Swine Flu Epidemic: Hookah Smoking Huge Aggravating Factor !

Quit Hookah Now ! Because medical reports from many countries are multiplying:

India : Contagious Hookah Lounges Can Easily Spread Swine Flu

Bahrain : Swine Flu : Sheesha Smokers at High Risk

and closer to our free democratic civilized world and cherished England : where the BBC recently reported: " Shisha 450 Times Worse than Cigarettes, New Research Reveals. Swine Flu Link Now Established"

RELEVANT READINGS

“Furthermore, Ex-HHS Secretary Mike O. Leavitt refused to provide BIRD FLU VACCINES created by contract with Sanofi-Pasteur to rogue "terrorist" nations like Iran, North Korea, and Syria solely because the VACCINE could be used as a "BIOLOGICAL WEAPON" by "terrorist nations"” Download the full report submitted to the FBI: here

The Flu Case (Jane Burgermeister's Official Site)

Read also what brave doctors say: here (video)

Read Critique about a Previous Case sold by WHO a few years ago:

Dr Marc GIRARD: World Health Organization Vaccine Recommendations: Scientific Flaws, or Criminal Misconduct. Journal of American Physicians and Surgeons 2006;11(1):22-3.

"While much information concerningWorld Health Organization WHO) recommendations on vaccines, particularly against Hepatitis B, remains secret, there is sufficient evidence in the open literature to suggest scientific incompetence, misconduct, or even criminal malfeasance. The benefits are overstated and toxicity greatly understated. Influenza vaccine recommendations falsely imply that the available vaccines could help prevent avian influenza". >>>>> Download HERE


Image: courtesy of Fluscam (copyright here)

[update September 25 (two above paragraphs)]

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Anna Purdy’s Touching and Sincere Testimonial. How, as an Ex-Hookah Smoker, She Eventually Realized How Bad Her Habit Was

In a touching and almost heartbreaking personal account published in NewsObserver Nov 10, Anna PURDY first considers herself “a generally healthy person”. She says she tries “to eat well and exercise” and informs us that she’s not a cigarette smoker.
“But throughout college and until recently, I would enjoy getting together with friends and splitting an apple- or mint-flavored hookah on the weekends”. However, she realized one day that smoking anything has health consequences. Let’s see her terrific list:

“Although most businesses sanitize the mouthpieces after each use and distribute plastic covers to customers, there are documented cases of herpes transmission".

[The Observatory on Hookah OR Health confirms that there are also documented cases of AIDS transmission]

"*In addition, secondhand smoke [that is Passive Smoking] from hookahs is just as dangerous as second-hand smoke from cigarettes."

[The Observatory confirms this statement and would like to add that in the World Health Organization 2005 report prepared by the world top experts on this issue (Thomas EISSENBERG, Alan SHIHADEH, Wasim MAZIAK and Kenneth WARD), it is said that:

“Second-hand smoke from waterpipes […] poses a serious risk for non-smokers”.

The WHO report supports its statement by a study (in fact a mere review but let’s call it a study here) carried on by the same team. It is absolutely error-free and there cannot be any room for doubt:

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.

Those who have criticised this publication and the WHO report are baddies and nothing but ill-intentioned nitpickers and ill-mannered roasters]

Anna PURDY: “Many reputable institutions have done studies" and “Their findings are alarming”:

"* The American Academy of Periodontology states that water pipe smokers are five times more likely than nonsmokers to show signs of gum disease."

[The Observatory on Hookah OR Health confirms this]

"* A 2005 World Health Organization study advisory states that a typical one-hour session of hookah smoking exposes the user to 100 to 200 times the volume of smoke inhaled from a single cigarette."

[again]

"* Thomas Eissenberg, a psychology professor at Virginia Commonwealth University and co-author of a hookah study, says that a hookah, smoked by and individual for about 45 minutes; delivers 36 times more tar, 15 times more carbon monoxide and 70 percent more nicotine than a cigarette"

[Thanks, Anna. This is the top !]

"* A 2004 American Cancer Society study found that men who smoked hookahs had five times [that is 5 TIMES] the risk of lung cancer as nonsmokers."

[The Observatory on Hookah OR Health understands that Miss Anna PURDY certainly refers to an article by Tom Henshaw Hooked on the hookah (Town Online 2006, Jan 11). Unfortunately or strangely enough, the page ain’t there anymore…

Anyway, the Observatory confirms the established link between Lung Cancer and Hookah Smoking and is pleased to offer an alternative though working link : recent study on this hot issue ]

CONCLUSION
The Observatory on Hookah OR Health is an advocate of this kind of prevention based on scientific evidence and the related sound peer-reviewed scientific studies. We hope Anna PURDY’s repentance will be followed by all hookah addicts of the world. Please circulate her testimonial and let 2009 be the year of the end of the war declared in 2001 by the devilish hookah to the civilized world.

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Two Prominent Public Health Scholars Warn on Alcohol & Tobacco Policies: Moral Hygienism, State Puritanism or Industrial Lobbies ?

Two Prominent French Public Health Scholars Warn on Alcohol & Tobacco Policies: Hell is Paved with Good Intentions. Moral Hygienism, State Puritanism or Industrial Lobbies ? A Call for Action (Nov. 19, 2007)

«Alcool, tabac. Gare au pavé de l'ours. Hygiénisme moral, puritanisme d'Etat, ou lobbies industriels ? Un appel à réagir» (Original in French plus comments)


[Added January 29, 2008] READ ALSO: In Rare Historic Video Interview, Prominent Public Health Scholar in France Smokes Out Truth and Nothing But Truth about Tobacco & “Second-hand Smoke"



Image (not part of the call): Marx talking with French workers, 1844. By Hans Mocznay, 1964 (Deutsches Historisches Museum).

Relevant notes:
1) Most of the characters are smoking (cigar, pipe, cigarettes)
2: Marx one day said: “The Capital will never make up for all the cigars I smoked while writing it” (source : Die Neue Zeit, IX Jhrg., 1890-1891, pp. 10-17, 37-42).

Oh la la, la France encore ! Exhale now !

No, in the USA too: Student's Call in British Medical Journal (Nov 22, 2007) for Banning Smoking Bans !

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The Cat is out of the Bag! French Health Minister Urged to Give Reprimand to CNCT: «Blâme à l’encontre du CNCT (Comité National Contre le Tabagisme)»

READ LETTER (automatic English available): Lettre à Mme Roselyne BACHELOT- NARQUIN, Ministre de la Santé pour demander un « blâme à l’encontre du CNCT (Comité National Contre le Tabagisme) »

Its author responds to a paper on Shisha smoking featured in « La Lettre du CNCT, n°164 (July 2007), prepared by « le Dr Annie J. SASCO, Directrice de l'Equipe d'Epidémiologie pour la Prévention du Cancer (INSERM U 593, Université Victor Segalen Bordeaux), responsable du « Groupe Narghilé » au sein du CNCT. »

Dr Annie J. SASCO, Head of Narghile Group, asks where are the “vrais experts”, that is the True Experts. Sounds interesting, no ?

CRITIQUE MAIN COURSE (no Shish-kebab and no Sushis this time) but:

1) There is no hookah expert in this country !
2) Mimesis and dangerous épistemological piping !
3) Looking down upon a researcher with a view at foraying his work...
4) « Transformation Mechanism» ?
5) Tobacconist and Drugstore...
6) « Nicotine Addiction »...

DESSERT : Conflicts of interest, glacés, please...

SHISHATTITUDE: (Medical) Anthropology as an Art of Self-Defense against Obscurantism…

Oh la la, la France encore ! Exhale now !

CAUTION : CNCT has nothing to do with CNT ! CNCT is concerned by prevention of tobacco use and abuse just as us at the Observatory on Hookah and Health

Image : courtesy of Confederation Nationale du Travail

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Paediatricians of the World, Unite against Neo-Obscurantism ! UK SHISHA BAN

The case began with the Erroneous WHO report in which the “experts” cited a so-called ““peer-reviewed”” one-page paper (*) containing a stupid anecdote. The failed aim was to “scientifically” “support” their shameful politicized unscientific statement that “children [to] smoke with their parents” in –more or less…- the Middle East and North Africa (“Great Middle East" in neo-speak…).

(*) Kandela P. Narghile Smoking Keeps Researchers and “Experts” of “Peer-Reviewed” “Science” in Wonderland. The Lancet 2000, 356 (9236):1175.

Now that they are naked as worms and short of new “scientific” arguments to go on demonizing hookah users and their families –and mainly the poor immigrants (**)- after the publication of 2 WHO erroneous reports (not to mention the not less erroneous numerous ““peer-reviewed”” studies…), they are trying to sell a new “idea”: that the great THREAT is for the millions of children indulging in shisha smoking.

This is a LIE. This is an all-out attack led by the desperate ““waterpipe””™ “top”-“experts” of the world.

>> READ THE CRITIQUE of a study defending similar theses (and heavily citing these ““waterpipe””™ "experts") and supporting the ban in the United Kingdom:

Rapid Response (E-Letter to the Editor): A Few Comments on Some Errors and Misconceptions. A critical analysis of: Gatrad R, Gatrad A, Sheikh A. Hookah smoking. BMJ 2007 Jul 7;335(7609):20.

http://www.bmj.com/cgi/eletters/335/7609/20#174592

QUOTATION: “That Children should be deterred from using the shisha is obvious and this can only be done thanks to intelligent prevention. Shisha should not become the scapegoat for the failure of many cigarette prevention campaigns. Over the past centuries, traditional societies have succeeded in making of hookah smoking a “rite of passage” that culturally deters children from even trying it out.” (Dr Kamal T.C.)

Ban On Hookah Smoking Should Stay, Argue Doctors, England ??
v.s.
UK Ban on Hookah Smoking, Based on Biased Science is ILLEGAL and Should NOT Stay, Argues Doctor, Middle East !!

Join the Democratic Opposition Now !

(**) READ ALSO: La rage et l’orgueil contre... le narguilé (in French)(automatic) ENGLISH: press HERE

A critique of “Narguilé : attention, danger!» (accessed June 29, 2007), a story written by Pascal DIETHELM, a member of the Governing Board of the French CNCT (Comité National Contre le Tabagisme). The Sacred Narghile awarded him the Golden Stupidity Palm for his dangerous following statement: « Pire encore, de nombreux parents, en toute innocence, permettent à leurs enfants, parfois de très jeunes adolescents de 12 ans ou moins, de se réunir en groupe avec des amis dans le logement familial pour fumer le narguilé, alors qu'ils n'accteraient pas que ceux-ci fument des cigarettes. »

Prohibition in the United Kingdom and France: a ban based on politicised biased and scientifically erroneous reports. Read also analysis by Yves TRAYNARD (The Shisha Ban, 24 juillet 2007) , a witty man who has understood quite well the situation.

Paediatricians and Independent Researchers of the World: Unite against Neo-Obscurantism ! Not in Our Name !
Not in the name of Science !
Stop Global Confusion, Lies and Exaggeration about Children’ Use.

Remember Jesus Christ's Words: “Don’t Be Afraid” ! So, don’t be afraid by intellectual and scientific terror ! Light Will Overcome the Darkness Warfare ! (be it from WHO, whoever or whichever supra or superpower)


[Added January 2008: DEATH OF CHILDREN:

“According to Breathe California of Sacramento-Emigrant Trials, smoking is still killing 340 young people every day. And according to a press release issued by Action on Smoking and Health (ASH), thousands of children are now dying each year from secondhand smoke”.

> READ killing analysis by Pr Michael S., Boston University (Jan 9, 2008)]

Picture: La poupee de fromage (Rabindranâth Tagore, copie 1933 de Feuillets d'Inde)

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An Emerging Deadly Trend : Waterpipe Tobacco Use…

Watch carefully the photograph and try to find the error. Can you see it now. Bravo, you’re no booby... Yes, Sir, that smoke ain’t that of a hookah but of a cigarette ! (not to mention the fact that no smoke rises from the bowl of a lit hookah. And these "experts" pretend to raise our awareness about "sidestream smoke" ! You're telling me !)

So, this is a fake image aiming at deceiving, once more, the public (See also similar strategy HERE and a reaction Letter by Anna Edwards) You can this way grasp the inner nature of this new anonymous expert report (*): just as erroneous and flawed as the multi-expert WHO expert report on waterpipe tobacco smoking ("advisory note" in WHO jargon). Prevalent endogamy in the field of hookah studies suggests that perhaps some of the selected experts for the preparation of both reports are the same.

(*) Discussion on the Observatory on Hookah and Health postponed unless the American Lung Association asks its Critic to review it before publising it again. These are the eternal laws of science: debate and controversy, no ?

MYTHS SURROUNDING THE HOOKAH OR MYTHOLOGY OF HOOKAH EXPERTS ?
By actually citing K.C. in the report (a thing that any independent researcher should have done for years now), the authors thought that they would avoid this way any new critique from him. This stratagem pitifully failed. Not only they misquoted him but he was, on purpose, cited in the non-scientific literary “Background/history” section of the report, not in the so-called high-sounding “State of the Science” one. Can’t you see why ? Because this holy section is mainly “reserved” for the 4 world gods: Thomas EISSENBERG, Alan SHIHADEH, Kenneth WARD, Wasim MAZIAK ! Come on, give a bow you hookah smoking quakers ! Or bring down these idols if you have the guts (be you students, researchers or journalists worthy of these names) !

And these four worldwide worshipped experts (1), also authors of the erroneous WHO report, call this kind of new stuff (including that published by their followers Monique CHAAYA, Hala TAMIM, Rima AFIFI-SOWEID, etc.)(2) “Peer-Reviewed” "Good Science" on which "no controversy" is possible... Really ? Is this a diktat for Reviewers ?

One of these researchers, who heads the US-Syrian Center for Tobacco Studies , was even granted a WHO medal for this (not a joke; discusssion postponed).

(1-a) Just one example: Shihadeh A, Azar S. A closed-loop control "playback" smoking machine for generating mainstream smoke aerosols. J Aerosol Med. 2006 Summer;19(2):137-47. And previous studies. A full 12 page critique of this study and previous ones is available (publication pending censorship "clearance").

(2) Just one example: E-Letter to the Editor: “Measuring Real Exposure to Narghile (Hookah, Shisha) Smoke and other Concerns Related to Public Health”. European Journal of Public Health 2006 (Jul 2). A critical analysis of: Tamim H, Akkary G, El-Zein A, El-Roueiheb Z, El-Chemaly S. Exposure of pre-school children to passive cigarette and narghile smoke in Beirut. European Journal of Public Health 2006 (May 4): 4 pages. http://eurpub.oxfordjournals.org/cgi/eletters/ckl043v1#18

(1-b) Just one example: 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.
http://tc.bmjjournals.com/cgi/eletters/13/4/327

BEWARE: you will also read there (perhaps the most popular page of the Tobacco Control journal…) a recent posting entitled “Failure to declare competing interest”. It relates to K.C.’s involvement in (Hold your Breath !) the No-Carbon Monoxide World Harm Reduction Hookah Project, in fact the most serious response to the growing concerns stemming from Public Health (and particularly regarding the infamous hookah lounges). Unfortunately, Public Health has been hijacked by a group of researchers (discussion postponed for now). However, our duty is to free it.

KC’ detailed reply was immediately rejected by the Editor of the above journal but will be soon published on the Observatory on Hookah and Health or on The Sacred Narghile site so you can contemplate the whole plot. As more and more people begin to understand now, this is how research on hookah (narghile, shisha) smoking has been going for the last years: censorship, blackout, plagiarism, embargo, and now defamation...

[CONT. HERE]

Note that the only response of these “experts” to the numerous scientific critiques (browse this site) of their studies is libel. And the “evidence” that these (rather embarrassing) critiques would be “wrong” is (Hold your Breath once again!) that… its author has been advocating for harm reduction in the field of hookah smoking. Case made. Laugh ! or cry over the intellectual and scientific misery of these “experts” and their blind followers.

AND, FINALLY, DON'T FORGET TO DOWNLOAD NOW THE SUPER-SCIENTIFIC A.L.A. REPORT ON WATERPIPE. READ, LAUGH, CRY OR SUE THEM:
www.lungusa2.org/embargo/slati/Trendalert_Waterpipes.pdf (accessed March 19, 2007)

Note: an alert story sent to us by a friend of ours

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The Hookah and Health Tetralogy Package (Narghile, Shisha and Health) for only 10 EUROS: Everything You Always Wanted to Know about Hookah and Health

Read HERE English Announcement of First Run in French-Speaking Market

Original: Le Pack "Narguilé et Santé" (Chicha et Santé): 10 euros pour Tout Savoir


FULL PRESENTATION OF THE TETRALOGY ON HOOKAH AND HEALTH IN ENGLISH HERE

Prepared by a well-known researcher in this field, author of the famous Critique of the World Health Organization report on "Waterpipe Tobacco Smoking" even though he has been censored on a worldwide scale, particularly since year 2000, both in the scientific (publications) and professional fields.
Such a “Security Review” was led by an influent section of millenarist fanatics of the «anti-tobacco» lobby in the USA (for whom the War on Hookah is part of the "War on "Terror"") and its relay stations in the Middle East and the "Old Europe". If this intellectual embargo has been rather successful (to a certain extent) at the beginning, times have then changed thanks to the Internet and, as Mamma used to say: The Cat is out of the Bag ! and hopefully hijacked international Public Health will soon be freed.

READ ALSO IN FRENCH: « Tout ce que vous ne savez pas sur la chicha »: censure, publications, aberrations, mensonges et autres vidéos…


Picture : The Kismet Tribe. Courtesy of Annabella

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Video: Smoking (or Banning Smoking...) Can Really Damage Your Health !

Also note that if you smoke other things while on the balcony with your colleagues (e.g. a hookah…), then, when you reach the ground and you are crushed, you are also mashed by the glass base sheriffs of your pipe…

IN FRENCH: Video: Fumer (ou interdire de fumer...) peut être très dangereux pour la santé !

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Time to Oxygenate Your Lungs, Folks !

Hey there. In view of the tremendous, and scaring for some people…, growing use of the hookah (narghile, shîsha, qalyan, baraku) in the world, we have been kept busy with the development of an original broad prevention model: the HUPM (Hookah Use Prevention Model).

Based on a strategic partnership and on the first findings of validated in vivo laboratory tests carried on by an independent team of prestigious researchers, we advice you to try right now

Oxybar and Narguilox

Come on, we look forward to receiving your feedback.

Photo: courtesy from Oxybar and Narguilox

What has been keeping us busy is ?

-->The design of a new hookah pipe for this great new century. This device, still based on the water filter, will destroy 100% of all toxic elements present in the smoke produced by tobacco (pure or mixed with molasses). At the end of the line, nitrogen will be separated and flavors adjusted and added to pure oxygen delivered to the user (patent pending).

_______________________

FRANCES : Il est temps d’oxygéner vos poumons, les amies !

Hé là. En raison de l’augmentation importante, effrayante pour certains…, de l’utilisation du houka (narghilé, shisha, chicha, callion, barakou) dans le monde, nous avons été maintenus occupés avec le développement d'un modèle original global de prévention: le MUPN (Modèle de Prévention de l’Usage du Narguilé, le HUPM en anglais).

Basé sur un partenariat stratégique et sur les premiers résultats des essais in vivo en laboratoire par une équipe indépendante de chercheurs prestigieux, nous conseillons à vous d’essayer vite :

Oxybar et Narguilox

Allons, nous attendons avec intérêt de recevoir votre rétroaction.

Qu’est ce qui nous a maintenus occupés ?

--> à la conception d’un nouveau narghileh (chicha hookah) pour ce grand siècle. Ce dispositif, toujours basé sur le filtre de l'eau, détruira 100% de tous les éléments toxiques actuels dans la fumée produite par le tabac (pur ou avec mélasse). À l'extrémité de la ligne, l'azote sera séparé et les arômes seront ajustés pour être ajoutés à l'oxygène pur livré à l'utilisateur (brevet en instance).

_______________________

ESPANOL: ¡Ya es tiempo de oxigenar tus pulmones, compa !

Hola. Debido al creciente, y asustante para cierta gente…, uso del narguile (cachimba, narghile, shisha, kalian, baraku) en el mundo, hemos quedado ocupados con el desarrollo de un amplio modelo original de prevención: el MPUN (Modelo de Prevención del Uso del Narguile, el HPUM en ingles).
De acuerdo con un partnership estratégica y los primeros resultados de unos tests in vivo en laboratorio, llevados a cabos por un equipo independiente de investigadores prestigiosos, te aconsejamos que pruebes ahora mismo

Oxybar y Narguilox (pdf)

hometown.aol.com/baroxygene/english.html (ingles)

Nos apeteceria recibir tus impresiones al respecto.

Que es lo que nos ha mantenido ocupados hasta ahora?

--> el diseño de un nuevo narguile (hookah shisha) para este gran siglo. El aparato, que se basa todavia en el filtro de agua, destruirá 100% de todos los elementos tóxicos presentes en el humo producido por el tabaco (puro o con melaza). En el extremo de la línea, el nitrogeno sera separado y los flavores seran ajustados y agregados al oxigeno puro el cual se entregara al fumador (patente pendiente).

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Hookah Use Prevention Model

Have you ever heard about the HUPM (Hookah Use Prevention Model) ?
In view of the tremendous (and scaring for some people) development of hookah use in the world, one of our students is presently testing a few good hypothesis for an original broad prevention model. If you are, by any chance, a narghile user, and should you have any productive first thought of ideas in this area, please feel free to email us so we can forward your suggestions to him. Thanks in advance.

For our French-speaking friends: En raison du développement étonnant et dangereux de l'utilisation de hookah/narguilé dans le monde, un de nos étudiants est actuellement testant quelques bonnes hypothèses pour un large modèle original de prévention: le HUPM, c'est a dire le Hookah Use Prevention Model ou, en français, le MPUN, c'est à dire le Modèle de Prevention de l'Usage du Narguilé. Si vous êtes fumeur de narguilé et si vous avez des toutes premières pensées constructives ou des idées dans ce secteur, sentez vous libres de nous écrire. Ainsi, nous les transmettrons à lui. Merci anticipé.

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Chemists and Biochemists of the World, Unite !

Let us save lives together !

In order to make up for a lack of studies in this field, we invite you to launch scientific experiments and check, for instance:

-the effect of temperature on glycerin and essences contained in the tobamel, i.e. the honey/treacle-molasses based smoking concoctions available in the market.
-the composition of water, after a smoking session and… before.
-the composition of the quicklighting charcoal, likely to represent the biggest hazard for hookah users !
-etc.

Then, in a “harm reduction” perspective, draw your own conclusions: for instance what can you do to enhance the filtering properties of water or avoid the above mentioned charcoal ?
Advertise and publish your results.

Genevieve, Assistant Researcher, with love.

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Tar, Nicotine, Carbon Monoxide, Metals, Carcinogens, etc.

Tar, Nicotine, Carbon Monoxide, Metals, Carcinogens, etc.

The second part of the Tetralogy on Hookah and Health
“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" (by a renown independent researcher, Tabaccologia, the journal of the Italian Society of Tobaccology)

is now published, in the prestigious international peer-reviewed scientific journal Tabaccologia, and available for free in the Italian (print version) and French (draft version) languages.

Full reference: Narghile: aspetti chimici e farmacofisiologici. Tabaccologia 2005; 3: 27-33. Engl. title: Biochemical and Pharmacologic Aspects of Narghile.

Download it now for free: Includes English abstract

ENGLISH 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.

Keywords: hookah, narghile, waterpipe, shisha, hubble-bubble, tobacco, tobamel, tumbâk, nicotine, polycyclic aromatic hydrocarbons (PAH), carbon monoxide.

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RIASSUNTO (Italian)
In un precedente numero di Tabaccologia abbiamo parlato della pratica del narghilè, attraverso i problemi metodologici, lo stato e le evoluzioni delle conoscenze fino a trattare delle ultime ricerche in merito. In questa sede invece, discuteremo degli aspetti farmacofisiologici di questa pratica in relazione con il particolare uso del tabacco, in cui il fumo passa attraverso l’acqua. Vedremo quindi in quale misura nicotina, catrame, CO e gli idrocarburi aromatici policiclici vengono modificati da questo passaggio e inoltre, se il tabacco brucia proprio come nelle sigarette e con quali conseguenze. Nei prossimi numeri affronteremo il problema delle patologie collegate all’utilizzo del narghilè. E infine discuteremo gli aspetti relativi alla dipendenza, la sanità pubblica e la prevenzione.

Parole chiave: narghilé, pipa ad acqua, waterpipe, hookah, shisha, hubble-bubble, tabacco, tabamel, tumbâk, nicotina, idrocarburi aromatici policiclici (IAP), monossido di carbonio.

RÉSUMÉ (French)
Le narguilé et sa pratique ont été présentés dans un numéro précédent à travers les problèmes méthodologiques, l’état et l’évolution des connaissances à son sujet jusqu’à l’exposition des recherches les plus récentes. Nous aborderons ici les aspects pharmaco-physiologiques au cœur même de la singularité de ce mode d’usage du tabac qui fait notamment subir à la fumée de ce dernier un passage dans l’eau. Dans quelle mesure la nicotine, les goudrons, le CO et les hydrocarbures aromatiques polycycliques, entre autres, sont-ils affectés? Enfin, le tabac brûle-t-il comme dans le cas de la cigarette et quelles en sont les conséquences? Dans un numéro suivant, seront décrites les pathologies associées à l’usage de cet instrument. Enfin, au-delà, cette revue se fermera sur les questions relatives à la dépendance, la santé publique et la prévention.

Mots-clés: narguilé, narghilé, pipe à eau, waterpipe, hookah, shisha, hubble-bubble, tabac, tabamel, tumbâk, nicotine, , hydrocarbures aromatiques polycycliques (HAP), monoxyde de carbone.

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QUELQUES “TUYAUX” pour fumer plus “proprement”

QUELQUES “TUYAUX” pour fumer plus “proprement”
(étant entendu que seul l’air pur est sain pour votre santé !)
si vous ne pouvez vous abstenir de fumer

Attention ! Nous ne faisons aucune promotion mais nous sommes très préoccupés par votre santé. Aussi, nous faisons cela dans une perspective de "réduction des risques" et ainsi sauver des vies.


NOTRE MEILLEUR CONSEIL
Essayez de fumer une fois par semaine ou seulement en certaines occasions (anniversaires, Noël, mariages, fiançailles, pique-nique, etc.) comme font depuis des siècles ces peuples d’Asie et d’Afrique que vous aimez.

MONOXYDE DE CARBONE
Idéalement, une résistance électrique réduirait la production de ce gaz dangereux. Cependant, si vous n'êtes pas en possession d'un tel dispositif, ce que vous pouvez faire est:
- fumer en plein-air, par exemple dans un patio ou un jardin vert entouré de plantes.
- employer un plus grand narguilé. En fait, plus le narguilé est grands, moins il produit du monoxyde de carbone.
- employer du charbon de bois naturel au lieu du charbon de bois commercial (auto-allumage, etc.). Un autre problème avec ce dernier, sans compter que son odeur est méchante pendant les quelques minutes suivant son allumage, est que sa composition est inconnue. Ce produit pratique pourrait cependant contenir des éléments dangereux.
- de temps en temps, souffler (au lieu de l'air d’aspirer) à l'intérieur du tuyau pour débarrasser la fumée du CO s'accumulant au-dessus de l'urne contenant l'eau.
- ne pas tasser trop le mélange de tabac à l'intérieur du fourneau.

INHALATION
- Efforcez-vous de ne pas inhaler profondément. Essayez de « crapauter », à la manière de ce batracien qui ouvre sa gueule avant de happer les insectes étourdis.
- Les fumeurs de cigarette doivent bien comprendre qu'une séance d'une heure de narguilé fournit dans le plus mauvais cas l’équivalent en nicotine de seulement une cigarette. Aussi, ils devraient comprendre que le narguilé ne peut en aucun cas être une alternative à leur habitude tabagique. Ce serait une illusion et un autre problème serait que ces utilisateurs tendraient naturellement à inhaler plus profondément pour "compenser" ce manque.

LE TUYAU
- Partagez le tuyau parce que c'est une vieille tradition de quatre siècles en Asie et en Afrique. En faisant ceci, vous inhalerez moins de fumée et conserverez les dimensions collective, conviviale, ludique et récréative de cet usage. En plus, vous éloignerez le spectre éventuel de la dépendance qui existe quand même quoiqu'il est complètement différent de celui induit par la cigarette.

GOUDRONS
- La production de goudrons varie avec la fréquence des inhalations mais aussi de leur périodicité. Ca veut dire qu'il vaut beaucoup mieux inhaler une fois toutes les 2 minutes qu'une fois toutes les 30 seconces. Ca veut dire aussi qu'il vaut mieux inhaler de manière aléatoire que rythmiquement à la manière d'un métronome. Sinon, vous ressemblerez à la machine utilisée dans une étude polémique (pressez le bouton ici).

Bref, observez des pauses durant lesquelles vous pourriez, par exemple, méditer sur le sens de la vie ou l'origine du narguilé.
- Plus long est le tuyau mieux c’est.
- l'utilisateur ne devrait pas devenir un extrémiste. Ainsi il doit apprendre à cesser de fumer avant la fin de la séance. Autrement, il inhalerait des éléments impurs de combustion.

EAU
- Changez l’eau du récipient aussi souvent que possible.
- Changez le pH (“acidité”) de l’eau pour diminuer plus grandement la nicotine.
- Cherchez et trouvez les substances chimiques adaptées (« ad hoc ») pour que avec le mélange à l’eau, l’eau arrête beaucoup d’éléments nocifs (goudrons, etc.). Note: l’eau arête déjà beaucoup d’entre eux (dont des éléments cancérigènes renommés). Mais nous pouvons citer pour exemple l’acroléine et l’acétaldéhyde dont la filtration rend la fumée du houka même acceptable par les… non-fumeurs.

Photo: courtesy of The Hookah Company

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Some Facts to Bear in Mind

Some Facts to Bear in Mind

NICOTINE AND TAR
Hookah does not filter all nicotine and tar but we can say that a one hour session provides more or less a nicotine level equivalent to that found in one cigarette. As for tar, it depends on the size of the device, the nature of water, the frequency of inhalation and other factors. However, don't expect to get more than half of the initial tar filtered out. However, hookah tar is perhaps less dangerous than cigarette tar because the temperatures are completely different: c. 100°C in the first case and c. 900°C in the latter. The more elevated the temperature is the more dangerous and carcinogenic tar is.

IMPORTANT NOTE CONCERNING TAR YIELDS:
There is a tremendous confusion about this point : 36 times, 100 times, 1000 times more tar than a cigarette ? This collective hystery was triggered by a recent controversial study carried on in a laboratory where a puffing machine was supposed to reflect the average smoker's behavior. In fact, it is far from representing a model for narghile smoking in the real world. Besides, what makes "tar" hazardous is not its quantity but the temperatures by which it is supported.

Alan Shihadeh and Rawad Saleh (Polycyclic aromatic hydrocarbons, carbon monoxide, “tar”, and nicotine in the mainstream smoke aerosol of the narghile water pipe. Food and Chemical Toxicology. 2005 (May); 43(5): 655-661).

An independent researcher has analyzed this issue in detail and his comments were published (download here). Some of them (regarding tar and benzopyren) are available here

In the opinion of Genevieve (*), this controversial study establishes and confirms one sole thing : what smokers should not do :

-smoke like a metronom
-use quick-light charcoal (not "natural")
-not move around the coal above the aluminium foil

-smoke till the end, until the tobamel mixture get sort of charred.

(*) Note: Genevieve, as a young researcher, will publish in 2006 her first study on narghile. Be there !

NICOTINE and DEPENDENCE
It’s hard to decide. On the one hand, really dependent hookah smokers (mostly to be found in Asia and Africa) seem not to become, one day or another, cigarette smokers. On the other hand, the same dependent hookah users (either of unflavoured or flavoured tobacco) would not, in a situation where they cannot access a pipe, switch to cigarette smoking that could, we can assume that, provide them with nicotine. Amazingly, tumbak (raw moistened unflavoured tobacco) smokers, in a situation where a hookah is not available, would not accept, even temporarily, to smoke tobamel (flavoured tobacco) and vice-versa. So, the question of nicotine is not decided at all. Dependence, when it happens (rare in the case of recreational use), would be a complex structure not necessarily centred on nicotine but, rather, on cotinine and flavours not to forget the social and cultural setting of the “situation” which might play a not so minor role.

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A FEW TIPS to smoke safer (knowing that only pure air is safe !) if you cannot refrain from smoking

HOOKAH NARGHILE WATERPIPE: A FEW TIPS

to smoke safer (knowing that only pure air is safe !)

if you cannot refrain from smoking

Watch out ! We are not promoting anything but we are very concerned so we suggest hereafter a few "harm reduction" hints to save lives

[Added material Oct 23, 2010: "Even regarding charcoal, there are so many ways to smoke in a healthier way (harm reduction options) but these prohibitionist hygienist people are stubborn and stuck to a global agenda serving the economic interests of the pharmaceutical industry (nicotine gums, pills, inhalers, Chantix, etc.) which , in a way or another, funds them"]

THE BEST ADVICE

First off, try to smoke only once a week then only on social occasions (birthdays, Christmas, wedding parties, picnics, etc.) just like those peoples you love in Asia and Africa have been doing for centuries.

CARBON MONOXIDE

Ideally, an electrical resistance would drastically reduce the amount of this dangerous gas. However, if you are not in possession of such a device, what you can do is:

-smoking outdoors, for instance in a green patio or garden surrounded with plants.
-using a bigger hookah. Effectively, the bigger the pipe, the lesser it produces CO.
-using natural charcoal instead of commercial (self-lighting and the lot) charcoal. Another problem with the latter, besides its nasty smell during the few minutes following its lighting up, is that its composition is unknown. This handy commodity might however contain dangerous elements.
-from time to time, blowing (instead of drawing air) inside the hose to get rid of the smoke CO building up over the water urn.
-not cramming too much the tobacco mixture inside the bowl.

INHALATION

- Try not inhale deeply. Retain smoke in your mouth ("chipping") imitating toads before they gulp down insects.
-It must be clear to cigarette smokers that a single one-hour hookah session provides in the worst case with the nicotine equivalent of only one cigarette so they should understand that hookah cannot be an alternative to their cigarette smoking habit. This would be an illusion and another problem would be that these users would naturally tend to inhale deeper and deeper in order to "compensate".

THE HOSE

-Share the hose because it is a four-century old tradition in Asia and Africa. By doing this, you will inhale less smoke and keep to the habit its essential playful, collective, convivial and recreational dimensions and, by the same token, you will move to a distance, further off and banish the dependency spectre which also exists albeit it’s completely different from that induced by cigarette smoking.

TAR

-The production of tar varies accordingly with the frequency of inhalations but also with their periodicity. This means that it is certainly better, from a health point of view, to inhale once every 2 minutes than twice each minute. This also means that it is much better to inhale at IRregular intervals (in an every which random way) than rhythmically like a rocking chair or a metronome. Otherwise, you could agree with the findings of a controversial study (press here).

In short, make pauses and breaks during which you could, for example, meditate upon the hidden meaning of life or give thought to the mysterious origin of the narghile, also called hookah...
-The longer the hose the better it is.
-The user should not become an extremist so he must learn to stop smoking before the end of the session. Otherwise, he would inhale impure combustion elements.

WATER
- Change water as often as possible.
- Change the pH (“acidity”) of water to hold back as much as nicotine as possible.
- Find the ad hoc chemical substances to be added to water to stop as many harmful elements (tar, etc.) as possible. Note: water already stops many of them (among them some known carcinogens). Let’s only consider here acrolein and acetaldehyde the filtration of which makes hookah smoke accepted even by… non-smokers.

[Added December 2007: Shocking ! Two Well Regarded Scientists Go Beyond All Acceptable Limits by Giving Tips to Hookah (Narghile, Shisha) Smokers !]

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