Abstract
BackgroundThe prevalence of waterpipe tobacco smoking (WTS) in the Middle East region and worldwide is increasing. There is evidence to indicate both short term and long term health effects of WTS, resulting in the issuance of an advisory note by the World Health Organization.MethodsThis research aimed at gaining an in-depth understanding of the factors contributing to the rise in WTS in Lebanon. Qualitative focus groups (25) and in-depth interviews (9) were conducted with adults in Lebanon in 2007. Participants were recruited to represent diversity in smoking status, gender, age groups and urban/rural residence. The interviews and focus groups were thematically analyzed, and recurrent themes noted and summarized.ResultsThe main themes identified were availability, affordability, innovation, influence of media, lack of a policy framework, and the sensory characteristics evoked from WTS. Men and women, smokers and non-smokers, and younger and older participants differed in their emphases on the above themes. These themes, though specific to waterpipe, are similar to themes manipulated by the cigarette industry, and eventually controlled through tobacco control policies.ConclusionsUnderstanding reasons behind the rise in waterpipe tobacco use is important if appropriate prevention, cessation, and policy interventions are to be formulated. Strict adherence to the FCTC is warranted, with careful and vigilant attention that all tobacco products are covered by laws in both high as well as middle to lower income countries.
Highlights
The prevalence of waterpipe tobacco smoking (WTS) in the Middle East region and worldwide is increasing
Global Youth Tobacco Survey (GYTS) results evaluating the trends of tobacco use among 13-15 year olds between 1999 and 2008 indicated that in all countries of the Arab region, use of tobacco products other than cigarettes was more common than use of cigarettes [4]
Participants identified the themes of availability, affordability, innovations in design, sensory qualities of WTS smoking, media influence, and policy
Summary
The prevalence of waterpipe tobacco smoking (WTS) in the Middle East region and worldwide is increasing. The prevalence of waterpipe (aka narghile, shisha, hookah) tobacco smoking (WTS) in the Middle East region and worldwide is increasing [1]. In Lebanon, the Global Youth Tobacco Survey (GYTS), administered to 13-15 year olds in 2005, indicated that 59.8% smoked other forms of tobacco (most likely waterpipe) at least once in the past month as opposed to 10% cigarettes. GYTS results evaluating the trends of tobacco use among 13-15 year olds between 1999 and 2008 indicated that in all countries of the Arab region, use of tobacco products other than cigarettes (most likely waterpipe) was more common than use of cigarettes [4]. In the UK, in a cross-sectional survey of students of Birmingham University, WTS was recognized as an impending public health threat as 37.9% of students had ever tried waterpipe and 8.0% were regular smokers, as compared to 9.4% regular cigarette smokers [6]
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