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).
Full text (in Italian) free plus English and French abstracts available online at: http://www.tabaccologia.org/rivista.html
Part 1: http://www.tabaccologia.org/PDF/1_2005/8_1_2005.pdf
Part 2: http://www.tabaccologia.org/PDF/3_2005/6_3_2005.pdf
Part 3: http://www.tabaccologia.org/PDF/1_2006/8_1_2006.pdf
Part 4: http://www.tabaccologia.org/PDF/4_2006/7_42006.pdf
By Kamal Chaouachi, researcher and consultant in Tobacco Control (Paris)
( kamchaAgmail.com )
Part 1: Presentation (Tabaccologia 2005; 1: 39-47)
( Presentazione del narghilè e del suo uso )
English 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.
Keywords: narghile, hookah, waterpipe, shisha, hubble-bubble, tobacco, tobamel, tumbâk, jurâk, sociology, anthropology, socio-anthropology, ethnology.
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.
Part 2: Chemistry (Tabaccologia 2005; 3: 27-33)
( Narghilè: aspetti chimici e farmacofisiologici )
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, jurâk, nicotine, cotinine, acrolein, acetaldehyde, phenols, polycyclic aromatic hydrocarbons (PAH), carbon monoxide, carboxyhaemoglobin.
Part 3: Diseases (Tabaccologia 2006;1:27-34)
( Patologie associate all’uso del narghilé )
English 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.
Keywords: hookah, narghile, waterpipe, shisha, tobacco, cancer, tumors, cardiovascular diseases, COPD.
Part 4: Public Health and Prevention (Tabaccologia 2006;4:29-38)
( Narghilé: un problema di Sanità Pubblica )
English 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.
Keywords: narghile, hookah, shisha, waterpipe, tobacco, smoking, anthropology.
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http://docs.google.com/View?docid=dgbz283m_3cm537w