Waterpipe tobacco smoking (WTS) control policies: global analysis of available legislation and equity considerations

Hala Alaouie; Sumithra Krishnamurthy Reddiar; Malak Tleis; Lama El Kadi; Rima A Afifi; Rima Nakkash

doi:10.1136/tobaccocontrol-2021-056550

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Waterpipe tobacco smoking (WTS) control policies: global analysis of available legislation and equity considerations

Journal article

Open access

Peer reviewed

Waterpipe tobacco smoking (WTS) control policies: global analysis of available legislation and equity considerations

Hala Alaouie, Sumithra Krishnamurthy Reddiar, Malak Tleis, Lama El Kadi, Rima A Afifi and Rima Nakkash

Tobacco control, Vol.31(2), pp.187-197

03/2022

DOI: 10.1136/tobaccocontrol-2021-056550

PMID: 35241587

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Abstract

The Framework Convention on Tobacco Control (FCTC) offers guidance on evidence-based policies to reduce tobacco consumption and its burden of disease. Recently, it has provided guidance for alternative tobacco products, such as the waterpipe. Waterpipe tobacco smoking (WTS) is prevalent worldwide and policies to address it need to take into consideration its specificities as a mode of smoking. In parallel, a growing body of literature points to the potential of evidence-based tobacco control policies to increase health inequities. This paper updates a previous global review of waterpipe tobacco policies and adds an equity lens to assess their impact on health inequities. We reviewed policies that address WTS in 90 countries, including 10 with state-owned tobacco companies; 47 were included in our final analysis. We relied primarily on the Tobacco-Free Kids organisation's Tobacco Control Laws website, providing access to tobacco control laws globally. We categorised country tobacco policies by the clarity with which they defined and addressed waterpipe tobacco in relation to nine FCTC articles. We used the PROGRESS (Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status and Social capital) framework for the equity analysis, by reviewing equity considerations referenced in the policies of each country and including prevalence data disaggregated by equity axis and country where available. Our results revealed very limited attention to waterpipe policies overall, and to equity in such policies, and highlight the complexity of regulating WTS. We recommend that WTS policies and surveillance centre equity as a goal. Our recommendations can inform global policies to reduce WTS and its health consequences equitably across population groups.

Global Health

Public Policy

addiction

Details

Title: Subtitle: Waterpipe tobacco smoking (WTS) control policies: global analysis of available legislation and equity considerations
Creators: Hala Alaouie - University of Bath
Sumithra Krishnamurthy Reddiar - Independent Researcher, Texcoco, Mexico
Malak Tleis - American University of Beirut
Lama El Kadi - American University of Beirut
Rima A Afifi - University of Iowa
Rima Nakkash - American University of Beirut
Resource Type: Journal article
Publication Details: Tobacco control, Vol.31(2), pp.187-197
DOI: 10.1136/tobaccocontrol-2021-056550
PMID: 35241587
NLM abbreviation: Tob Control
eISSN: 1468-3318
Language: English
Date published: 03/2022
Academic Unit: Injury Prevention Research Center; Community and Behavioral Health
Record Identifier: 9984227003102771

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