Hookah hook ups: An insight

The World Health Organization Study group on Tobacco Product Regulation (TobReg) has issued in 2005 an ―Advisory Note‖ entitled ―Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulars‖. This important report, the first ever prepared by WHO, has considered ‗waterpipe‘ or ‗hookah‘ smoking a global public health threat. The global tobacco epidemic may kill 10 million people annually in the next 20-30 years with 70% of these deaths occurring in developing countries. Current research, treatment and policy efforts focus on cigarettes, while many people in developing regions (Asia, Indian subcontinent, Eastern Mediterranean) smoke tobacco using waterpipes. Waterpipes or hookah are increasing in popularity and more should be learnt about them so that we can understand their effects on public health, curtail their spread and help their users quit. Medline search using keywords ―Waterpipe‖, ―Hookah‖ and ―Indian subcontinent‖ was conducted with special emphasis on chemistry of smoke, health related effects, smoking patterns, history, gender and under age use aspects, prevention, and research needs. Every identified published study related to water pipe was included. We found that research regarding water pipe epidemiology and health effects is limited. Hookah is increasing globally particularly in Indian subcontinent where perceptions regarding health effects and traditional values may facilitate use among women and children. We conclude that more scientific documentation and careful analysis is needed before the spread of hookah use, its health effects can be understood, and empirically guided treatment and public policy strategies can be implemented.