Narghile and Health: "Evidence" or Growing Confusion ?

Copy of a letter sent by an independent researcher to the Editor of the Cancer Letter (Lebanese Cancer Society)_ 15 Sept. 2005 ©

Dear Editor,
I was surprised to see to what extent Afifi Soweid's paper entitled “Nargileh and health: what’s the evidence ?” (1) relies on a review article (2) containing serious errors listed and published in the Tobacco Control Journal (3).

I think that instead of citing such a controversial study, which has created a great deal of confusion among researchers, we should focus on the real methodological problems related to the sound analysis of narghile smoking. The most important one is to pay utmost attention to the profile of the volunteers, and particularly to their past smoking career.

Indeed, in almost all the cited studies, the profile of the volunteers is not given. Before jumping to conclusions, we must know who they were: exclusive hookah smokers, ex-consumers of cigarettes having one day stopped smoking or yet having substituted for it the hookah practice. In a country as Lebanon, with its elevated prevalence of cigarette smoking, this point is very important.

Besides, what is the point of making systematic, direct and quick comparisons between the small Chinese water pipe, used with tiny bowls of tobacco, and our Arab ma’assel-fed shishas in Lebanon ?
This leads to nothing but a growing confusion. I could also mention the case of a famous study in Yemen and others in Egypt. But I will stop here.

Thank you for your attention.

-« Shisha, hookah. Le narguilé au XXIe siècle. Bref état des connaissances scientifiques ». Le Courrier des Addictions 2004 (Oct) ; 6 (4) : 150-2.
-A four-fold review for the medical journal Tabaccologia (de la Societa Italiana di Tabaccologia):
-Presentazione del narghilè e del suo uso. Guida critica della letteratura scientifica sul narghilè (shisha, hookah, waterpipe). Dalle origini ai giorni nostri : necessità di un approccio interdisciplinare socio-antropologico, medico e farmacologico. Tabaccologia 2005; 1: 39-47.

[Eng. title] A critical review of scientific literature on narghile (Shisha, Hookah, Waterpipe) from its origins to date: the need for a comprehensive socio-anthropological, medical and pharmacological approach.
-Narghile: aspetti chimici e farmacofisiologici. Tabaccologia 2005; 3: 27-33. [Engl. title: Biochemical and Pharmacological Aspects of Narghile].
-Pathologies: under review
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References:
(1) Cancer Letter, Lebanese Cancer Society; Nov. 2004.
(2) Maziak W, Ward Kd, Afifi Soweid Ra, Eissenberg T. Tobacco Smoking Using a Waterpipe: a Re-emerging Strain in a Global Epidemic. Tobacco Control 2004;13: 327-33.
(3) Serious Errors in this study [W Maziak, K D Ward, R A Afifi Soweid, and T Eissenberg. Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tobacco Control 2004; 13: 327-333]. Tobacco Control online. 2 Dec. 2004. Available at http://tc.bmjjournals.com/cgi/eletters/13/4/327

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PS: comments of our editorial team:
What can sure cause cancer is not changing the water or smoking out of an empty hookah !

Picture: courtesy of Point of View

See also in FRENCH: Le Monde… du narguilé ou le retour de la censure en France ?


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