) and seizure: The overlooked link

Eid

2021

J Emerg Pract Trauma

View full text Add to dashboard Cite

Objective: Numerous drugs and medications from various pharmacological classes can lead to seizures as an unwanted side effect. Midwakh is a pipe commonly used to smoke tobacco blend in small quantities. Midwakh use is increasing, especially among young people. Case Presentation: A 17-year-old patient with a history of seizures was provoked by smoking midwakh, despite having no previous disease history. Conclusion: Although the patient had a negative workup for epilepsy, midwakh should be classified as an epileptogenic drug. More studies need to be conducted on the effects of midwakh on the neurological system.

show abstract

“…It also is possible that the high nicotine content of midwakh was responsible for seizures in seven otherwise healthy 14 to 27 year olds with no history of other drug use, and in all of whom the seizures resolved after midwakh cessation [11]. Further, a recent chemical analysis of dokha tobacco found levels of nitrogen, heavy metals and other compounds known to be harmful to human health including carcinogens, central nervous system depressants, and irritants [12].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, attitudes, behaviours and policy evaluation of midwakh smoking among young people in the United Arab Emirates: Cross-sectional analysis of the Global Youth Tobacco Survey

Jawad

Al-Houqani²,

Ali

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

Introduction Non-cigarette tobacco products are an increasing public health concern globally. Little is known about midwakh, a pipe indigenous to the United Arab Emirates (UAE). This study aimed to assess the prevalence, attitudes, behaviours and policy evaluation of midwakh smoking among 13 to 15 year olds in the UAE. Methods We conducted secondary analyses of the 2013 UAE Global Youth Tobacco Survey. The main three outcomes were ever use, current use (past-30 days), and the number of midwakhs smoked per day. We assessed cessation, attitude, and policy measures. Regression models identified the association between each outcome measure and sex, school grade, nationality, weekly spending money, cigarette use, and parent and peer tobacco use. Results The prevalence of ever and current midwakh use were 18.5% and 9.0%, respectively. Daily midwakh users smoked a median of 8.0 per day while non-daily users smoked 3.8 per month. Higher midwakh prevalence was reported among wealthier males, older age groups, concurrent cigarette users and among participants having peers or parents who use tobacco. There was also variation by nationality. Reduced harm perception was greater among midwakh users than non-users. About 39.6% reported being declined a midwakh purchase due to age, and 35.5% reported noticing health warnings on packages. Conclusions Midwakh use is prevalent among 13 to 15 year olds in the UAE, and burden lies mainly with daily users. Further needed research should not delay implementation and evaluation of policies known to curb tobacco use among youth, including taxation, media campaigns, and provision of cessation services.

show abstract

Chemical characterization and safety assessment of dokha: An emerging alternative tobacco product

Cited by 20 publications

References 15 publications

‘When I smoked it, it was like a slap in the face but it felt really good’: exploring determinants of midwakh use among young adults in Lebanon

‘When I smoked it, it was like a slap in the face but it felt really good’: exploring determinants of midwakh use among young adults in Lebanon

Midwakh (pipe) and seizure: The overlooked link

Prevalence, attitudes, behaviours and policy evaluation of midwakh smoking among young people in the United Arab Emirates: Cross-sectional analysis of the Global Youth Tobacco Survey

Contact Info

Product

Resources

About