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Member Research and Reports

UMiami: Waterpipe Smoking Is Increasing Globally, But Health Warning Labels Reduces Satisfaction in Users, Researchers Find

Dr. Taghrid Asfar, research assistant professor at the University of Miami Miller School of Medicine’s Department of Public Health Sciences, and Dr. Wasim Maziak, professor and chair of the Department of Epidemiology at Florida International University, initiated a five-year project funded by the National Institute of Health and the Fogarty International Center in 2017.

“The goal of the project is to develop and test waterpipe (WP)-specific health warning labels (HWLs) in Tunisia and Lebanon, two countries in the Eastern Mediterranean Region, and equip them with the means to implement them successfully,” Dr. Asfar said.

Dr. Asfar led the first stage by developing the labels using a Delphi study among international tobacco control experts. In this study, which was published in Tobacco Control, 28 HWLs were developed, which communicated WP smoking’s health risks, its harm to others, specific harm, and harm compared to cigarettes. A Delphi study was conducted among an international panel of tobacco control experts to reach a consensus on the most effective HWLs for each theme. The top-ranked HWLs were then selected for the final list of 12 HWLs.

The researchers also conducted a pilot study to test how HWLs on smoking devices would affect the satisfaction of WP smokers and their exposure to toxins, which showed that doing so has the potential to reduce their positive experiences, and exposures, such as to carbon monoxide, nicotine, suggesting a strong consideration for the labels.

The research team will now continue to test the effectiveness of the developed HWLs in Lebanon and Tunisia using focus groups and experimental study.

“Findings will likely benefit other countries trying to curb WP trends among youth, including the U.S.,” said Dr. Asfar.

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