Kamal Chaouachi (pronounced "sha-wa-shi"). Researcher interested in complex issues, particularly those related to the health of populations, as hookah smoking is (a "global epidemic" according to the WHO). After 15 years of research in this field, he has privileged what he sees as the most relevant approach to the issue: medical anthropology. Solid hard-scientific background (in physics, chemistry, thermodynamics and electronics, studied for more than 4 years at university). Holder of a post-graduate diploma in Tobacco Science from the University of Paris (1998). Author of a 420-page 850-substantial-footnote comprehensive transdisciplinary doctoral thesis, sealing 5 years of research and bridging between social and biomedical sciences. Native of Tunisia-Middle East. Taught hookah science (what sound science says about hookah) to French doctors (University of Paris XI-XII, 2006-2010). Scientific collaborator of various research centres in Asia, Africa and Europe. Bibliographical Profile. Interview on world tobacco policy [Interview en FRANCAIS ici], [Interview Italiano 2013 (Controcampus)] and New 2010 (SciTopics). Exclusive Article (2012): Ten Great Myths about Hookah Smoking & Public Health. Click to get this page translated into : Arabic ; Spanish ; French.
2013. Times are a changing... Interestingly, the new creed is that “hookah smoking carries many of the same health risks and has been linked to many of the same diseases caused by cigarette smoking” (American Lung Association). Not only is such a statement in full contradiction with the substance of the ««waterpipe»» literature over the last half decade, but is it also totally antiscientific and even more deceitful than the previous ones.
Plagiarism & Metaplagiarism: In France, an extensive part of this work was plagiarised in the form of a “"book"” titled "Tout ce que vous ne savez pas sur la chicha" (Editions MARGAUX-ORANGE). Its "authors" are Bertrand Dautzenberg, president of OFT (Office Français du Tabagisme), the French top national antismoking authority, and Jean-Yves Nau, columnist with Le Monde national newspaper and collaborator of Revue Médicale Suisse ( type “nau jy” here) with drawings by "Charb", i.e. Stéphane Charbonnier from the "Charlie Hebdo" journal. The above publisher (Stéphane Arbouze, Dir. Editions MARGAUX-ORANGE, whose products are financially supported by the great names of the Pharmaceutical Industry [browse its site]) defends such a practice and ""peer-reviewed"" articles (Jacques Prignot, Annie Sasco et al. in International Journal of Tuberculosis and Lung Disease; Becquemin et al. in Revue des Maladies Respiratoires) have openly cited this great fraud. Evidence here : Letter published in a peer-reviewed biomedical journal (English and Italian) and comparative table there. NEW:Supporting Editorial by Tabaccologia. In Belgium, Jean Paul Vooren, "Editeur responsable"(sic) of FARES, has then marketed a laundered recycled version of the above ""book"", ""peer-reviewed"" by Jacques Prignot and Pierre Nys. Such a deed qualifies for Metaplagiarism (Metaplagiat).
Funding & competing interests: none/zero vs. $ 10 MILLION for antismoking research backed by the pharmaceutical industry (nicotine patches, gums, Chantix, etc.). The marketing label of the latter is easy identifiable: ““waterpipe””. By Spring 2011, we identified a new source of funding: the Tobacco Industry (cigarettes) itself... Read Big Tobacco & Big Pharma Against "Oriental" Hookah Outsider. See our detailed acknowledgement (with pictures...) of our potential competing Interests. This is not all (2012). See HERE how the US-Syrian & US-Lebanese ««waterpipe»» prohibitionist group (Wasim MAZIAK/Thomas EISSENBERG/Alan SHIHADEH/Kenneth WARD/Jack HENNINGFIELD/GLOBALINK) has recently intended to block the (non-US, i.e. not their money) funding of an independent Harm Reduction Project. Their only “scientific” arguments were that "Harm Reduction doesn't work" and that KC is a key researcher in the project...
An important note about their “methods”(apart from "classical" plagiarism, systematic bias, facts twisting and forging of "evidence", pressures on Editors): for almost each of our publications of importance, the ««waterpipe»» antismoking group (mainly: Maziak, Shihadeh, Eissenberg, authors of the WHO flawed report) has pressured Editors & Journals in a desperate intent to get each of them them UN-PUBLISHED. Just one example (among many) about a disturbing paper exposing the fallacy of the manipulation through so-called ««systematic reviews»»: (full details here).
Last but not least: The below list represents “the tip of the iceberg” only... When confusion is spreading (on purpose) like fire, listen to Reason (Jacob SULLUM)... When chaos in this field has become global and science turned authoritarian in this unbalanced unconventional showdown, Letters to the Editors are a moral duty and always a victory on censorship and totalitarianism (cf. lessons from the so-called ““Arab Spring””). For example, an important short Letter in the British Journal of Cancer (2013) exposes One Decade of Tricks & Scientific Misconduct on Behalf of «Waterpipe»» «Tobacco Control» Researchers
Abstract: http://www.amazon.fr/Savoir-Narguile-Societe-Culture-Histoire/dp/2296966209
Brochure in English :
http://docs.google.com/Doc?id=dgbz283m_19f97ts3
Brochure en français:
https://docs.google.com/View?docid=dgbz283m_23f696g4
Abstract: A recent short though important article exposes one full decade of numerous serious methodological errors published in the ""waterpipe"" biomedical literature [1]. Not only have these errors remained uncommented for a so long period but they have also been (and still are they) cited again and again... Never before or elsewhere in the biomedical research field had global confusion reached such limits.
Our critique particularly applies to a recent study from the University of California at San Francisco [2]. The latter was widely advertised in the media, e.g. the Huffington Post and Reuters. However and as a principle, is this ethically decent to confront antismoking âexpertsââ highly politicised pseudo-scientific views to that of hookah users having not the least idea of the details of such a study [3]?
The latter was actually led by Neal Benowitz, consultant to pharmaceuticals companies and, in our view this is worth mentioning because the latter are producers of nicotine patches and medicines such as Chantix, etc. In these conditions, it is no surprise to see the anti-scientific hazard represented by ânicotine addictionâ hyped on so many occasions in the ««waterpipe»» literature. In the strange related experiment on âcarcinogen exposureâ of ««waterpipe»» smokers, the water was, on purpose, NOT changed after each session and almost two consecutive hookah smoking sessions took place. This is not the only flaw since the subjects were not exclusive ever hookah smokers but mixed cigarette/hookah smokers...
Question: since the actual filtering effect of hookah smoking is systematically denied by antismoking researchers -because it jeopardises their theoretical pseudo-scientific constructions about âtobacco controlâ and the planned world Prohibition agenda for which they have been working and paid (particularly through intense funding by pharmaceutical companies) for one decade now, without any supporting sound scientific evidence, then, WHY and so often in their âstudiesâ:
1) Water is not changed after each session?
2) The smoking mixture is charred to a great extent through the use of biased smoking machines?
3) All water pipes of the world, in spite of their wide diversity (particularly regarding chemical composition of smoke and nicotine delivery), are systematically lumped, for one decade now, under a sole object dubbed ««waterpipe»» ?
4) Cigarette and hookah prevalence figures (measured among populations during antismoking surveys) are compared in a meant deceiving unscientific way?
Taking into account the above four points, why do publications on ««waterpipe»»⢠smoking systematically refer to legislation and such prohibition instruments as the FCTC (âFramework Convention for Tobacco Controlâ)? Does everybody know that the draft of the latter was actually prepared by the same researchers or their colleagues from the Globalink antismoking network ?[4]
Notes: [1] Chaouachi K. False positive result in study on hookah smoking and cancer in Kashmir: measuring risk of poor hygiene is not the same as measuring risk of inhaling water filtered tobacco smoke all over the world. British Journal of Cancer 2013 (7March) ; 1-2 XX. Doi:10.1038/bjc.2013.98
http://www.nature.com/bjc/journal/vaop/ncurrent/full/bjc201398a.html
[2] Jacob P 3rd, Abu Raddaha AH, Dempsey D, Havel C, Peng M, Yu L, Benowitz NL. Comparison of Nicotine and Carcinogen Exposure with Water pipe and Cigarette Smoking. Cancer Epidemiol Biomarkers Prev. 2013 Mar 5. [Epub ahead of print]
http://cebp.aacrjournals.org/content/early/2013/03/05/1055-9965.EPI-12-1422.abstract
[3] Hookah smoking no less harmful than cigarettes, study finds. The Huffington Pot and Reuters. 23 April 2013
http://www.huffingtonpost.com/2013/04/23/hookah-not-less-harmful-than-cigarettes-_n_3133590.html
[4] Chaouachi K. Prohibition through the hookah looking glass. Speech delivered at the second world conference of TICAP (The Tobacco International Coalition Against Prohibition)(Theme: âAre Guests Welcome? Prohibition and the Hospitality Industryâ). 15 Mar 2010. Nieuwspoort; The Hague, The Netherlands.
https://hookahhealth.wordpress.com/article/prohibition-through-the-hookah-looking-534k6mvefph-15/
Abstract: A critique of Boskabady MH, Farhang L, Mahmodinia M, Boskabady M, Heydari GR. Comparison of pulmonary function and respiratory symptoms in water pipe and cigarette smokers. Respirology 2012;17(6):950â6. Doi: 10.1111/j.1440-1843.2012.02194.x
Notes: Boskabady et al' study was consensually praised by antismoking activists: e.g. "Hookah Effects as Harmful as Cigarettes, Study Finds (Wheeze, cough, chest tightness evident in those who smoke using either method)". Health Day News, 31 Aug 2011. Unfortunately for its authors and extollers, it is full of errors and misconceptions.
Abstract: ENGLISH ABSTRACT: Thirty years ago, a German team of scientists let the world think over the tremendous consequences of cutting-edge research findings related to the presence of substances such as cocaine, nicotine and cannabis in Pre-Columbian mummies. The first outcome was the rebuttal of the official universal history of tobacco supposed to have begun in the Old World in the wake of Columbusâ discovery of the Americas. Most recent findings confirm the presence of nicotine without totally discarding the possibility of environmental tobacco contamination, not to mention, at a more or less remote date, the use of the latter as a preservation insecticide. Nevertheless and as a whole, the results reviewed in this article, further to being contextualised with anthropological discoveries related to âexoticâ forms of smoking such as the mysterious hookah (narghile, shisha) and the âdissentingâ though cogent views on tobacco history, elicit an unexpected turn to the debate. For instance, leaving aside the question of actual linguistic convergences between both sides of the Atlantic Ocean, a variety of forest tobacco of the Nicotiana rustica species (vs. Nicotiana tabacum, that of the New World) was widely known in Africa long before Columbusâ discovery. The mysterious origin of the water pipe (so different by its shape and smoking techniques) also represents an extra argument supporting early transoceanic (Africa/America) Pre-Columbian contacts. Anthropological research led by separate teams from the USA, South Africa, and Tunisia, unfailingly agree on this point.
Abstract: FUNDING : See HERE how the Maziak-Eissenberg-Shihadeh-Ward-Henningfield-Globalink Group has recently intended to block the (non-US) funding of an independent Hookah Harm Reduction Project. Their only âscientificâ argument was that KC was part of the project...
http://docs.google.com/open?id=0B2iXoxgyuf9lQUhOa2tRbHEtUjg
Abstract: The alpha-radioactive Polonium 210 (Po-210) is one of the most powerful carcinogenic agents of tobacco
smoke and responsible for the histotype shift of lung cancer from squamous-cell type to adenocarcinoma.
According to several studies, the principal source of Po-210 are the fertilizers used in tobacco plants, which
are rich in polyphosphates containing radio (Ra-226) and its decay products, lead-210 (Pb-210) and Po-210.
Tobacco leaves accumulate Pb-210 and Po-210 through their thrichomes and Pb-210 decays into Po-210
over time. With the combustion of the cigarette and smoke becomes radioactive and Pb-210 and Po-210
reach the broncho-pulmonary apparatus, especially in bifurcations of segmental bronchi. In this place,
combined with other agents, it will manifest its carcinogenic activity, especially in patients with
compromised mucous-ciliary clearance. Various studies have confirmed that the radiological risk from Po-
210 in a smoker of 20 cigarettes per day for a year is equivalent to the one deriving from 300 chest X-rays,
with an autonomous oncogenic capability of 4 lung cancers per 10000 smokers. Po-210 can also be found in
passive smoke, since part of Po-210 spreads in the surrounding environment during tobacco combustion.
Tobacco manufacturers have been aware of the alpha-radioactivity presence in tobacco smoke since the
sixties.
Abstract: Tobacco smoking is hazardous for health. However, not all forms of tobacco use entail the same risks and the latter should be studied and compared in a sound realistic way. Smoking machines for cigarettes (which are consumed in a few minutes) were early designed as a tool to evaluate the actual intake of toxic substances (âtoxicantsâ) by smokers. However, the yields (tar, nicotine, CO, etc.) provided by such machines poorly reflect the actual human smoking behaviour known to depend on numerous factors (anxiety, emotions, anthropological situation, etc.). In the case of narghile smoking, the problems are even more complex, particularly because of the much longer duration of a session. A recent study from the US-American University of Beirut was based on a field smoking topography and claimed consistency with a laboratory smoking machine. We offer a point by point critical analysis of such methods on which most of the âwaterpipeâ antismoking literature since 2002 is based.
Notes: IMPORTANT Pre-Publication history at http://docs.google.com/document/pub?id=1H5i9zuoUFODg3YntQ1gPRuzIA_0Kw0CeoGaOfSrTseM
Abstract: "The first error in Dr Imed Harrabi and colleaguesâ article is geographical as our country, Tunisia, is not located in the "in the northeast of Africa" as stated by the authors [1]. Probably this error is a consequence of another one: the fact that ««waterpipe»» use would be « growing in popularity worldwide, essentially in the Eastern Mediterranean region »[1]. Indeed, the « Western Mediterranean Region » (Libya, Tunisia, etc.) is also affected by the shisha "epidemic" that the authors describe as having reached âworldwideâ proportions. Obviously there is a serious contradiction. The geographical distribution of shisha use is something and the official ««waterpipe »» antismoking research -mainly led by the the US-American University of Beirut and the US-Syrian Centre for Tobacco Studies/US-SCTS (Wasim Maziak, co-author of the paper, is also director of the latter)-, undoubtedly based in the âEastern Mediterraneanâ, is something else.
Then, we have two other errors, of a methodological nature this time [...] [...] [...] [...] [...] [...]"
Notes: "Amazingly in their response, the authors cite Wikipedia (absolutely not peer-reviewed nor even scientific) as a source of information.... and are still convinced that Tunisia is part of Eastern Africa..... #################################### The situation has reached a point where ââwaterpipeââ antismoking authors such as Wasim Maziak argue by citing WIKIPEDIA as if this so-called âonline encyclopaediaâ were a peer-reviewed or even scientifically reliable source of information.... Not only it is not absolutely not reliable but, with such sensitive issues as hookah smoking, it is entirely monitored and harnessed (its "administrators") by antismoking lobbies defending the interests of the pharmaceutical industry (Globalink, in particular).
Abstract: ****************************AIM Much has been written about the toxicity of narghile (hookah, shisha) smoke. However, it is seldom mentioned that narghile smoke is actually far less complex than that of cigarettes. In spite of being a much simpler object to research, there has been a world of avoidable and preventable confusion due, to a great extent, to the inappropriate use of the narghile smoking machine designed at the US-American University of Beirut that now is considered to be âstandardisedâ. This machine has allowed the claims of high yields of tar, CO, PAH, heavy metals and, lastly, volatile aldehydes. Consequently, any public health intervention against narghile (hookah, shisha) use requires a long overdue critique of this machine on which a large amount of the peer-reviewed âwaterpipeâ literature uncritically relies. Public health policy makers should be aware of the unprecedented degree of confusion in this field.
************************** METHODS: The analysis is twofold. On one hand, the classical FTC (Federal Trade Commission) regime applied to cigarette testing (and behind the official figures printed on cigarette packs) is presented, whereby it is recalled that a 35-ml puff is drawn each minute for only a few minutes. On the other hand, a discussion follows about the relevancy of the narghile smoking machine based on averaging a complex human and social activity to a puff relentlessly drawn every 17 s over a full hour, with, marginally, the heating source (coal) in the same position over the smoking mixture (contrary to common practice). It is assumed that such stress-strain conditions result in abnormal perturbations in the chemical reactions at stake. The case of aldehyde generation is taken as an example.
**************************** RESULTS: The narghile smoking machine was modelled after the one for cigarettes, which not only is an inappropriate reference, but also is totally irrelevant for a kind of tobacco use that is different from all points of view. The narghile smoking machine and its underlying smoking topography represent a biased toxicological model of the related practice. Human-centered alternatives are presented.
**************************** CONCLUSIONS: Against the background of a public health epidemic, a recommended research avenue is to focus on biological measurements of human subjects (urinary carcinogens, chemical or biological markers) carried out in a natural environment in realistic conditions and coupled with a puff-by-puff smoke analysis.
Abstract: The medical hypothesis that the mainstream smoke (the one inhaled by the user) from âwater pipesâ (mainly: shisha, hookah, narghile) causes oral cancer is certainly acceptable. However, most of the recent reviews on this issue, including an attempt to develop an hypothesis for hookah carcinogenesis, have not cited key references of the world available literature which, so far, generally do not support such an hypothesis. Besides, the proposal is biased since it is apparently an adaptation of the cigarette model whereas cigarette and hookah smokes are, chemically to start with, completely different. Furthermore, all water pipes, despite their striking varieties and the consequences on the chemical processes, are, according to the same cancer-hypothesis, considered as one. The reason is the use, in the cited mainstream literature, of a nominalism (ââwater pipeââ, often in one word) which does not allow any distinction between devices. This critical article suggests to take into account all the peculiar characteristics into consideration in order to come up with another (or several other) carcinogenesis model(s). âFirmly believ[ingâ] that water pipe smoking can provoke lung cancer as well as oral cancerâ, based on what may be seen as a rather reductionist view of the issue, is not enough.
Abstract: SUMMARY
Among all others polycyclic aromatic hydrocarbon [PAH]
compounds, benzo(a)pyrene is the most dangerous deriving
from solid substances combustion. Optimal temperature range
for the formation of PAH is between 660 and 740 °C, while
the ideal for the formation of benzo(a)pyrene is 710 °C which
is within the range of combustion temperatures for cigarette
smoke (up to 900°C).
Many variables influence the formation of PAH in tobacco
smoke: the frequency and duration of inhaling, tobacco
blend, humidity content in the tobacco, permeability properties
of the paper used to make the cigarettes. Within cigarette
smoke more than 150 PAH have been identified which
constitute the most dangerous components of the so called
"bitumen".
Regarding benzo(a)pyrene (BaP), its mainstream intake values
vary between 8 ng per cigarette up to 122,5 ng per cigarette
with an average of around 30 ng/cigarette. BaP side
stream concentration is even higher and reaches 130 ng per
cigarette. BaP is also found in narghilè smoke (shisha and hooka).
In this case PAH are produced, besides tobacco combustion,
by the combustion of coal and other materials used as
sweeteners (apples and others).
The main source of BaP (as well as source of carbon monoxide)
is the combustion of coal for the narghilè. Benzo(a)pyrene
is one of the numerous chemicals identified as tumoral by
the IARC (International Agency for Research on Cancer). Tobacco
smoke is the most dominant risk factor for lung cancer
and among all the cancer initiating chemicals BaP is the main
one. The main mechanism for cancer formation connected
to BaP goes through G in T type genetic mutations induced
in gene p53.
A minimum risk level for benzo(a)pyrene (which is a Group
I tumoral agent according to IARC) has not been set in tobacco
smoke but its action is boosted also by other tumoral
chemicals such as Polonium-210, already present in tobacco
smoke. j
Keywords: benzo(a)pyrene, tabacco smoking, narghilè, cancer
lung.
Notes: RIASSUNTO
Il benzo[α]pirene, fra tutti i benzopireni, è lâidrocarburo policiclico
(PAH) più pericoloso che si forma per pirosintesi durante
la combustioni di sostanze solide. Le temperature ottimali per
la formazione dei PAH vanno da 660 a 740 °C, mentre quella
ottimale per la pirosintesi del benzo(a)pirene è di 710 °C che
ritroviamo anche nel fumo di sigaretta la cui massima temperatura
di combustione è fra gli 880 e i 900 °C. Molteplici
variabili influenzano la formazione di PAH nel fumo di tabacco:
la frequenza e la durata delle aspirate, il tipo di tabacco, il
contenuto di umidità del tabacco, il tipo di permeabilità della
carta della sigaretta. Nel fumo di sigaretta sono stati identificati
oltre 150 differenti PAH che costituiscono le componenti
più pericolose del cosiddetto "catrame". Riguardo al benzo(a)
pirene (BaP), i suoi valori nel mainstream variano da 8 ng/
sigaretta a 122,5 ng/sigaretta, con una media attorno ai 30
ng/sigaretta. La concentrazione di BaP nel sidestream è più
alta (circa 130 ng/sigaretta) rispetto al mainstream.
Il PaP lo ritroviamo oltre che nel fumo di sigaretta anche in
quello di narghilè (shisha, hookah). In questo la produzione di
PAH avviene per combustione oltre che del tabacco, anche di
quella del carbone utilizzato e altri materiali solidi edulcoranti
come mela etc.
La principale fonte di BaP, come per il CO, nel narghilè è
data in gran parte dalla combustione del carbone. Il benzo(a)
pirene è uno dei numerosi cancerogeni presenti nel fumo di
tabacco individuati come certi per lâuomo dallo IARC (International
Agency for Research on Cancer). Il fumo di tabacco
è il più importante fattore di rischio per tumore polmonare e,
fra i vari cancerogeni individuati, il BaP è il principale agente
cancerogeno. Il principale meccanismo di formazione tumorale
imputabile ai BaP avviene attraverso lâinduzione di mutazioni
di tipo G in T del gene p53. Non è stabilito un livello
minimo di rischio del benzopirene (carcinogeno di Gruppo 1
IARC) nel fumo di tabacco. La cancerogenesi del BaP è potenziata
in maniera sinergica dagli altri cancerogeni presenti nel
fumo di tabacco, fra cui il Polonio-210. j
Parole chiave: benzo(a)pirene, fumo di tabacco, narghilè,
tumore polmonare.
Abstract: Quotation: "Only recently experts have acknowledged that "WP [ââwaterpipeââ] smoking is so different from cigarette smoking that data on smoke composition and toxicity cannot be extrapolated from one to the other". However, the same tobacco researchers mention, and therefore validate, the yields of toxicants obtained through a âstandardisedâ ââwaterpipeââ smoking machine study which is at the very source of the global confusion."
Abstract: "In their interesting and original study, El-Setouhy and colleagues faced the unexpected counterintuitive finding that no associations were found between micronuclei and tobacco smoke exposure (duration and dose) or even addiction [...]"
Notes: A good academic example of the tragic consequences of using the """waterpipe""" scientific nominalism.
Abstract: [A Tribute to Gian Turci] This paper reviews the present knowledge about the nature of hookah (narghile, shisha) ETS and, in the light of the controversy over the actual health effects of cigarette ETS, concludes that the former should not be hyperbolised in an unscientific way as, unfortunately, a WHO report suggests.
Notes: "Hookah (narghile, shisha) smoking is seen as a global tobacco epidemic and there is definitely a lack of sound studies on the hazards related to its active smoking [1]. Amazingly, and as if hookah and cigarette smoking were similar, more and more biomedical publications report hazards related to its ETS (environmental tobacco smoke). Not only is the model of cigarette smoking irrelevant but [...]"
Abstract: The article refers to the following materials:
[*][*][*][*][*][*]Rodrigues AA. To convince and to inform: ethical issues in public health campaigns. J Bras Pneumol. 2009 Apr;35(4):396-7.
http://www.jornaldepneumologia.com.br/english/artigo_detalhes.asp?id=1352
[*][*][*][*][*][*]http://www.jornaldepneumologia.com.br/PDFenglish/2009_35_4_16_english.pdf
[*][*][*][*][*][*] Viegas CAA. Authorâs reply. J Bras Pneumol. 2009 Apr;35(4):397-8.
http://www.jornaldepneumologia.com.br/english/artigo_detalhes.asp?id=1353
[*][*][*][*][*][*]http://www.jornaldepneumologia.com.br/PDFenglish/2009_35_4_17_english.pdf
[*][*][*][*][*][*]Viegas CAA. Noncigarette forms of tobacco use. J Bras Pneumol. 2008 Dec;34(12):1069-73.
http://www.jornaldepneumologia.com.br/english/edicoesanteriores_exibe.asp?volume=34&edicao=12
[*][*][*][*][*][*]http://www.jornaldepneumologia.com.br/PDFenglish/2008_34_12_13_english.pdf
[*][*][*][*][*][*]Kandela P. Nargile smoking keeps Arabs in Wonderland. The Lancet 2000 ; 356 (9236):1175.
Abstract: In their review on water pipe smoking, Watad et al. (2009) credit Rakower & Fatal (1962) for stating that "plasma carboxyhaemoglobin was significantly higher for WP [water pipe] smokers when compared to nonsmokers and cigarette smokers". This is a first misquotation. In another instance, the same authors are credited for stating that "jurak or ajami are cruder forms of measselâ. Once again, this is not exact.
Bedwani et al. (1997) are cited in connection with a âsignificantly increased riskâ of bladder cancer among water pipe smokers compared to non-smokersâ. This is another misquotation as the Egyptian authors clearly emphasised that "it is more important, and more original, that our data did not find users of products other than cigarettes (i.e., water pipe and hashish) to be at elevated risk, after allowance for cigarette smoking". Watad et al. might not be responsible for this error as it was published in a previous review by Maziak et al (2004). However, they should have been more critical in their review of the literature as a last example -that of Yadav & Thakur (2000), unduly cited for "complication rates during pregnancyâ- shows.
<b>References:</b>
Bedwani, R., El-Khwsky, F., Regnanathan, E., Braga, C., Abu Seif, H., Abul Azmm, T. et al. (1997). Epidemiology of bladder cancer in Alexandria, Egypt: Tobacco smoking. International Journal of Cancer, 73, 64â67.
Maziak, W., Ward, K.D., Afifi Soweid, R.A., Eissenberg, T. (2004). Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tobacco Control 13, 327-333.
Rakower, J., Fatal, B. (1962). Study of narghile smoking in relation to cancer of the lung. British Journal of Cancer, 16, 1â6.
Watad, W., Sukhera, J., Shushan, S., Kazlak, M., Skinner, H.A., Alnueirat, A.A., Roth, Y. (2009). Water Pipe Smoking: Effects, Attitudes and Directions. Journal of Smoking Cessation, 4, 18-25.
Yadav, J., & Thakur, S. (2000). Genetic risk assessment in hookah smokers. Cytobios, 101(397), 101â113.
Abstract: Aim This comment is based on a critical review of a study on blood pressure and heart rate in shisha (narghile, hookah) smokers in Jordan.
Subjects and methods The study was analysed against the most recent literature on this issue, in general, and against peer-reviewed biomedical publications from the Middle East, in particular.
Results Several errors and misquotations were found in the study under scrutiny. Most of them stem from misrepresentations related to the chemistry of shisha smoke, the anthropology and geography of its use, and the relevance of the literature cited by the authors (vs. the non-cited one), both from a quality and quantity viewpoint.
Conclusion A clarification is made about all these points of utmost importance and will hopefully help a new generation of researchers avoid wading too far in this field. Against the background of a world epidemic, public health interventions will gain credibility and performance.
Abstract: NOTE : This Letter to the Editor took almost one year to get published and confusion (passive/active smoking) has now reached hight levels further to Dr Mirahmadizadeh and Dr Nakhaee's response. Consequently, it was decide, in order to spare time, to expedite the matter by addressing their arguments in the form of a KNOL [1].
Notes: [1] Chaouachi K. Pregnant Women in Iran and Environmental Tobacco Smoke:Exposing Animals to Hookah MainStream Smoke is Not Measuring Human Passive Smoking [Internet]. Version 8. Knol. 2009 Oct 2. #################################################
http://knol.google.com/k/kamal-chaouachi/pregnant-women-in-iran-and/534k6mvefph/5?hd=ns#
Abstract: Hookah (narghile, shisha, âwater-pipeâ) smoking is now seen by public health officials as a global tobacco epidemic. Cigarette Environmental Tobacco Smoke (ETS) is classically understood as a combination of Side-Stream Smoke (SSS) and Exhaled Main-Stream Smoke (EMSS), both diluted and aged. Some of the corresponding cigarette studies have served as the scientific basis for stringent legislation on indoor smoking across the world. Interestingly, one of the distinctive traits of the hookah device is that it generates almost no SSS. Indeed, its ETS is made up almost exclusively by the smoke exhaled by the smoker (EMSS), i.e. which has been filtered by the hookah at the level of the bowl, inside the water, along the hose and then by the smokerâs respiratory tract itself. The present paper reviews the sparse and scattered scientific evidence available about hookah EMSS and the corresponding inferences that can be drawn from the composition of cigarette EMSS. The reviewed literature shows that most of hookah ETS is made up of EMSS and that the latter qualitatively differs from MSS. Keeping in mind that the first victim of passive smoking is the active smoker her/himself, the toxicity of hookah ETS for non-smokers should not be overestimated and hyped in an unscientific way.
Notes: Dr Kamal T. Chaouachi
Researcher and Consultant in Tobacco Control (Paris)
http://PublicationsList.org/kamal.chaouachi
__________
References
[1] Khoury A, Hanan HS, Hamade H, Meqdade M. Characteristics of bacteria in smoking tube of water pipe (Narghile). Eur Respir J 2006; 28: Suppl. 50, 466s.
[2] Kamel M, Elyes H, Sophia B, Raya S, Abdellatif C. Pulmonary tuberculosis in narghile (Ng) lighters. Eur Respir J 2002; 20: Suppl. 38, 555s.
[3] Meleigy M. Waterpipe and communicable diseases link, says WHO. The Lancet/Infections 2007 (July); Vol 7; issue 7:448. http://infection.thelancet.com
[4] Chaouachi K. A Critique of the WHO's TobReg "Advisory Note" entitled: "Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulatorsâ. Journal of Negative Results in Biomedicine 2006 (17 Nov); 5:17. http://www.jnrbm.com/content/5/1/17
[5] Steentoft J, Wittendorf J, Andersen JR. Tuberculosis and water pipes as source of infection in Storstroem County, Denmark. Ugeskr Laeger 2006 (Feb 27);168(9):904-7.
Abstract: Critical comment on: Tamim H, Yunis KA, Chemaitelly H, Alameh M, Nassar AH; National Collaborative Perinatal Neonatal Network Beirut, Lebanon. Effect of narghile and cigarette smoking on newborn birthweight. BJOG. 2008 Jan;115(1):91-7.
Abstract: Narghile (hookah, shisha, goza, "water-pipe") smoking has become fashionable worldwide. Its tobacco pastes, known as moassel and jurak, are not standardized and generally contain about 30-50% (sometimes more) tobacco, molasses/juice of sugarcane, various spices and dried fruits (particularly in jurak) and, in the case of moassel, glycerol and flavoring essences. Tobacco contains minute amounts of radiotoxic elements such as (210)Pb, (210)Po and uranium, which are inhaled via smoking. Only very few data have been published on the concentrations of natural radionuclides in narghile tobacco mixtures. Consequently, the aim of this study was to draw first conclusions on the potential hazards of radioactivity in moassel tobacco in relation to narghile smoking. The results indicate the existence of a wide range in the radioactivity contents where the average (range) activity concentrations of (238)U, (234)Th (226)Ra, (210)Pb, (210)Po, (232)Th and (40)K, in Bq/kg dry weight were 55 (19-93), 11 (3-23), 3 (1.2-8), 14 (3-29), 13 (7-32), 7 (4-10) and 719 (437-1044)Bq/kg dry weight, respectively. The average concentrations of natural radionuclides in moassel tobacco pastes are comparable to their concentration in Greek cigarettes and tobacco leaves, and lower than that of Brazilian tobacco leaves. The distribution pattern of these radionuclides after smoking, between smoke, ash and filter, is unknown, except for (210)Po during cigarette smoking and from one existing study during moassel smoking. Radiological dose assessment due to intake of natural radionuclides was calculated and the possible radio-toxicity of the measured radionuclides is briefly discussed.
Abstract: EXCERPTS **************
âI was very surprised by the admonishing tone of Dr Maziakâs criticism of Carroll et al. study in Issue 5 of Vol. 32. After careful evaluation, I found the latter article excellent all the more that it involved a large sample, made a clear division of groups, and was the first to report the prevalence of hookah (shisha, narghile) smoking in an Australian population.â **************
ââPublic healthâ does not belong to any group or individual in particular. It is public and should remain a public concern as its names clearly show, even when the matter deals with such a hot topic as tobacco and âwaterpipeâ smoking. It is sad to see how Carroll et al. were led to justify their âunexpectedâ finding by adding: âthis may not be reflected in other regional or population settingsâ. They did not have to, [â¦]â
**************
"Concerning health aspects, it must be understood that hookah smoke is actually far less complex than cigarette smoke. For the first time in 1991, 142 compounds were detected in its smoke with a filtration rate of 38%. This figure is to be compared to the 4,700 substances that have been identified so far in cigarette smoke."
**************
âFinally, did we need eight years of international research and half hundred of âwaterpipeâ studies to establish that âthe waterpipe is mainly an intermittent tobacco use methodâ, or was this fact already established by four centuries of literature, including early scientific studies, and not to mention common sense? What are scientific reviews made for?"
Notes: A pedagogicl example of the tragic consequences of using the """waterpipe""" scientific nominalism.
Abstract: Many biomedical studies of the past seven years have failed in giving a sound picture of what hookah (shisha, narghile, goza) smoke and smoking are. The reasons are many: from the widespread use of a confusing neologism (âwaterpipeâ) instead of the few clear and natural words used for centuries by indigenous and non-indigenous people in their real life, to the use of artificial smoking (machines) instead of relying on quantitative and qualitative analysis of toxicants directly performed on real hookah smokers.
Notes: ###################################################################################
IMPORTANT NOTE: ONLINE (pdf file) with the kind permission (5 Oct 2008) of the Editor of the Journal. Please acknowledge by citing exlclusively as follows:
Chaouachi K. The narghile (hookah, shisha, goza) epidemic and the need for clearing up confusion and solving problems related with model building of social situations. TheScientificWorldJOURNAL: TSW Holistic Health &Medicine 2007 (7): 1691â6.
DOI 10.1100/tsw.2007.255.
Abstract: BACKGROUND: Hookah (narghile, shisha) smoking is growing worldwide and particularly in France. The main reasons for this are: first, the arrival on the market of new highly flavored tobacco-based mixtures; second, a new type of charcoal used as a quick heating source; third, the pleasure to experiment with an exotic orientalist practice or the desire to return to the corresponding tradition; fourth, the belief that water filtration would lower the risk of smoking. METHODS AND RESULTS: Long-term epidemiological data on complications are scarce. Little is known about qualitative and quantitative transformations occurring when hookah is smoked (in particular regarding carcinogenic agents). Such information will be difficult to collect due to the lack of standardization for this mode of tobacco use. The only current consensus on this issue is that a significant amount of carbon monoxide is produced by the charcoal used to heat and distil the tobacco-molasses mixture. Apart from direct inhalation, concentrations measured in some fashionable hookah lounges and bars are particularly high. Moreover, the additives contained in the widely used quick-lighting charcoals and their harmlessness remain unknown. CONCLUSION: This study sets out the available scientific knowledge regarding the real medical consequences related to the growing use of hookah and focuses on the best known and urgent issue, i.e. concern related to carbon monoxide intoxication in a very peculiar context.
Abstract: ################################################################################################# OBJECTIVE : To find CEA levels in smokers of different categories (hookah smokers, cigarette smokers smoking different brands of cigarettes and different number of cigarettes per day) and to correlate CEA levels with type and rate of smoking. #################################################################################################
METHODS : A total of 122 cigarette smokers (115 men and 7 women) and 14 hookah smokers (all men) with age ranging from 16-80 years were studied. CEA levels were also measured in 36 non-smokers who served as controls. Enhanced chemilumiscent immunometeric technique was applied to measure CEA levels in our subjects. #################################################################################################
RESULTS : The mean CEA levels of cigarette smokers were compared with the mean CEA levels observed in
hookah smokers (7.16 ±10.4 ng/ml) and non-smokers (2.15 ± 0.68 ng/ml). The mean value of CEA level observed in cigarette smokers, 9.19 ± 14.9 ng/ml (n=122) was significantly higher than the levels in non-smokers and hookah smokers (p<0.0067). It was also observed that CEA levels increased with the number of cigarettes smoked per day. The highest levels were observed in smokers who smoke more than 31 cigarettes per day. The smokers that use relatively cheaper brands of cigarettes had higher levels of CEA compared to those who use high quality brands. #################################################################################################
CONCLUSION: It was concluded that the brands of cigarettes (which were ranked on the basis of price) and the rate of smoking both play an important role in raising the CEA levels. Further the common belief that hookah also called narghile or shisha is a relatively safe mode of smoking is not completely correct; a significant proportion of hookah smokers have high levels of CEA although mean levels of hookah smokers were low compared to cigarette smokers (JPMA 57:595;2007).
Notes: #################################################################################################
IMPORTANT NOTE#####################
For some reason, we were unable to respond to Dr Maziak's Letter to the Editor of JPMA about our first study on CarcinoEmbryonic Antigen (CEA) levels in hookah and cigarette smokers [1]. However, we wish to inform readers that the related concerns have been exhaustively addressed in the online Comments section of the Harm Reduction Journal which has published our second study on the same topic [2].
#################################################################################################
Dr Kamal Chaouachi #################################################################################################
[1] Maziak W. Carcinoembryonic antigen (CEA) levels in hookah smokers, cigarette smokers and non-smokers--a comment. J Pak Med Assoc. 2008 Mar;58(3):155. #################################################################################################
[2] Sajid KM, Chaouachi K, Mahmood R. Hookah smoking and cancer. Carcinoembryonic Antigen (CEA) levels in exclusive/ever hookah smokers. Harm Reduction Journal 2008 24 May;5(19).
http://www.harmreductionjournal.com/content/5/1/19
Abstract: This paper is the last one of a Tetralogy on Narghile (Hookah, Shisha) and Health worked out within a transdisciplinary socio-anthropological and biomedical framework. 15 reasons are outlined to help understand the corresponding sudden world craze. The article analyses the relationship with the world tobacco industry, the relevance of comparisons with cigarettes, the use by women and the issue of environmental smoke. The most recent epidemiological studies are reviewed as well as findings and hints at research regarding the peculiar dependence associated this practice. This publication also gives the keys for an intelligent preventive approach respecting the local socio-cultural context in which it deeply takes its roots. Clarification is made about alcohol and cannabis related use. Lastly, harm reduction measures and key-messages are given for tobacco prevention activists.
Abstract: Hookah (Narghile), its practice, the past and present research on it and the corresponding methodological problems have been set out in Tabaccologia 1/2005. In issue 3/2005, its pharmaco-physiological aspects (nicotine, tar, CO, polycyclic aromatic hydrocarbons, heavy metals) were given a detailed description. Here, the health aspects and related pathologies will be reviewed: tumors, lung pathologies, cardio-vascular risks and others. Beyond, the last issue will be sealed with the presentation and analysis of issues in connection with dependence, public health and prevention concerns.
Conclusion : this paper calls on the international community to respond urgently to a fourfold world public health emergency.
Abstract: BACKGROUND AND AIM: The World Health Organisation Study Group on Tobacco Product Regulation (TobReg) has issued in 2005 an "Advisory Note" entitled: "Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators". "Waterpipe" smoking is now considered a global public health threat and the corresponding artefact is actually known in the world under three main terms: hookah, narghile and shisha. This important report, the first ever prepared by WHO on the subject, poses two major problems. On one hand, its bibliographical references dismiss world chief relevant studies. On the other, it contains a certain number of errors of many orders: biomedical, sociological, anthropological and historical. The purpose of the present study is to highlight, one by one, where these weaknesses and errors lie and show how this official report can be considerably improved. RESULTS: We realise that widely advertised early anthropological studies were not taken into consideration whereas they shed a substantial light on this peculiar form of smoking and help understanding its high complexity. As for concrete errors to be found in this report, they deal with the chemistry of smoke, health-related effects, smoking patterns, description and history of the artefact and its use, gender and underage use aspects, prevention and research needs in this field. CONCLUSION: The scientific credibility of an international expert report may be at stake if its recommendations do not rely on sound objective research findings and a comprehensive review of the existing literature. The critical comments in this study will certainly help improve the present WHO report.
Notes: SEE ALSO: Chaouachi K. WHO and Peer-Review Standards in Studies on Hookah Smoking. The Lancet Early Online Publication 2007 (29 Oct). In reply to Dr Douglas Bettcher, Dir. WHO/TFI a.i.âs comment: Bettcher D. WHO Response to Use of evidence in WHO recommendations. The Lancet Early Online Publication 2007 (10 Sept).
http://www.thelancet.com/journals/lancet/article/PIIS0140673607606758/comments?totalcomments=1#1305
SEE ALSO: Chaouachi K. Comment entitled: In Reply to Drs Eissenberg, Maziak, Shihadeh and Ward. Submitted to JNRBM (Journal of Negative Results in Biomedicine) on 26 Aug 2007. Unpublished to date (probably because it was deemed redundant by the Editors).
SEE ALSO: Letter to Dr Margaret CHAN, Director-Gal of WHO (World Health Organisation) to demand the dissolution (winding up) of WHO TobReg: http://docs.google.com/View?docid=dgbz283m_106vf22zw (07 Sept 2007).
Abstract: The narghile (hookah, shisha, âwaterpipeâ) is a key element of everyday's life in the Middle East. Its ethnographic, folkloric and anthropological dimensions are analysed in relation to its traditional settings and particularly the Oriental coffee-houses. Then, we try to understand the long silence of social sciences regarding this ancient and common practice, from both the Northern and Southern sides of the Mediterranean. With Pierre Bourdieu, we ask: who decides what is important or relevant in social sciences; in other words, which theme deserves attention? With a few researchers, we agree that not all the social sciences corpus of the colonial times must be considered historical garbage. As our bibliographical sources were extremely scarce, we realised that a few valid and usable elements could be picked out of that huge production, particularly in the ethnographic field.
Indeed, literature, poetry and painting actually made up for the long silence of social sciences regarding the narghile. Consequently, the present world sudden craze for hookah smoking can be construed as a backlash effect and even a bad joke played to the official representatives of the corresponding disciplines. Now that hookah lounges are popping up everywhere in the world, what will they say? That they did not know or that there were more "serious" themes to be studied: religion, sex, power, conflicts, identity, etc.?
The narghile practice and its revival show how an ancient popular culture now challenges the dominant and global one. Contrary to some quick analysis, the underlying identity feature is not so important. In fact, the unexpected phenomenon poses the question of cultural transfer and, beyond, the question of culture itself.
The critique of orientalism by Edward Said actually touched off an epistemological revolution in the field of social and human sciences. We develop further an analysis begun in a doctoral thesis about the relation between material culture and orientalist representations. However, beyond the classic orientalist vision of the past, a new question emerges: that of neo-orientalism. On a practical level, this concept refers to the development of hookah lounges all over the world (about one thousand in a country like France and more or less the same figure for the USA). Amazingly, people patronise these places for the narghile experience. In these conditions, the owners of these establishments, most of them of Middle Eastern origin, actually began to sell an orientalist "service" or "product" (Arabian Nights decor, exotic food, drinks, music and narghiles) to both "Westerners" and "Easterners" living in the West. Even in the Middle East, a kind of neo-orientalism is sold to the Orientals themselves.
On a theoretical level, and because hookah smoking is now considered a world epidemic and a global threat, US-funded research centres were set up in key countries of the Middle East to try to contain the damage caused to the world by this new virus. Biomedical studies on this epidemic have been published on almost a monthly basis over the last three years. In this context, Edward Saïd's criticism is, once again, highly relevant because Oriental researchers are involved in this last process.
Abstract: A first review of relevant medical and pharmacological studies was carried on by the author within the framework of a doctoral research encompassing all aspects - socio-anthropological, historical and tobaccological - of narghile (hookah, waterpipe) use. Further to the revival of its use in the Middle East in the 80s and 90s, the use of narghile has now become a globalised habit in the wake of which new studies appeared. However, in most cases, the corresponding results cannot be relevantly exploited because very often one cannot clarify if the committed volunteers were exclusive narghile smokers, ex-consumers of cigarettes having one day stopped smoking or yet having substituted for it the narghile practice. Indeed, as pointed out by several researchers in Turkey, narghile smokers, particularly those who are dependent, belong to this last category. In addition, we note that, unfortunately, the very large majority of studies systematically gloss over important research works of sociological, ethnological and anthropological nature. Most of the time, such a negative attitude leads to ill-considered and even wrong or absurd interpretations. Notwithstanding, the mentioned disciplines, by embracing the vast field of knowledge, practices and human representations, form, in this very case, an essential and heuristic tool allowing the approach of an object and a practice both known as highly "exotic" and complex.
Conclusion: in our opinion, it is now necessary to study the effects of narghile on exclusive smokers, not having indulged during their past career neither in the use of cigarettes nor in any other form of tobacco (cigar, pipe, bidi, etc.). Because of the tobaccological peculiarity of its mechanisms (nicotine, cotinine, aromas, important interaction with the socio-cultural context) and thanks to the diverse points of view it offers to the researcher, narghile undoubtedly can help improve our understanding of cigarette dependence. This critical review aims at being a modest contribution to such an objective.
Structure of this 4-part document: The whole review on hookah/narghile is presented through a general introduction followed by 3 main sections. The first one tackles the pharmacological aspects of hookah use. The second one embraces all observed pathologies related to the corresponding practice. Finally, the third and last section poses issues in connection with dependence, public health and prevention concerns.
Abstract: Hookah (Narghile) and its practice have been introduced in the last issue through the methodological problems, the state and evolution of knowledge about it until the most recent research existing in this field. We will now offer a review of its pharmaco-physiological aspects in direct relation to the very peculiarity of this tobacco use mode known to force smoke to go through water. To what extent are nicotine, tar, CO and polycyclic aromatic hydrocarbons, inter alia, affected by this process ?
Besides, does tobacco really burn as in the case of cigarette and what are the consequences? In a further issue, pathologies in relation with the use of this device will be thoroughly reviewed. Finally, the panorama will be closed with the presentation and analysis of issues in connection with dependence, public health and prevention concerns.
Abstract: SEE ALSO http://www.actupparis.org/IMG/pdf/Action_51-2.pdf (pages 12/28 to 15/28). Contains excerpts of the translation into French. John MARKS is introduced to the readers. Noteworthy: Table on Opium use page 15/28.
Abstract: FRENCH: free full-text available online at http://www.cedej.org.eg/article.php3?id_article=838 ########################################
ENGLISH: Title: âNarghile (Shisha, Hookah): A World Epidemic Coming from Egyptâ
The unexpected growing use of the hookah (narghile, shisha) in the world, including in its Middle Eastern âcradleâ, is already called an âepidemicâ by some scientists. The use of prevention and eradication models developed for virus, emergent diseases, drug addiction are definitely irrelevant and results in common methodological errors, misconceptions (regarding dependence, smoking patterns, health, gender, historical and other aspects) and prejudices of orientalism. A transdisciplinary approach seems necessary in order to tackle the various dimensions of this mode of tobacco use because it is deeply rooted in a complex network of closely interrelated social, cultural and health issues in a given human context.
Abstract: Date: 21-26 August, 2005
Location: Istanbul, Turkey
Region: EMRO
Topics: General Bioethics
"The 2005 World Meeting of the International Forum for Social Science and Health (IFSSH) aims to realize a universal platform for reflections and forward-looking discussions in all important areas that fall under the health social science agenda. Marked by the shadow of global terrorism and war, the 21st century has started with significant challenges for socially relevant and policy oriented understandings of health, disease, death and birth. Unprecedented advances in technology and informatics have been accompanied with the relentless burden of poverty and disease. Growing health inequity is accompanied by the emergence of new forms of disease. An interdisciplinary gathering of the experiences and perspectives of social scientists and health specialists is crucial for an assessment of the human condition at the onset of the new millennium. The 2005 World Meeting of the International Forum for Social Sciences and Health (IFSSH) will be held in collaboration with the International Children's Center (ICC), the IVth International Congress of Ethnobotany (ICEB 2005) and a number of sessions will be run jointly with them."
Event type: Conference
International focus: Yes
Further information:
Prof. Dr. Akile Gürsoy
IFSSH Secretary General
Congress Chairperson
Head, Anthropology Department
Yeditepe University
Tel: +90 (0216) 578 08 91
GSM: +90 (0532) 457 22 24
E-mail: akile@yeditepe.edu.tr
or ifssh@yeditepe.edu.tr
Website: Congress for Social Sciences and Health
Abstract: Correspondence relating to: Islami F, Kamangar F, Nasrollahzadeh D, Møller H, Boffetta P, Malekzadeh R. Oesophageal cancer in Golestan Province, a high-incidence area in northern Iran - A review. Eur J Cancer, Volume 45, Issue 18, December 2009, Pages 3156-3165.
Notes: A critique of Elie Akl et al (University of New York at Buffalo)' "systematic reviews" on ""waterpipe"" smoking:
[1] Akl EA, Aleem S, Gunukula SK, Honeine R, Abou Jaoude P, Irani J. Survey instruments used in clinical and epidemiological research on waterpipe tobacco smoking: a systematic review. BMC Public Health. 2010 Jul 13;10(1):415.
http://www.biomedcentral.com/1471-2458/10/415
[2] Akl E, Gaddam S, Gunukula SK, Honeine R, Abou Jaoude P, Irani J. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. International Journal of Epidemiology. Advance Access published online on March 4, 2010. Doi:10.1093/ije/dyq002
http://ije.oxfordjournals.org/cgi/content/abstract/dyq002v1
[3] Raad D, Gaddam S, Schunemann HJ, Irani J, Abou Jaoude P, Honeine R, Akl EA. Effects of waterpipe tobacco smoking on lung function: a systematic review and meta-analysis. Chest. published 29 July 2010. Doi: 10.1378/chest.10-0991
http://www.ncbi.nlm.nih.gov/pubmed/20671057
Notes: A comment on:
[*] Islami F, Pourshams A, Nasrollahzadeh D, Kamangar F, Fahimi S, Shakeri R, Abedi-Ardekani B, Merat S, Vahedi H, Semnani S, Abnet CC, Brennan P, Møller H, Saidi F, Dawsey SM, Malekzadeh R, Boffetta P. Tea drinking habits and oesophageal cancer in a high risk area in northern Iran: population based case-control study. BMJ. 2009 Mar 26;338:b929.
http://www.bmj.com/cgi/content/full/338/mar26_2/b929
Notes: A critical comment on :
[1] University of Pittsburgh School of Medicine. Many College Athletes Reject Cigarettes But Smoke Hookah, Pitt Study Finds. Medical News Today 2009 (27 Aug)
http://www.medicalnewstoday.com/articles/161977.php
AND
[2] Primack BA, Fertman CI, Rice KR, Adachi-Mejia AM, Fine, MJ. Waterpipe and Cigarette Smoking Among College Athletes in the United States. J Adol Health 2009; 1â7.
http://dx.doi.org/10.1016/j.jadohealth.2009.05.004
"Dr. Primack is supported with funding from the Robert Wood Johnson Foundation, the National Cancer Institute and the Maurice Falk Foundation."
Abstract: Contains the 4 first critical reviews in sociology, anthropology, history and tobaccology (biomedical aspects) on hookah (narghile, shisha) smoking. For instance, concerning the heating of the smoking product, this document showed that what is chemically taking place inside the bowl of a shisha filled with tobamel (the tobacco [or no-tobacco]-molasses based smoking mixture), and topped with a pierced aluminium foil and some charcoal, is something different from âcombustionâ (a common misstatement put forward by major experts). I showed it was a chemical process more akin to the Maillard Reaction (with a âdistillationâ dimension) than a âcombustionâ.
Notes: The original critical review on biomedical aspects was further updated several times: e.g.:
> Chaouachi K. The medical consequences of narghile (hookah, shisha) use in the world. Rev Epidemiol Sante Publique 2007 (Jun) ; 55(3):165-70 [article in English].
> Tetralogy on Narghile (Hookah, Shisha) and Health published in Tabaccologia, the
official Journal of the Italian Society of Tobaccology:
-Part 1: Presentation (Tabaccologia 2005; 1: 39-47);
-Part 2: Chemistry (Tabaccologia 2005; 3: 27-33);
-Part 3: Diseases (Tabaccologia 2006;1:27-34);
-Part 4: Public Health and Prevention (Tabaccologia 2006;4:29-38).
http://docs.google.com/View?docid=dgbz283m_3cm537w
Abstract: NOTE : A Letter to the Editor about a study published by Dr Mirahmadizadeh and Dr Nakhaee (M&N) took almost one year to get published [1][2]. Unfortunately, confusion (passive/active smoking) has now reached hight levels further to (M&N)'s response [3]. Consequently, it was decided, in order to spare time, to expedite the matter by addressing their arguments in the form of a Knol (piece of knowledge)[4].
Notes: [1] Chaouachi K. Qalyan, Narghile, Shisha and pregnant women's exposure to passive smoking in Iran. Med Princ Pract. 2009;18(5):425.
http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=000226301
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
[2] Mirahmadizadeh A, Nakhaee N. Prevalence of waterpipe smoking among rural pregnant women in Southern Iran. Med Princ Pract. 2008;17(6):435-9.
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
[3] Mirahmadizadeh A, Nakhaee N. Reply: Recent Evidence Is Alerting Us to the Critical Importance of Secondhand Water Pipe Smoke. Med Princ Pract. Med Princ Pract. 2009;18(5):425-6.
http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=000226301
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
[4] Chaouachi K. Pregnant Women in Iran and Environmental Tobacco Smoke. Exposing Animals to Hookah MainStream Smoke is Not Measuring Human Passive Smoking. Knol 2009 (3 Oct)
http://knol.google.com/k/kamal-chaouachi/pregnant-women-in-iran-and/534k6mvefph/5#
