Health warning labelling practices on narghile (shisha, hookah) waterpipe tobacco products and related accessories

Abstract

BackgroundWaterpipe tobacco smoking prevalence is increasing around the globe despite current evidence that smoke emissions are toxic and contain carcinogenic compounds.ObjectiveTo evaluate current health warning labelling practices on waterpipe tobacco products and related accessories.MethodsAll waterpipe tobacco products, as well as waterpipe accessories, were purchased from Lebanon and a convenience sample was obtained from Dubai (United Arab Emirates), Palestine, Syria, Jordan, Bahrain, Canada, Germany and South Africa.FindingsOf the total number of waterpipe tobacco products collected from Lebanon, the majority had textual health warning labels covering on average only 3.5% of total surface area of the package. Misleading descriptors were commonplace on waterpipe tobacco packages and related accessories.ConclusionsThere are no WHO FCTC compliant waterpipe-specific health warning labels on waterpipe tobacco products and related accessories. Introducing health warnings on waterpipe tobacco products and accessories will probably have worldwide public health benefits.

Shisha Smoking and Associated Factors among Medical Students in Malaysia

“…In reality, shisha smoke is just as dangerous as cigarette smoke (Knishkowy and Amitai, 2005). As compared to a single cigarette, shisha smoke contains even higher level of metals such as arsenic, lead, and nickel, 36 times more tar, 15 times more carbon monoxide and nicotine (Knishkowy and Amitai, 2005 Nakkash and Khalil, 2010). Some studies claim a session of shisha smoking produces the same levels of cotinine, a nicotine metabolite, as smoking two cigarettes daily (Neergard et al, 2007).…”

Graphic health warnings and their best position on waterpipes: A cross-sectional survey of expert and public opinion

“…Some studies have suggested that GHWs should be placed on the waterpipe device itself 25,40 . Turkey has gone a step further, requiring that health warnings be placed on the waterpipe's effect that smoking status might have on the effectiveness of GHW location, our study did not aim to test different subgroups such as women and young adults.…”

“…Turkey has gone a step further, requiring that health warnings be placed on the waterpipe's effect that smoking status might have on the effectiveness of GHW location, our study did not aim to test different subgroups such as women and young adults. As WPS rates are increasing and attracting more youth and women, the effectiveness of the design, content, and position of GHWs needs to be assessed in these groups 1,17,25,45 . Our study focused mainly on the visibility of GHWs, but it did not investigate quit intention and quit attempts as a result of seeing the warnings.…”

“…Placement of GHWs on waterpipes and their accessories is still substandard. In 2010 a study investigated health warning labelling practices on waterpipes and accessories (mouthpieces, filters, charcoal and aluminum foil) in different countries and found that only filters had health warnings, of which fewer than half had a clear GHW 25 . Most waterpipe users smoke at cafés and typically choose the flavour of tobacco from options offered on a menu.…”

Review of hookah tobacco smoking among college students: policy implications and research recommendations

“…The misperception that hookah tobacco is a safe non-cigarette product is perpetuated by the inaccurate labeling in which tar and nicotine levels are listed as negligible (20). In addition, hookah tobacco packages are devoid of health warning labels (21). Indeed, the full complement of hookah tobacco ingredients are unknown (22).…”