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Policy and regulations

Waterpipe Tobacco Smoking (WTS) is a growing epidemic.

What is the definition of “tobacco product”?

Generic definition of ‘tobacco product’ or ‘smoking’ “Means a product consisting wholly or partly of tobacco whether genetically modified or not and intended to be smoked sniffed, sucked or chewed” (England 2002 No 3041 consumer protection).

Defined Waterpipe tobacco is entirely on par with cigarettes by virtue of a definition of ‘tobacco product’ or ‘smoking’ which makes reference to waterpipe tobacco “tobacco products shall be understood as cigarettes, cigars, tobacco, chopped tobacco, hookah or waterpipes, tobacco leaf extracts and other products of similar use, prepared entirely or in part by using tobacco leaves as raw material and which are designed to be smoked, inhaled, sucked, chewed or used as snuff.

Who are the leading waterpipe tobacco companies?

Very little is known about the global waterpipe tobacco industry; some of the known manufacturing is in Middle Eastern and North African countries such as Nakhla, the world’s leading WPT Company with over 30% of the market.

What are the regulatory WTS measures?

  1. Smoke-free law (FCTC article 8).
  2. Tobacco advertising, promotion and sponsorship (FCTC artice 13).
  3. Tobacco packaging and labelling (FCTC artice 11).
  4. Misleading descriptors.

WHO FCTC Article specific policy recommendations for waterpipes

  1. Article 5 General Obligations.
  2. Article 5.3 Protection from Vested Commercial Interests.
  3. Article 6 Price and Tax Measures to Reduce the Demand for Tobacco.
  4. Article 8 Protection from Exposure to Tobacco Smoke.
  5. Articles 9 And 10 Regulation of the Contents of Tobacco Products and Tobacco Product Disclosures.
  6. Article 11 Health Claims.
  7. Article 12 Education, Awareness and Training.
  8. Article 13 Advertising, Promotion and Sponsorship.
  9. Article 14 Demand Reduction Measures Concerning Tobacco Dependence And Cessation.
  10. Article 15 Illicit Trade in Tobacco Products.
  11. Article 16 Sales to and by minors.
  12. Additionally Product Design and Information.

What are the policy challenges related to the control and prevention of waterpipe tobacco products?

  1. Article 6 (tax and price measures).
  2. Article 8 (protection from exposure to tobacco smoke).
  3. Article 11 (packaging and labelling) and Article 12 (Education, communication, training and public awareness).
  4. Article 13 (Tobacco advertising, promotion and sponsorship).

The WTS industry marketing

Little is known of the waterpipe tobacco industry, Waterpipe industry products and marketing strategies; the waterpipe industry operates relatively freely and there is considerable scope for better legislation and regulation. Understanding product development and marketing strategies of transnational tobacco companies has been of vital importance in developing an effective tobacco control policy. Waterpipe tobacco smoking should be taxed accordingly to discourage purchase, and packaging that is non-compliant with the FCTC should be prohibited.

Misconceptions about the less harmful nature of waterpipes may be reinforced by marketing tools for the pipes and the tobacco:

  1. The label of a popular waterpipe tobacco brand sold in several regions of the world states that it contains “0.5% nicotine and 0% tar”.
  2. Others claim their product to be “natural” or “free of chemicals”.
  3. Packaging typically displays bright colors, fruits, herbs or flowers with little or no mention of the word tobacco.
  4. Popular advertising shows waterpipes made from coconuts or pineapples.
  5. One advertisement states that not a single tree was cut down to make the product.
  6. Waterpipe tobacco products are commonly sold with no health warning.
  7. International exhibits have been held to promote WP tobacco products and WP accessories.
  8. A recent study identified the fact that health warnings on WP tobacco packaging and its accessories covered a surface area of less than 3%, whereas the recommendation is 30%.

What are the future recommendation to face the waterpipe specific legislation challenges?

  1. Develop a regulatory framework to evaluate the effectiveness and tailor the specificities of WTS.
  2. Regulate the proliferation of producers, importers and manufacturers of waterpipe tobacco and accessories.
  3. Strengthen and revise existing laws to appropriately address waterpipe tobacco use.
  4. Consider the WTS unique differential features to cigarette smoking, such as:
    1. The use of charcoal briquettes.
    2. A large apparatus and hose available in variety of sizes.
    3. A wide array of tobacco flavors.
    4. Diverse packaging modes.
  5. Guide Health warning labels on their practical application because existing health warning labels on waterpipe tobacco packets contain a variety of deliberately misleading features such as:
    1. Incorrect ingredients labeling.
    2. Do not conform with guidelines suggested by the WHO FCTC.
    3. Presence of harmful waterpipe tobacco substitutes ‘herbal’ or ‘non-tobacco’ which may be exempt from tobacco control laws

    Related paper: Health Warning Labelling Practices On Narghile (shisha,hookah) waterpipe tobacco products and related accessories

    Available information about:

    • Examples of textual warning.
    • Waterpipe tobacco product health warning labels and WHO FCTC compliance.
    • Examples of misleading qualitative descriptors on waterpipe related accessory packages.
    • Proposed health warning labels for waterpipe tobacco packs and accessories.

Additional links and documents:

  1. Health Warning Labelling Practices On Narghile
  2. Toward a Regulatory Framework for the Waterpipe

Related references

  1. WHO Framework Convention on Tobacco Control FCTC - Website
  2. WHO Framework Convention on Tobacco Control FCTC - PDF
  3. Framework Convention Alliance (FCA) Control and prevention of waterpipe tobacco products briefing paper
  4. Health Warning Labelling Practices On Narghile (shisha,hookah) waterpipe tobacco products and related accessories by Dr. Rima Nakkash, Joanna Khalil
  5. The Tobacco Atlas
  6. Tobacco Control Laws
  7. National Centre for Smoking Cessation and Training (NCSCT) – Waterpipe tobacco smoking

U.S. Food and Drug Administration - FDA
Tobacco Products- Guidance & Regulations- Rules, Regulations & Guidance

  1. Retailer Overview of FDA Regulations for Selling Tobacco Products
  2. Hookah Tobacco (Shisha or Waterpipe Tobacco)
  3. Harmful and Potentially Harmful Constituents (HPHCs)
  4. American Lung Association -Tobacco Policy Trend Alert – An Emerging Deadly Trend: Waterpipe Tobacco Use
  5. WHO – Waterpipe tobacco smoking & health
  6. Pamphlet on Arghileh prepared by the Tobacco Control Research Group at the American University of Beirut (AUB)