Dr Kamal Chaouachi

Posted 15th November 2009

An update of health effects can be found in the first aetiological study on hookah smoking and cancer led by Pakistani doctors (on rigorously selected exclusive hookah smokers who have been using, for decades and in several daily sessions, large amounts of tobacco; the weight equivalent of up to 60 cigarettes in the bowl)[1] . [1] Sajid KM, Chaouachi K, Mahmood R. Hookah smoking and cancer. Carcinoembryonic Antigen (CEA) levels in exclusive/ever hookah smokers. Harm Reduct J 2008 24 May;5(19) http://www.harmreductionjournal.com/content/5/1/19

thomson

Posted 31st October 2008

The health hazards that the Narghile smoker is exposed to include interference with oxidation, damage to genetic compounds, increased risk of developing malignancies, infectious diseases, damage to the fetus and newborn, and exposure to commonly abused chemicals. ================================= james Drug Rehabs

Kamal Chaouachi

Posted 18th June 2007

Dear Editor,
The study by Urkin et al. on “hubble-bubble” (shisha, hookah, narghile, shisha) contains some errors [1]. A fair number of them has been highlighted in the critique of an important report on “waterpipe” smoking [2].
For instance, there is, in their review, some confusion regarding the potentially related diseases because of the unfortunately light attention paid to many factors. In these conditions, I had to state again in a recent publication: “Other pathologies like oral, gastric and bladder cancer, contact eczema, tuberculosis or aspergillosis, etc. are not clearly established because of a non-rigorous methodology (simultaneous use of other products [e.g. qât, cigarettes, bidis, etc.], strongly neglected hygiene, current profile and remote and recent career of smokers not specified, etc)”[3].
And since the case of aspergillosis is, with not enough caution, mentioned again in this new study, I am afraid I have to recall the following: “The case of Szyper-Kravitz and alii is particularly striking because the patient he analysed did not change the water of his hookah for weeks whereas it is a common practice to do so at the end of each session, i.e., one to several times each day”, as I did in when commenting the very study on which Urkin and colleagues’ paper is mainly based [4][5].
Another regrettable salient error is their misinterpretation of a study by Gieringer according to whom “in comparison with cigarette smoke, Narghile smoke [would] contain[s] an increased concentration of tar and volatile carcinogens.”[6]. This statement is wrong simply because Gieringer never analysed cigarette smoke but actually compared the efficiency of a “a joint with a cigarette filter” (for cannabis use) with that of other smoking devices, including water pipes of diverse types (narghile, “bong”, etc.).

Kamal Chaouachi

Posted 18th June 2007

(continued from above)
Finally, the authors conclude with a statement -that “Narghile is easy to use”- which is in contradiction with all available anthropological studies, whose references are obviously absent in their review [1].
They also state that hookah smoking is definitely “a gateway to the world of cigarette and substance abuse” whereas there is, to date, absolutely no unbiased scientific evidence to support such an opinion. More, the reverse is true because cigarette smokers are more likely to become hookah smokers because of their generally bad, in the long run, experience with tobacco smoking.
Indeed, a minimum of inter-disciplinary vision is needed in this complex field to avoid adding to the existing confusion, a fatal trend for the world public health [7].
Kamal Chaouachi
kamchaAgmail.com
Researcher and consultant in Tobacco Control (Paris)
(References below)

Kamal Chaouachi

Posted 18th June 2007

References (to Kamal Chaouachi’s comment above)
[1] Urkin J., Ochaion R, Peleg, A. Hubble Bubble Equals Trouble: The hazards of water pipe smoking. TSW Holistic Health & Medicine 2006; 1:34-41
[2] Chaouachi K. A Critique of the WHO's TobReg "Advisory Note" entitled: "Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators”. Journal of Negative Results in Biomedicine 2006 (17 Nov); 5:17. >http://www.jnrbm.com/content/5/1/17
[3] Chaouachi K. The Medical Consequences of Narghile (Hookah, Shisha) Use in the World. Rev Epidemiol Sante Publique [Epidemiology and Public Health] 2007 (20 June):3. [Article in English][Epub Ahead of print (17 Apr)].
[4] Szyper-Kravitz M, Lang R, Manor Y and Lahav M. Early invasive pulmonary aspergillosis in a leukemia patient linked to aspergillus contaminated marijuana smoking. Leuk Lymphoma 2001 (Nov-Dec);42(6):1433-7.
[5] Chaouachi K. Post-publication Peer Review : Errors in this New Review. Pediatrics 2005 (15 Aug). A critical analysis of the following study: Knishkowy B and Amitai A. Water-Pipe (Narghile) Smoking: An Emerging Health Risk Behavior. Pediatrics 2005 (Jul); 116(1): e113-9 http://pediatrics.aappublications.org/cgi/ele...
[6] Gieringer, D. (2000) Marijuana Water Pipe and Vaporizer Study. Newsletter of the Mutidisciplinary Association for Psychedelic Studies MAPS. 6(3), 1–6. [Cited by Urkin et al.] http://www.norml.org.nz/modules.php?name=News...
[7] Oxman AD, Lavis JN, Fretheim A. Use of evidence in WHO recommendations. The Lancet Early Online Publication 2007 (9 May). DOI:10.1016/S0140-6736(07)60675-8 http://www.thelancet.com/journals/lancet/arti...