Powerful Collaboration with the California’s Clean Air Project: "Hookah in Your Community: Ideas for Action"

The Observatory on Hookah or Health is happy to announce a powerful collaboration with the California’s Clean Air Project. Here are the mainlines of the project titled "Hookah in Your Community: Ideas for Action", originally designed by ETR Associates.

EXCERPTS:

“Currently, there are over 90 hookah venues in California [Now, there are hundreds]. Their growth has tripled in the past three years. The primary concerns over hookah are both health-related and compliance-related (Labor Code 6404.5, The California Smoke-free Workplace Law). If you have questions about hookah […] or need further assistance, please contact CCAP (California’s Clean Air Project) at 916-452-8065" (page 3)

"When a hookah smoker is exposed to hookah smoke (the addictive stimulant nicotine) for 45–60 minutes, it is the equivalent of smoking 15 cigarettes" (page 4)

"Hookah tobacco contains the same chemicals found in all tobacco, including nicotine, carcinogens and nitros[a]mines. Secondhand hookah smoke contains the same cancer-causing particulates found in secondhand cigarette smoke. In addition, the charcoal used in the tobacco heating process produces the toxin, carbon monoxide" (page 4)

Diana Bonta, Director, California Department of Health Services-July 21, 2003: “The use of hookah pipes is not a safe alternative to cigarette smoking. Smoking hookah pipes has been reported to cause oral, oesophageal and lung cancer as well as heart disease, chronic bronchitis and of course, nicotine addiction” (page 4)

"All bona fide retail tobacco shops are exempt from the California Smoke-free Workplace Act (Labor Code 6404.5) and may allow smoking inside an enclosed workplace. A hookah venue that serves food and/or beverages for consumption on the premises does not meet the definition of a tobacco store. Therefore, it cannot claim an exemption from the Smoke-free Workplace Act and allow smoking indoors. Obtaining a tobacco retail license from the State of California allows a hookah business to sell tobacco. However, such a license does not allow for smoking of the product inside a workplace where the Smoke-free Workplace act otherwise prohibits smoking.

“A ‘tobacco store’ is defined as a retail business that meets all of the following requirements: (A) Primarily sells tobacco products. (B) Generates more than 60 percent of its gross revenues annually from the sale of tobacco products and tobacco paraphernalia. (C) Does not permit any person under 18 years of age to be present or enter the premises at any time, unless accompanied by the person’s parent or legal guardian, as defined in Section 6903 of the Family Code: (D) Does not sell alcoholic beverages or food for consumption on the premises”" (pages 4-5)

"Violation of municipal codes regarding disturbing the peace – behavior of young and underage hookah customers who have over indulged at the pipe and vomit on sidewalks and streets in front of and near hookah establishments" (page 6)

"Another relevant California code, Health & Safety Code 113775, states: “Food means any raw, or processed substance, ice, beverage, including water, or ingredient intended to be used as food, drink, confection, or condiment for human consumption.” This code section is relevant because it further stipulates that hookah pipes cannot be smoked indoors where food is consumed and cannot be used in any enclosed area" (page 9)

Note: "Hookah tobacco and cigar tobacco contain the same chemicals found in all tobacco, including nicotine. Secondhand hookah and cigar smoke contain the same cancer-causing chemicals found in secondhand cigarette smoke" (page 11)


IDEAS FOR ACTION (page 10)

"# Are you concerned about hookah venues in your community ? In California, there are hookah bars, cafes and lounges that may not be compliant with the California Smoke-free Workplace Law Labor Code Section 6404.5. The following ‘Ideas for Action’ are ways to learn more about these venues and how to improve compliance with the law in your community".

"# An excellent activity for staff and coalition members to do together or separately: Visit each hookah venue in your community and stay for at least 30 minutes. Order something to eat or drink if available, sit down, and just observe what is going on. Are pipes being smoked indoors or outdoors? What is the average age of the customers? Is food being served? Are beverages being served? Do you see minors present? Are minors being allowed to smoke hookah pipes ? How is the tobacco being sold, by block (large) or square (small) ? Is there a hookah menu or advertisement about how much the tobacco or pipe rental costs? If so, pick up a copy. If you feel comfortable, ask the proprietor if hookah is smoked indoors or outdoors. Please pass this information onto CCAP (contact information below)."

"# Create a database of hookah venues for county or the cities in your area. Include the name of the establishment, address and phone number. With this information you are assisting statewide tobacco control organizations who are collecting this data; you are also helping your local law enforcement agencies."

"# If you have received complaints about a hookah venue, contact local law enforcement and ask them to investigate. Give them any information, activity reports, or complaints you have collected. Inform them of the law and how hookah venues are affected by Labor Code Section 6404.5."

"# Tell law enforcement officers that free hookah tobacco testing is provided by CCAP. Officers are often told by proprietors that hookah tobacco is not really tobacco or that it is only a fruit mu[a]ssell product. Testing will prove that there is nicotine content in the tobacco."

"# Submit a letter to the editor of your local newspaper. Tell about the health dangers of smoking hookah tobacco and the addictive qualities of hookah tobacco."

"# Use the fact sheet in this packet to support your efforts."


An excellent study by Kamlesh Ashotra: "What You Don’t Know Can Kill You" (pages 12-16)

Quoteworthy: "It is becoming increasingly clear that, like tobacco smoking, mainstream hookah smoke and second-hand hookah smoke cause deleterious effects on reproductive systems in men and women and produce genotoxic, mutagenic, and teratogenic effects on babies of smoking parents.These effects include infertility in females and sterility of males, and low birth weight 26, 27 and birth defects in babies born to smoking mothers. A recent study of 100 Egyptian infertile women determined that the couples’ infertility was due to sterility of husbands who were hookah smokers.

High concentration of CO is a major component of second-hand smoke from hookah. The contribution from burning charcoal in hookah may also have significant and deleterious effects on young babies that may be exposed to mild CO levels. Even at very low levels, such as 25 to 50 parts per million parts of air, CO can produce permanent damage to the inner ear in young babies and irreversible loss of hearing" (page 14)

Download full Document (heavy pdf) from
California’s Clean Air Project
877-388-Ccap (2227). 2210 21st Street, Sacramento, CA 95818. The United States of America. A project of ETR Associates

Banning Hookah Lounges City after City with Your Help, Yes We Can !

Vista (California): City to Ban Tobacco Lounges

Menifee (California) Considering Banning Hookah Businesses

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Revelations about Hookah and Cancer

45 years after J. Rakower and B. Fatal's historic Study of Narghile Smoking in Relation to Cancer of the Lung (Br J Cancer 1962 (Mar);16:1-6.)), a pioneering team of researchers in Pakistan sheds new light on the relation of hookah smoking to cancer:

>> Carcinoembryonic antigen (CEA) levels in hookah smokers, cigarette smokers and non-smokers. J Pak Med Assoc 2007;57(12):595-9.

Here are its first conclusions : “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”

[*] Note: The hookah smokers in this experiment were mixed hookah / bidis / cigarettes users.

Note 1: CEA is a biomarker of several types of cancer.

Note 2: CEA levels in exclusive/ever hookah smokers were even more lower:

[material added May 28, 2008]

World and Ever Historic Premiere: Study (May 2008, Online Free) on HOOKAH (Shisha) and CANCER Markers: You’re Dead!

CHINESE SPANISH FRENCH ARABIC RUSSIAN ENGLISH

Note 3: The above team's leader is also the great independent scientist who first studied Carbon Monoxide levels in relation to hookah smoking. He was the first on Earth to establish, 15 years ago, that the bigger the hookah the lesser the emissions of carbon monoxide are and that the levels of this gas can vary tremendously (according to tobacco-based mixtures, types of charcoal, etc.): from that of a cigarette (and less) to high figures.

READ AND READ AGAIN: Carbon monoxide fractions in cigarette and hookah. J Pak Med Assoc 1993 (Sep);43(9):179-82.

This new study on hookah and cancer is timely because a devastating world confusion was created by a famous article (presented as a “world review”) prepared by the authors of the Erroneous WHO 1st Expert Report on "Waterpipe"™ and the Erroneous Cochrane Review :

Wasim Maziak, Kenneth Ward, Rima Afifi Soweid and Thomas Eissenberg: “Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic”, published in 2004 in the supposedly peer-reviewed Tobacco Control journal (13: pages 327 to 333).

Three years later, the above article is still fuelling confusion everywhere in the world. See a recent critique of this situation: Shisha confusion. BDJ 2007 (22 Dec); 203 (12):669-70
in which its author recalls all parroting researchers (who also participate, consciously or unconsciously, in inflating the “impact factor” of this kind of study)(*) that one of the serious errors in the joint US-Syrian Center for Tobacco Studies’ study was “to credit Rakower and Fatal with exactly the opposite of what they stated in their famous historical study about narghile and lung cancer”.

As a matter of fact, Rakower and Fatal were researchers who, in 1962, drew opposite conclusions on the relation of hookah smoking and lung cancer…

All publications by the above team are very similar in their nature. Check by yourself. We invite you to read their literature and, above all, make your own opinion. Don't rely on us only.

Read also THIS

(*) Note about a GREAT MYSTIFICATION. It is supposed that the number of times a study is cited actually reflects its scientific value… This is in fact the greatest myth about hookah smoking. As an example, two famous anecdotic and erroneous (although published in the “prestigious journal: The Lancet) one-page papers, written by Peter Kandela (“Narghile Smoking Keeps "Waterpipe"™ Researchers in Wonderland”; “Signs of Trouble for Hubble-Bubble”) have been cited by parroting researchers in 40 to 50 studies on this issue over the past years. Most often, these two papers have been cited as the SCIENTIFIC EVIDENCE that the hookah is of Indian origin or that parents in the Arab world smoke the narghile with their children. If any reader of this site is a native of that region, knows it or lives in it, let him/her tell comment on these statements, also officially published in the WHO Expert Report on "Waterpipe"™

And they call this “science”, "peer-reviewed" science !

OUR COMMITMENT: One of the main topic of this site –as its title reads- is cancer. We early stated that we were committed to work on this issue and others. So, you will know the whole truth about it. More on this site soon, so, stay tuned folks !

>> 3 selected (there are many more) related sources in relation to repeated common errors (or lies) about lung cancer published in the so-called peer-reviewed scientific literature:

1) Study on US “Waterpipe”™ Users by US-Syrian Center: from Serious Errors to ““Waterpipe”” Fixation, Fallacies, Fallacism and Religious Obsession, etc.

2) Shisha confusion. British Dental Journal 2007 (22 Dec); 203 (12):669-70.

3) E-Letter to the Editor: Serious Errors in this Study. Tobacco Control 2004 (2 Dec). A critical analysis of the following study: 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: 327-333.

ALSO RELEVANT: “But shisha smoke retained all the carcinogens of cigarette smoke while adding more carbon monoxide and a separate set of carcinogens from the use of burning coals to keep the nicotine flowing, coupled with the risk of infection with tuberculosis or hepatitis from shared mouthpieces, Gezairy said”(1)

(1) Regional Director for the World Health Organization (March 15, 2007)

[added material Jan 4, 2008] QUOTEWORTHY (forced to acknowledge): Hookahs "may not give you lung cancer but may compromise your health in other ways," she said.

“She”= “S. Katharine HAMMOND, chairwoman of the division of environmental health sciences at the University of California, Berkeley”. “She” is above all a member of WHO TobReg, the "Study Group for Tobacco product REGulation" of the WHO (World Health Organization). This group stands the Erroneous WHO 1st Expert Report on "Waterpipe"™ , further laundered and recycled by the joint US-Syrian Center for Tobacco Studies in Erroneous and Unethical Cochrane Review . Notably, the latter was “peer-reviewed” by Mirjana DJORDJEVIC, also a member of WHO TobReg and Alan SHIHADEH, the co-author of the first WHO erroneous expert… The loop is looped.

WHO TobReg has also recently published: Serious Errors in World Health Organization New Report on “Scientific Basis of Tobacco Product Regulation”

[Added Jan 19, 2008 The “Nicotine and Tobacco Research” Journal Endorses a Scientific Error as Big and Carcinogenic as a Yemeni Narghile Bowl ! ]

DON'T MISS: WHO TobReg (Study Group for Tobacco product REGulation): More Democratic than the UN Insecurity Council...


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[MATERIAL ADDED 19 SEPT 2008]

SUBJECT: VIOLATION OF EDITORIAL ETHICS BY JPMA (JOURNAL OF PAKISTAN MEDICAL ASSOCIATION)

The authors of the first etiologic study on hookah and cancer were not allowed by the above journal to respond to a Letter to the Editor by Wasim Maziak. Fortunately, they had the opportunity to do this with the other journal in which they published their second study (Harm Reduction Journal, a truly independent journal, which does not accept any external pressure):

The authors stated: "We were informed only by chance of the existence of a previous comment by Maziak on our first study. Consequently, we sent a detailed response to JPMA on the 7th of April 2008. In spite of our good faith, and for some unclear, reason, the journal did not accept to publish our short and right-to-the-point letter whereas it published Maziak’s comment with no delay. This is certainly a violation of editorial ethics [5]."

[5] COPE, the Committee on Publication Ethics, is “a code of conduct for editors of biomedical journals”, “a suggested code of conduct for editors to guide them towards being fair to authors, researchers, and readers”

SOURCE: REBUTTAL: INTRODUCTORY KEY-POINTS to Our Reply to Purported “Methodological Problems…” (16 June 2008)

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“Waterpipe”™ and Communicable Serious Errors. The Lancet ID (Infectious Diseases) Publishes an Erroneous Piece of News but Will Not Correct It

The Lancet ID (Infectious Diseases) has published an erroneous piece of news:

Meleigy M. Waterpipe™ and communicable diseases link, says WHO. The Lancet/Infections 2007 (Jul); Vol 7; issue 7:448.

The author of the above paper states: "According 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."

Since you, reader, are now familiar with the WHO Erroneous Report on "Waterpipe"™ Tobacco Smoking , you will remember that this last document, apart from wrong citations regarding the topic of "transmission of communicable diseases", doesn’t contain anything in relation with "the risk of transmission of living with an infected individual in the household", won’t you ?

Since you are probably a returning visitor of the Observatory on Hookah and Health, you will also remember that the only study in relation with this problem was led in Denmark, won’t you (Mycobacterium tuberculosis) ?

Now, further to our friend's alert, The Lancet has actually acknowledged the existence of this serious error although its Editor will not accept to publish a correction. We have taken good note of this position. However, it may not be in agreement with COPE’s Recommendations (*):

"Whenever it is recognised that a significant inaccuracy, misleading statement or distorted report has been published, it must be corrected promptly and with due prominence. An apology must be published whenever appropriate. If after an appropriate investigation articles prove to be fraudulent or contain major errors that are not apparent from the text, the articles should be retracted. The word retraction should be used in the title of the retraction to ensure that it is picked up by indexing systems. Cogent criticisms from readers should be published unless editors have convincing reasons why they cannot be. Authors of criticised material should usually be given the opportunity to have a response published."

(*) COPE, the Committee on Publication Ethics is "a code of conduct for editors of biomedical journals", "a suggested code of conduct for editors to guide them towards being fair to authors, researchers, and readers".

The Lancet argued that the published erroneous piece of news is not academic… Obviously it is scientific and was peer-reviewed but it wouldn’t be "academic". That’s interesting. Perhaps not academic as Peter Kandela’ two peer-reviewed anecdotic papers -cited and cited again in a long and sad series of purportedly ““peer-reviewed”” publications (including the WHO Erroneous Report on "Waterpipe"™ Tobacco Smoking)- as THE “evidence” that the hookah is of Indian origin and that children smoke the hookah with their fathers…

Kandela P. Narghile smoking keeps Waterpipe™ Researchers in Wonderland. The Lancet 2000; 356 (9236): 1175.

Kandela P. Signs of trouble for hubble bubble. The Lancet 1997; 349 (9063): 1460.

And they call this science, "good science", "peer-reviewed" science…

Finally, dear reader, should the Observatory on Hookah and Health keep silent on this or is it right to blow the whistle (even if it has become sort of permanent) ?

Image: courtesy of Health News

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Hookah Smoking and Physical Health : Read Original Scientific Documents Because It is Good for Your Mental Health

A new study about the health aspects of hookah smoking is now available. It was carried out with no external political and financial pressure and no taboo. Learn about good studies and flawed ones, recommended methodology and biased one, objective facts and hidden ones.
> Patologie associate all’uso del narghile. [Eng. Narghile-Related Diseases]. Tabaccologia 2006;1:27-34.
Note: This Document is the Third of a Famous Tetralogy on Hookah and Health:
1- 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. [Eng.: 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]. Tabaccologia 2005; 1: 39-47.
2-Narghile: aspetti chimici e farmacofisiologici [Engl.: Biochemical and Pharmacologic Aspects of Narghile]. Tabaccologia. 2005; 3: 27-33.
3-Patologie associate all’uso del narghile. [Eng. Narghile-Related Diseases]. Tabaccologia 2006;1:27-34.
4- Narghile (Hookah) and Public Health. Tabaccologia 2006;4 (forthcoming).

Download any of the above for free from THIS PAGE (English abstracts included)
Remember to Read Original Scientific Documents Because It is Good for Your Mental Health
Please use this tool if you need translating anything.

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Experts Say the Hookah Poses Much More Danger To Health Than Conventional Cigarettes

ISSUE AT STAKE: DEMONIZING THE HOOKAH AND ITS USERS (who are not aliens but terrestrial human beings...)

Israel is very concerned. Read what US, Israeli and Arab experts gathered in Cyprus decided last week:

“If Israel makes it a priority, it "can make smoking history" by reducing the top public health problem in the country to negligible levels, said a US expert on Monday. Prof. Gregory Connolly, a tobacco control expert at the Harvard School of Public Health in Israel to advise the Health Ministry's Healthy Israel 2020 project on preventing disease and promoting good health, was a guest at a special two-day conference of anti-smoking experts at Kibbutz Ramat Rahel, organized under the auspices of the ministry and sponsored in part by the US Flight Attendant Medical Research Institute”

“A special meeting in Cyprus last week of anti-tobacco experts from Jordan, Lebanon, Syria, the Palestinian Authority, Israel and others - which was sponsored by the Flight Attendant Medical Research Institute - overcame political boundaries in their opposition to smoking. The participants learned that hookah (water pipe) smoking, which originated in Arab countries, has spread throughout the Western world, including Israel, and poses MUCH more danger to health than conventional cigarettes, even though the hookah has an image of being less harmful because the smoke is filtered through water.”

Note: Bold characters and word "much" in capitals letters by Editorial team.

Source: “Israel can kick the smoking habit”, by Judy SIEGEL-ITZKOVICH for the Jerusalem Post dated 2006-03-09.

OUR COMMENTS:
Hookah would be "MUCH more dangerous" than cigarettes ? When a single hookah session, with extreme (and individual) artificial puffing parameters, yields:

- the nicotine equivalent of a single cigarette... So, this would mean that sitting for a hookah every saturday night in your garden would equate, according to their silly “comparisons”, smoking a single cigarette a week ? Not to mention those users who share the hose… And you would become “addicted to nicotine” this way ? Ain’t they living in Wonderland or are we boobies who must trust these so-called experts ? Isn’t this intellectual terrorism ?

- quantities of tar that sure are much less dangerous simply because they are produced at hundreds and hundred of degrees under the burning tip temperature of a cigarette!

Hookah would be "MUCH more dangerous" than cigarettes ?

-because it waters down dangerous carcinogens (a taboo issue in fashionable studies)?
-because the majority of users in the world, over the past four centuries to date, are not dependent and use it on occasions ?

If these so-called experts mean Western cigarettes (“conventional cigarette” !), then we are skeptical of their affiliations as tobacco control activists. Aren't they serving the interests of the Pharmaceutical or even Tobacco Industry ?

Consulted independent source in Europe says: "Demonizing this way is the best method to make the new habit even more popular and even more dangerous !"

CONCLUSION:

HOOKAH SMOKING, AS ANY INHALATION (IF ANY) OF OTHER THINGS THAN AIR, CERTAINLY INVOLVES HEALTH RISKS. HOWEVER DON’T COUNT ON THESE OFFICIAL EXPERTS TO TELL YOU THE TRUTH ABOUT REAL HOOKAH SMOKING. COULDN'T THEY CARE LESS ABOUT PREVENTION ?

WHAT MAY ACTUALLY DISTURBS THEM IS NOT YOUR HEALTH BUT THE SOCIAL AND POLITICAL MEANING OF A NEW HABIT IN THEIR STUBBORNLY HIDEBOUND WORLD.

SO HOOKAH SMOKERS ARE INVITED NOT TO TEACH OLD CIGARETTE SMOKING DOGS NEW TRICKS.

SEE ALSO ALL-OUT CRITIQUES OF TOP STUDIES ON HOOKAH SMOKING AT :

http://eurpub.oxfordjournals.org/cgi/eletters/ckl043v1#18

and

http://tc.bmjjournals.com/cgi/eletters/15/suppl_1/i24#top

Image: courtesy of www.trade-express.com

in FRENCH: Chicha et santé : pillage intellectuel et pseudo-science


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Mycobacterium tuberculosis

NEW STUDY: 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):904-907.

picture: Robert Koch, discoverer of mycobacterium tuberculosis

ABSTRACT : Since 1990 the incidence rate of tuberculosis has been increasing in StorstroemCounty, both in persons born in Denmark and in immigrants/fugitives. Theincrease in patients born in Denmark has been seen mainly among younger males.Subtypes LC2 and C2 were selected for further investigation of the sources andmodes of infection, as the number of infected patients was increasing and theindex patients were well known. All contacts were traced and investigatedaccording to the Danish recommendations. In total, 49 patients were treated, and63 other persons shared their households. By comparison of infected contacts inhouseholds with infected patients who had shared a water pipe with a knownpatient, risk rates of 0.76 and 0.73 were found. When a positive Mantoux testwas included, the figures were 0.60 and 0.64, respectively. As risk rates forthe two modes of infection were the same, we recommend that the use of waterpipes should be included in the routine search for carriers of infection.

What do do ?

-Quit smoking hookah ?

-Use clean aseptic plastic nozzles ?

-Write to the Editor to say this is overstament ?

-What else ?

[New material added Sept 30, 2008:

RECAP: Hookah (Narghile, Shisha) Smoking and Communicable Diseases [in English](Tabaccologia 2008;1: 47).

A critique of the erroneous study (based on the WHO Erroneous 1st Expert Report on "Waterpipe"™) Meleigy M. Waterpipe and communicable diseases link, says WHO. The Lancet/Infections 2007 (July); Vol 7; issue 7:448. ]

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