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Kamal Chaouachi
French: go to end
kamcha@gmail.com
> Tobacco Researcher and consultant, mainly from a medical anthropology perspective. Native of Tunisia-Middle East. The only concern here is Public Health and the related urgent concrete actions that have not been taken so far. Postgrad. DIU Tobaccology (*) 1998 and early university education in non-social sciences (physics, chemistry...). Teacher of a comprehensive course on Hookah (Narghile, Shisha) smoking for French doctors (University of Paris XI-XII). Consulted by the French Ministry of Health. Scientic Collaborator of various excellence research centres in Asia, Africa and Europe.

> Author of critique of WHO erroneous expert report on “waterpipe" (jnrbm.com)

> Author of first PUBLIC HEALTH RECOMMENDATIONS in relation with carbon monoxide intoxication risk in hookah lounges (Alcoologie 1999).

> Co-translator into French of John MARKS' PUBLIC HEALTH CLASSIC: Drug Misuse and Social Cost (Br J Hosp Med. 1994).

> All below cited studies have come to light in spite of a negative global environment for this kind of research, mainly caused by a regrettable competition (race for funds) and prohibitionist agenda. They have been PEER-REVIEWED by academic teams from excellence research centres such as INSERM, CNRS (France), worldwide renown university laboratories and by not less prestigious scholars in this field. Presently working on Hookah Smoking and CANCER (harmreductionjournal.com).

(*) Note for English-speakers: TABACOLOGIE (Tobaccology) is in France (in particular) the official cutting-edge scientific discipline for the study of all aspects (health, pharmacological, behavioural, social, cultural, historical and economical) of tobacco use with a strong focus on the dependence phenomenon.

> COMPETING INTERESTS: NONE of the below cited publications bears the slightest conflicting interest. The author was involved, from Spring to Autumn 2004, in the development of a no-CO (carbon monoxide) narghile prototype (Harm Reduction objective). He signed away all his past and future rights (total relinquishment) on June 15, 2005 (legally certified), before the potential commercial exploitation of the product. He has received only but a lump sum for his participation in this project. Furthermore, he declares that, in the course of his research on this issue (1996 to date) [*], he has unfortunately NEVER received FUNDING (direct or indirect) neither from PHARMACEUTICAL COMPANIES (nicotine "replacement" therapies; patches, gums, etc.) nor from the TOBACCO INDUSTRY. However, he would welcome any financial help from any source in order to help clearing up the growing confusion surrounding ““waterpipe”” smoking as far as Public Health is concerned.
[*] Year 2004 (Jan-Oct) marked a pause in his publications because of hard work on the above-mentioned No-CO narghile. His participation in the project was frozen from Oct 2004 to 15 June 2005 (official end).

Books

2007
1997
1994
UNESCO, Toxibase, Olivier Ralet, Sylvain Millérioux, Kamal Chaouachi (1994)  International annotated bibliography on the prevention of drug abuse through education. Editor in-chief: Olivier Ralet. [annotated, i.e. each of the c. 400 entries with an abstract]   Edited by:Toxibase, UNESCO. Paris: UNESCO, European Commission  
Abstract: Other lang. title: Bibliographie internationale annotée sur la prévention de l'abus des drogues par l'éducation; Bibliografía internacional anotada sobre la educación en prevención del abuso de drogas
Notes: Microfiche no: 94s0657 [mul-4mf] Document Type: Unesco document Catalog Number: 98771

Journal articles

2008
 
DOI   
PMID 
Kamal Chaouachi (2008)  Errors and misquotations in study on narghile and newborn birthweight.   BJOG: An International Journal of Obstetrics and Gynaecology 115: 6. 800-1  
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.
Notes:
Kamal Chaouachi (2008)  Hookah (Narghile, Shisha) Smoking and Communicable Diseases [Narghilé et malattie trasmissibili].[English and Italian versions] >>> A critique of: Meleigy M. Waterpipe and communicable diseases link, says WHO. The Lancet/Infections 2007 (July); Vol 7; issue 7:448. http://infection.thelancet.com   Tabaccologia 1: 47  
Abstract: [A critique of: Meleigy M. Water-pipe and communicable diseases link, says WHO. The Lancet/Infections 2007 (July); Vol 7; issue 7:448. http://infection.thelancet.com] There is a dearth of sound research in this field. Recently, a Syrian team led by Khoury has analysed 41 narghile hoses in several cafes of the Aleppo (Syria) region. They have detected the presence of various bacterial germs, 80% of which were to be found in the hoses of downtown cafés [1]. In Tunisia, narghile lighters deserve a special attention as Kamel et al. found that 10 of them featured among 385 bacteriologically confirmed pulmonary tuberculosis patients followed over a full decade [2]. I have informed The Lancet (Infectious Diseases) that a serious error has slipped in its paper on âwater-pipeâ and communicable diseases [3]. Its author relied on one of the numerous erroneous statements contained in the first WHO report on hookah (narghile, shisha) smoking [4] and declared: âAccording to an advisory released by WHO, studies have shown that the risk of transmission of tuberculosis from an infected waterpipe is similar to the risk of transmission of living with an infected individual in the same household.â While acknowledging the existence of this error and thanking me for correcting it, Dr Hargreaves, Editor of The Lancet ID, said she was âunable to publish [my] letter in the print journal because of the time delayâ (28 Sept 2007). In these conditions, I wished to take this opportunity to inform Tabaccologiaâs readers on what research actually says on this potential risk. First, the WHO âAdvisoryâ report states (page 5, 9th conclusion) that âsharing a waterpipe mouthpiece poses a serious risk of transmission of communicable diseases, including tuberculosis and hepatitisâ. This statement was wrongly attributed to researchers (Kniskowny et al) who were not the authors of studies on such risks. In the case of hepatitis, these studies were carried on by Habib et al. and Medhat et al.. As for tuberculosis, they were carried on, recently, by Munckhof et al. and long before by Salem et al. References already given in the critique of the erroneous WHO report will not be repeated here [4]. As for âthe risk of transmission of living with an infected individual in the householdâ, the only study that began to mention this aspect in relation with âwater-pipeâ use is, unfortunately, available only in Danish [5]. On a practical level, this potential risk of communicable diseases seems to be controlled thanks to the systematic use of personal aseptic disposable nozzles in hookah lounges and neo-orientalist coffee houses of the world. It is certainly good news in view of the growing size of the corresponding epidemic. Harm reduction prevention messages directed at smokers who do not want to quit now, should recommend their use [4].
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.
2007
 
DOI   
PMID 
Kamal Chaouachi (2007)  The medical consequences of narghile (hookah, shisha) use in the world.   Rev Epidemiol Sante Publique 55: 3. 165-170 Jun  
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.
Notes: ARTICLE IN ENGLISH
 
PMID 
Khan Mohammad Sajid, Riffat Parveen, Durr-e-Sabih, Kamal Chaouachi, Ayisha Naeem, Rubaida Mahmood, Rahat Shamim (2007)  Carcinoembryonic antigen (CEA) levels in hookah smokers, cigarette smokers and non-smokers. 2007;57:595-9.   J Pak Med Assoc 57: 12. 595-9 Dec  
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:
 
DOI   
PMID 
Kamal Chaouachi (2007)  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 207: 7. 1691-6  
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:
2006