Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature

Abstract

Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Methods: Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. Results: To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Conclusion: Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States.

Emerging adulthood themes and hookah use among college students in Southern California

“…The profile for hookah use may differ from that of cigarettes among emerging adults, requiring specific intervention programs and policies to curb further use (Haddad et al, 2015). For example, in contrast to combustible cigarette use, hookah has not been associated with mental health problems or stress among college students in the U.S (Goodwin et al, 2014).…”

“…The Food and Drug Administration (FDA) Family Smoking and Prevention Control Act specifies (Section 907, titled ‘Tobacco Product Standards’) a ban on flavored cigarettes, but does not currently include hookah tobacco (United States, 2009). Policies also allow tobacco companies the ability to market and sell hookah, and related products, to vulnerable populations like emerging adults (ages 18 to 25) (Haddad, El-Shahawy, Ghadban, Barnett, & Johnson, 2015). Lax tobacco control policies may have allowed for hookah use to grow in popularity in the U.S.…”

“…In the U.S., recent research demonstrated that 25% of emerging adults reported lifetime hookah use (Villanti, Cobb, Cohn, Williams, & Rath, 2015), and demonstrated that 10% of college students reported past 30-day use (Jarrett, Blosnich, Tworek, & Horn, 2012). A systematic review of the literature suggested that the majority of hookah smokers were unaware of its potential risks (Haddad et al, 2015), and research has suggested that emerging adults perceive fewer negative consequences of hookah use compared with combustible cigarette use (Holtzman, Babinski, & Merlo, 2013; Heinz et al, 2013). Low perception of harm and low perceived addictiveness were positively associated with hookah use in the past year among emerging adults (Primack, Sidani, Agarwal, Shadel, Donny, & Eissenberg, 2008).…”

Consensus statement on assessment of waterpipe smoking in epidemiological studies

“…In this setting, the café menu becomes perhaps an essential component of disclosing product constituents and associated health risks, given that smokers are served a ready-to-consume waterpipe and are not exposed to product packaging. [46][47][48] Our proposed policy/regulatory items therefore are only the first step for in-depth assessments that tap different policy/regulatory domains in a way that is compatible with unique waterpipe features and context (table 1).…”

Smoking Behavior in Arab Americans: A Systematic Review

“…It is well known that health disparities exist in the US, particularly among ethnic minorities [29]. Thus, in recent years, there has been a proliferation of research on human behaviors and practice based on minorities along with an emphasis from the National Institutes of Health (NIH) to have more minorities included in research [39]. In current health research, however, most acculturation studies are generally conducted with Hispanic or African American minorities [36].…”