Publications
115 results found
Jawad M, Khader A, Millett C, 2016, Differences in tobacco smoking prevalence and frequency between adolescent Palestine refugee and non-refugees populations in Jordan, Lebanon, Syria, and the West Bank: cross-sectional analysis of the Global Youth Tobacco Survey, Conflict and Health, Vol: 10, ISSN: 1752-1505
Background: Evidence is conflicting as to the whether tobacco smoking prevalence is higher in refugee thannon-refugee populations. The aim of this study was to compare the prevalence and frequency of tobacco smokingin Palestine refugee and non-refugee adolescent populations in the Middle East.Methods: We conducted a cross-sectional analysis of the Global Youth Tobacco Survey (GYTS) conducted inJordan, Lebanon, Syria, and the West Bank among adolescent Palestine refugees and non-refugees. Age- and sexadjustedregression models assessed the association between refugee status and current (past-30 day) tobacco useprevalence and frequency.Results: Prevalence estimates for current tobacco smoking were similar between Palestine refugee and nonrefugeegroups in Jordan (26.7 % vs. 24.0 %), Lebanon (39.4 % vs. 38.5 %), and the West Bank (39.5 % vs. 38.4 %).In Syria, Palestine refugees had nearly twice the odds of current tobacco smoking compared to non-refugees(23.2 % vs. 36.6 %, AOR 1.96, 95 % CI 1.46–2.62). Palestine refugees consumed more cigarettes per month thannon-refugees in Lebanon (β 0.57, 95 % CI 0.17–0.97) and Palestine refugees consumed more waterpipe tobaccoper month than non-refugees in Syria (β 0.40, 95 % CI 0.19–0.61) and the West Bank (β 0.42, 95 % CI 0.21–0.64).Conclusions: Current tobacco smoking prevalence is in excess of 20 % in both adolescent Palestine refugee andnon-refugee populations in Middle Eastern countries, however Palestine refugees may smoke tobacco morefrequently than non-refugees. Comparison of simple prevalence estimates may therefore mask importantdifferences in tobacco use patterns within population groups.
Jawad M, Ingram S, Choudhury I, et al., 2016, Television-based health promotion in general practice waiting rooms in London: a cross-sectional study evaluating patients’ knowledge and intentions to access dental services, BMC Oral Health, Vol: 17, ISSN: 1472-6831
Background: This study aimed to evaluate whether television-based dental health promotion initiatives in General Practice waiting rooms would increase patients’ knowledge of and intentions to seek dental services.Methods: This cross-sectional survey of 2,345 patients attending 49 General Practices in Brent, northwest London, evaluated the ‘Life Channel’ – a series of six brief health promotion advertisements, including one dental health promotion advertisement, displayed over ten minutes on television in General Practice waiting rooms. Primary outcome measures were a self-reported gain in the knowledge to contact a National Health Service (NHS) and emergency dentist, and an intention to seek dental services, attributed to viewing the Life Channel.Results: Among the 1,088 patients who did not know how to contact an NHS dentist prior to the survey, and the 1,247 patients who did not know how to contact an emergency dentist prior to the survey, 48.0% (95% CI 45.0-51.0%) and 35.1% (95% CI 32.4-37.8%) attributed the Life Channel to educating them how to do so, respectively. Among the 1,605 patients who did not have any intention to contact a dentist prior to the survey, 15.2% (95% CI 13.4-17.0%) attributed the Life Channel to creating such an intention. We report adjusted odds ratios on sociodemographic disparities in this evaluation.Conclusions: Television-based dental health promotion may significantly increase knowledge of and intention to seek dental services in this sample in London. Television-based dental health promotion may appeal more to certain population groups. More research is needed to identify longer term outcomes of television-based health promotion.
Jawad M, Power G, 2016, Waterpipe tobacco and electronic cigarette use in a southeast London adult sample: a cross-sectional analysis., Journal of Public Health, Vol: 38, Pages: e114-e121, ISSN: 1741-3842
BACKGROUND: Waterpipe tobacco and electronic cigarettes (e-cigarettes) share several features: rising popularity, use of product flavourings and concerns about marketing to youth. We sought to compare prevalence and predictors of waterpipe tobacco and e-cigarette use, and explore knowledge of waterpipe tobacco and support for interventions. METHODS: We used convenience sampling methods to conduct a cross-sectional survey among adults in the ethnically diverse southeast London area. Multivariate logistic regression identified predictors of waterpipe and e-cigarette use. Predictor variables were age, gender, ethnicity and current (past 30-day) cigarette use. RESULTS: Of 1176 respondents (23.0% aged 25-34 years, 56.0% male, 57.4% white ethnicity and 30.4% current cigarette smokers), 31.0% had tried waterpipe tobacco and 7.4% had tried e-cigarettes. Both products were significantly associated with younger age groups, non-white ethnicities and use of each other. Waterpipe tobacco was independently associated with consumption of cigarettes while e-cigarettes were not. Among those aware of waterpipe, a third answered incorrectly to knowledge questions. Among those self-identified as coming from a traditional waterpipe-using community, two-thirds supported further legislative and health promotion waterpipe interventions. CONCLUSIONS: Waterpipe tobacco was common and more prevalent than e-cigarettes in this population. Interventions to prevent and control waterpipe are unlikely to marginalize traditional waterpipe-using communities.
Jawad M, Afifi RA, Mahfoud Z, et al., 2016, Validation of a simple tool to assess risk of waterpipe tobacco smoking among sixth and seventh graders in Lebanon., Journal of Public Health, Vol: 38, Pages: 403-410, ISSN: 1741-3842
BACKGROUND: Waterpipe tobacco smoking (WTS) is highly prevalent in the Eastern Mediterranean region. While studies have identified socio-demographic factors differentiating smokers from non-smokers, validated tools predicting WTS are lacking. METHODS: Over 1000 (n = 1164) sixth and seventh grade students in Lebanon were randomly assigned to a prediction model group and validation model group. In the prediction model group, backward stepwise logistic regression enabled the identification of socio-demographic and psychosocial factors associated with ever and current WTS. This formed risk scores which were tested on the validation model group. RESULTS: The risk score for current WTS was out of four and included reduced religiosity, cigarette use and the perception that WTS was associated with a good time. The risk score for ever WTS was out of seven and included an additional two variables: increased age and the belief that WTS did not cause oral cancer. In the validation model group, the model displayed moderate discrimination [area under the curve: 0.77 (current), 0.68 (ever)], excellent goodness-of-fit (P > 0.05 for both) and optimal sensitivity and specificity of 80.1 and 58.4% (current), and 39.5 and 94.4%, (ever), respectively. CONCLUSIONS: WTS use can be predicted using simple validated tools. These can direct health promotion and legislative interventions.
Jawad M, Jawad S, Waziry RK, et al., 2016, Interventions for waterpipe tobacco smoking prevention and cessation: a systematic review, Scientific Reports, Vol: 6, ISSN: 2045-2322
Waterpipe tobacco smoking is growing in popularity despite adverse health effects among users. We systematically reviewed the literature, searching MEDLINE, EMBASE and Web of Science, for interventions targeting prevention and cessation of waterpipe tobacco smoking. We assessed the evidence quality using the Cochrane (randomised studies), GRADE (non-randomised studies) and CASP (qualitative studies) frameworks. Data were synthesised narratively due to heterogeneity. We included four individual-level, five group-level, and six legislative interventions. Of five randomised controlled studies, two showed significantly higher quit rates in intervention groups (bupropion/behavioural support versus placebo in Pakistan; 6 month abstinence relative risk (RR): 2.3, 95% CI 1.4–3.8); group behavioural support versus no intervention in Egypt, 12 month abstinence RR 3.3, 95% CI 1.4–8.9). Non-randomised studies showed mixed results for cessation, behavioural, and knowledge outcomes. One high quality modelling study from Lebanon calculated that a 10% increase in waterpipe tobacco taxation would reduce waterpipe tobacco demand by 14.5% (price elasticity of demand −1.45). In conclusion, there is a lack of evidence of effectiveness for most waterpipe interventions. While few show promising results, higher quality interventions are needed. Meanwhile, tobacco policies should place waterpipe on par with cigarettes.
Maziak W, Ben Taleb Z, Jawad M, et al., 2016, Consensus statement on assessment of waterpipe smoking in epidemiological studies, Tobacco Control, Vol: 26, Pages: 338-343, ISSN: 0964-4563
Numerous epidemiological accounts suggest that waterpipe smoking (aka hookah, shisha, narghile) has become a global phenomenon, especially among youth. The alarming spread of waterpipe and accumulating evidence of its addictive and harmful effects represent a new threat in the global fight to limit tobacco-related morbidity and mortality. In response to waterpipe's alarming trends, major public health and tobacco control organisations have started or are considering systematic collection of data about waterpipe smoking to monitor its trends and assess its harmful effects in different societies. Such plans require coordination and agreement on epidemiological measurement tools that reflect the uniqueness of this tobacco use method, and at the same time allow comparison of waterpipe trends across time and place, and with other tobacco use methods. We started a decade ago our work to develop standardised measures and definitions for the assessment of waterpipe smoking in epidemiological studies. In this communication, we try to expand and update these assessment tools in light of our increased knowledge and understanding of waterpipe use patterns, its context and marketing, as well as the need for evidence-guided policies and regulations to curb its spread. We have assembled for this purpose a group of leading waterpipe researchers worldwide, and worked through an iterative process to develop the suggested instruments and definitions based on what we know currently about the waterpipe epidemic. While the suggested measures are by no means comprehensive, we hope that they can provide the building blocks for standard and comparable surveillance of waterpipe smoking globally.
Waziry R, Jawad M, Ballout RA, et al., 2016, The effects of waterpipe tobacco smoking on health outcomes: an updated systematic review and meta-analysis, International Journal of Epidemiology, Vol: 46, Pages: 32-43, ISSN: 1464-3685
BACKGROUND AND AIMS: A systematic review conducted in 2008 found significant associations between waterpipe tobacco smoking and lung cancer, respiratory disease, periodontal disease and low birthweight. Since then, a number of relevant studies have been published. The objective of this study was to update the systematic review on the effects of waterpipe tobacco smoking on health outcomes. METHODS: In May 2015 we electronically searched the following databases with no date restrictions: MEDLINE, EMBASE and the ISI Web of Science using a detailed search strategy with no language restrictions. We also screened the references' lists of the included studies. We included cohort, case-control and cross-sectional studies, and excluded case reports, conference abstracts, editorials and reviews. We excluded studies not conducted in humans, assessing physiological outcomes, not distinguishing waterpipe tobacco smoking from other forms of smoking or not reporting association measures. We assessed risk of bias for each included study and conducted meta-analyses for each of the outcomes of interest. RESULTS: We identified 50 eligible studies. We found that waterpipe tobacco smoking was significantly associated with: respiratory diseases [COPD; odds ratio (OR) = 3.18, 95% confidence interval CI = 1.25, 8.08; bronchitis OR = 2.37, 95% CI = 1.49, 3.77; passive waterpipe smoking and wheeze OR) = 1.97, 95% CI = 1.28, 3.04]; oral cancer OR = 4.17, 95% CI = 2.53, 6.89; lung cancer OR = 2.12, 95% CI = 1.32, 3.42; low birthweight (OR = 2.39, 95% CI = 1.32, 4.32); metabolic syndrome (OR 1.63-1.95, 95% CI = 1.25, 2.45); cardiovascular disease (OR = 1.67, 95% CI = 1.25, 2.24); and mental health (OR 1.30-2.4, 95% CI = 1.20, 2.80). Waterpipe tobacco smoking was not signifi
Jawad M, Abdulrahim S, Daouk A, 2016, The Social Patterning of Tobacco Use Among Women in Jordan: The Protective Effect of Education on Cigarette Smoking and the Deleterious Effect of Wealth on Cigarette and Waterpipe Smoking, NICOTINE & TOBACCO RESEARCH, Vol: 18, Pages: 379-385, ISSN: 1462-2203
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- Citations: 15
Kotecha S, Jawad M, Iliffe S, 2016, Knowledge, attitudes and beliefs towards waterpipe tobacco smoking and electronic shisha (e-shisha) among young adults in London: a qualitative analysis, PRIMARY HEALTH CARE RESEARCH AND DEVELOPMENT, Vol: 17, Pages: 166-174, ISSN: 1463-4236
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- Citations: 15
Jawad M, Power G, 2016, Prevalence, correlates and patterns of waterpipe smoking among secondary school students in southeast London: a cross-sectional study, BMC Public Health, Vol: 16, ISSN: 1471-2458
BackgroundWaterpipe smoking is growing worldwide, but little is known of its epidemiology in the UK due to its absence from national health surveys. We sought to address this by calculating the prevalence of waterpipe smoking among secondary school students in southeast London.MethodsWe conducted a pooled secondary analysis of routine health surveillance surveys among 11–17 year olds in convenience-sampled secondary schools from three ethnically-diverse areas of southeast London. We calculated ever (lifetime) waterpipe use, and compared its sociodemographic correlates to ever (lifetime) cigarette use. In one area we collected data on patterns of waterpipe use.ResultsOf 2,098 respondents (mean age 14.1 ± 1.7 years, 55.7 % male, 46.6 % of black ethnicity), ever waterpipe use was 39.6 % (95 % CI 37.6–41.7 %) and was higher than that for ever cigarette use (32.4 %; 95 % CI 30.5–34.4). While waterpipe users were significantly and independently more likely to be male and of non-white ethnicities, at least 30 % of all age, gender and ethnic sub-groups had tried waterpipe smoking. In contrast, cigarette users were more likely to be older and of white ethnicity. In one of the three areas, over a quarter of waterpipe users were occasional or regular waterpipe smokers, and most were introduced to and currently used waterpipe in waterpipe-serving premises or friends’ homes.ConclusionsWaterpipe smoking prevalence was high in southeast London, and users exhibited a different sociodemographic profile to cigarette users. Waterpipe should be included in national health surveys of young people. National surveillance is warranted to help develop suitable interventions to prevent uptake and promote cessation.
Jawad M, Choaie E, Brose L, et al., 2016, Waterpipe tobacco use in the United Kingdom: a cross-sectional study among university students and stop smoking practitioners, PLOS One, Vol: 11, ISSN: 1932-6203
IntroductionDespite cigarette-like adverse health outcomes associated with waterpipe tobacco smoking and increase in its use among youth, it is a much underexplored research area. We aimed to measure the prevalence and patterns of waterpipe tobacco use and evaluate tobacco control policy with respect to waterpipe tobacco, in several universities across the UK. We also aimed to measure stop smoking practitioners’ encounter of waterpipe tobacco smoking.MethodsWe distributed an online survey to six UK universities, asking detailed questions on waterpipe tobacco. Multivariable logistic regression models, adjusted for age, gender, ethnicity, graduate status, university and socioeconomic status (SES) assessed associations between waterpipe tobacco smoking (single use and dual use with cigarettes) and sociodemographic variables. SES was ascertained by average weekly self-spend on non-essentials. We also descriptively analysed data from a 2012 survey of stop smoking practitioners to assess the proportion of clients that used waterpipe regularly.Resultsf 2217 student responses, 66.0% (95% CI 63.9–68.0%) had tried waterpipe tobacco smoking; 14.3% (95% CI 12.8–15.8%) reported past-30 day use, and 8.7% (95% CI 7.6–9.9%) reported at least monthly users. Past-30 day waterpipe-only use was associated with being younger (AOR 0.95, 95% CI 0.91–0.99), male (AOR 1.44, 95% CI 1.08–1.94), higher SES (AOR 1.16, 95% CI 1.06–1.28) and belonging to non-white ethnicities (vs. white, AOR 2.24, 95% CI 1.66–3.04). Compared to less than monthly users, monthly users were significantly more likely to have urges to smoke waterpipe (28.1% vs. 3.1%, p<0.001) report difficulty in quitting (15.5% vs. 0.8%, p<0.001), report feeling guilty, and annoyed when criticised about waterpipe smoking (19.2% vs. 9.2%, p<0.001). Nearly a third (32.5%) of respondents who had tried waterpipe had violated the UK smokefree law and a quarter (24.5%) reporting seei
Siddiqi K, Jawad M, Mushtaq N, et al., 2015, Tobacco and Health Disparities, BioMed Research International, Vol: 2015, ISSN: 2314-6141
Kassim S, Jawad M, Croucher R, et al., 2015, The Epidemiology of Tobacco Use among Khat Users: A Systematic Review, Biomed Research International, Vol: 2015, ISSN: 2314-6133
Khat, an “amphetamine-like green leaf,” may influence the consumption of tobacco. This study reviews the epidemiology of tobacco use among khat users. Electronic database searches using appropriate keywords/terms were conducted to identify observational studies of khat use. Assessment of quality and risk of bias of all included studies was conducted, and the results were synthesised descriptively. Nine eligible cross-sectional studies were identified. All assessed self-reported tobacco among khat users and were carried out in Africa and the Middle East. Eight reported cigarettes and one reported waterpipes as the mode of use. Methods of tobacco use prevalence assessment varied. Prevalence of “current” tobacco use among students and university teachers ranged from 29 to 37%; “lifetime” tobacco use in university teachers was 58% and “undefined” tobacco use in nonspecific adults and students ranged from 17 to 78%. Daily tobacco use among adults was reported as 17% whilst simultaneous tobacco and khat use was reported as between 14 and 30% in students. In conclusion, tobacco prevalence among khat users appears significant. Findings should be interpreted cautiously due to self-reported tobacco use, diversity in questions assessing tobacco use, and type of tobacco consumption. Future research should address the methodological shortcomings identified in this review before appropriate policy interventions can be developed.
Jawad M, Abass J, Hariri A, et al., 2015, Social Media Use for Public Health Campaigning in a Low Resource Setting: The Case of Waterpipe Tobacco Smoking, BioMed Research International, Vol: 2015, ISSN: 2314-6141
Introduction. Waterpipe tobacco smoking prevalence is increasing worldwide despite its documented health effects. A general belief that it is less harmful than cigarettes may be fuelled by the lack of media campaigns highlighting its health effects. We aimed to create and assess the impact of a social media campaign about dangers of waterpipe smoking. Methods. The “ShishAware” campaign included three social media (Facebook, Twitter, and YouTube) and a website. Nine months after launch we collected data to assess use of, and reaction to, our media accounts. Results. Requiring limited maintenance resources, Facebook attracted campaign supporters but YouTube attracted opposers. Twitter enabled the most organisation-based contact but Facebook was the most interactive medium. Facebook users were more likely to “like” weekday than weekend statuses and more likely to comment on “shisha fact” than “current affairs” statuses. Follower subscription increased as our posting rate increased. Our YouTube video gained 19,428 views (from all world continents) and 218 comments (86% from pro-waterpipe smokers). Conclusions. Social media campaigns can be created and maintained relatively easily. They are innovative and have the potential for wide and rapid diffusion, especially towards target audiences. There is a need for more rigorous evaluation of their effects, particularly among the youth.
Jawad M, Bakir A, Ali M, et al., 2015, Impact of Waterpipe Tobacco Pack Health Warnings on Waterpipe Smoking Attitudes: A Qualitative Analysis among Regular Users in London, BioMed Research International, Vol: 2015, ISSN: 2314-6141
Background. Despite the rise in prevalence of waterpipe tobacco smoking, it has received little legislative enforcement from governing bodies, especially in the area of health warning labels. Methods. Twenty regular waterpipe tobacco smokers from London took part in five focus groups discussing the impact of waterpipe tobacco pack health warnings on their attitudes towards waterpipe smoking. We presented them with existing and mock waterpipe tobacco products, designed to be compliant with current and future UK/EU legislation. Data were analysed using thematic analysis. Results. Participants felt packs were less attractive and health warnings were more impactful as health warnings increased in size and packaging became less branded. However, participants highlighted their lack of exposure to waterpipe tobacco pack health warnings due to the inherent nature of waterpipe smoking, that is, smoking in a café with the apparatus already prepacked by staff. Health warnings at the point of consumption had more reported impact than health warnings at the point of sale. Conclusions. Waterpipe tobacco pack health warnings are likely to be effective if compliant with existing laws and exposed to end-users. Legislations should be reviewed to extend health warning labels to waterpipe accessories, particularly the apparatus, and to waterpipe-serving premises.
Jawad M, Nakkash RT, Hawkins B, et al., 2015, Waterpipe industry products and marketing strategies: analysis of an industry trade exhibition, Tobacco Control, Vol: 24, Pages: E275-E279, ISSN: 0964-4563
Introduction Understanding product development and marketing strategies of transnational tobacco companies (TTCs) has been of vital importance in developing an effective tobacco control policy. However, comparatively little is known of the waterpipe tobacco industry, which TTCs have recently entered. This study aimed to gain an understanding of waterpipe tobacco products and marketing strategies by visiting a waterpipe trade exhibition.Methods In April 2014, the first author attended an international waterpipe trade exhibition, recording descriptions of products and collecting all available marketing items. We described the purpose and function of all products, and performed a thematic analysis of messages in marketing material.Results We classified waterpipe products into four categories and noted product variation within categories. Electronic waterpipe products (which mimic electronic cigarettes) rarely appeared on waterpipe tobacco marketing material, but were displayed just as widely. Claims of reduced harm, safety and quality were paramount on marketing materials, regardless of whether they were promoting consumption products (tobacco, tobacco substitutes), electronic waterpipes or accessories.Conclusions Waterpipe products are diverse in nature and are marketed as healthy and safe products. Furthermore, the development of electronic waterpipe products appears to be closely connected with the electronic cigarette industry, rather than the waterpipe tobacco manufacturers. Tobacco control policy must evolve to take account of the vast and expanding array of waterpipe products, and potentially also charcoal products developed for waterpipe smokers. We recommend that tobacco substitutes be classified as tobacco products. Continued surveillance of the waterpipe industry is warranted.
Siddiqi K, Shah S, Abbas SM, et al., 2015, Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries, BMC Medicine, Vol: 13, ISSN: 1741-7015
BackgroundSmokeless tobacco is consumed in most countries in the world. In view of its widespread use and increasing awareness of the associated risks, there is a need for a detailed assessment of its impact on health. We present the first global estimates of the burden of disease due to consumption of smokeless tobacco by adults.MethodsThe burden attributable to smokeless tobacco use in adults was estimated as a proportion of the disability-adjusted life-years (DALYs) lost and deaths reported in the 2010 Global Burden of Disease study. We used the comparative risk assessment method, which evaluates changes in population health that result from modifying a population’s exposure to a risk factor. Population exposure was extrapolated from country-specific prevalence of smokeless tobacco consumption, and changes in population health were estimated using disease-specific risk estimates (relative risks/odds ratios) associated with it. Country-specific prevalence estimates were obtained through systematically searching for all relevant studies. Disease-specific risks were estimated by conducting systematic reviews and meta-analyses based on epidemiological studies.ResultsWe found adult smokeless tobacco consumption figures for 115 countries and estimated burden of disease figures for 113 of these countries. Our estimates indicate that in 2010, smokeless tobacco use led to 1.7 million DALYs lost and 62,283 deaths due to cancers of mouth, pharynx and oesophagus and, based on data from the benchmark 52 country INTERHEART study, 4.7 million DALYs lost and 204,309 deaths from ischaemic heart disease. Over 85 % of this burden was in South-East Asia.ConclusionsSmokeless tobacco results in considerable, potentially preventable, global morbidity and mortality from cancer; estimates in relation to ischaemic heart disease need to be interpreted with more caution, but nonetheless suggest that the likely burden of disease is also substantial. The World Health Organization needs
Shipman KE, Jawad M, Sullivan KM, et al., 2015, Ethnic/racial determinants of glycemic markers in a UK sample, ACTA DIABETOLOGICA, Vol: 52, Pages: 687-692, ISSN: 0940-5429
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- Citations: 13
Shipman KE, Jawad M, Sullivan KM, et al., 2015, Fructosamine; is the current interest in alternative glycaemic markers justified?, DIABETIC MEDICINE, Vol: 32, Pages: 1116-1117, ISSN: 0742-3071
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- Citations: 1
Maziak W, Jawad M, Jawad S, et al., 2015, Interventions for waterpipe smoking cessation, Cochrane Database of Systematic Reviews, Vol: 2015, ISSN: 1469-493X
Jawad M, Nakkash RT, Hawkins B, et al., 2015, Gaining Insights Into the Waterpipe Tobacco Industry: Participant Observation and a Cross-Sectional Survey of Products at a Trade Exhibition, Nicotine and Tobacco Research, Vol: 18, Pages: 874-878, ISSN: 1462-2203
Introduction:The rise in waterpipe tobacco smoking has been accompanied by the emergence of a diverse range of products, such as “herbal” waterpipe tobacco substitutes and electronic waterpipes. The aims of this study were to assess the extent to which emerging waterpipe products are being developed by waterpipe tobacco companies themselves, to understand the key characteristics of the main market players, and to examine the connections between producers of different product categories.Methods:In 2014, one researcher attended an international waterpipe trade exhibition in Germany, conducting a survey of products at exhibition stands, and gathering qualitative data on exhibitors and products using participant observation. Cross-tabulations and chi-square tests identified the association between waterpipe tobacco, waterpipe tobacco substitutes, and electronic waterpipe products. We thematically analyzed field notes into information about exhibitors and products.Results:Of 97 exhibitors, 55 displayed waterpipe-related products. Of these, nearly half (45%) displayed electronic waterpipe products, 38% displayed waterpipe tobacco and 23% displayed waterpipe tobacco substitutes. There was an inverse association between the display of waterpipe tobacco and electronic waterpipe products, and a positive association between the display of waterpipe tobacco and waterpipe tobacco substitutes. We found that Japan Tobacco Inc, Philip Morris, and British American Tobacco were partnered or affiliated with exhibitors displaying waterpipe-related products.Conclusions:Electronic waterpipe products were the main feature of this exhibition. Waterpipe tobacco substitutes are likely to be produced by the waterpipe tobacco industry whereas electronic waterpipes are not. There is a developing interest in waterpipe-related products by transnational tobacco corporations. Further industry surveillance is warranted.
Jawad M, Millett C, 2015, Epidemiological surveys might underestimate waterpipe smoking, BMJ-BRITISH MEDICAL JOURNAL, Vol: 350, ISSN: 1756-1833
Jawad M, Lee JT, Millett C, 2015, Waterpipe Tobacco Smoking Prevalence and Correlates in 25 Eastern Mediterranean and Eastern European Countries: Cross-Sectional Analysis of the Global Youth Tobacco Survey, Nicotine & Tobacco Research, Vol: 18, Pages: 395-402, ISSN: 1469-994X
Introduction: Waterpipe tobacco smoking is highly prevalent among young people in some settings. There is an absence of nationally representative prevalence studies of waterpipe tobacco use and dual use with other tobacco products in young people.Methods: We conducted a secondary analysis of the Global Youth Tobacco Survey, a nationally representative cross-sectional study of students aged 13–15 years. Of 180 participating countries, 25 included optional waterpipe tobacco smoking questions: 15 Eastern Mediterranean and 10 Eastern European countries. We calculated the prevalence of current (past 30-day) waterpipe tobacco use, including dual waterpipe and other tobacco use, and used logistic regression models to identify sociodemographic correlates of waterpipe tobacco smoking. Individual country results were combined in a random effects meta-analysis.Results: Waterpipe tobacco smoking prevalence was highest in Lebanon (36.9%), the West Bank (32.7%) and parts of Eastern Europe (Latvia 22.7%, the Czech Republic 22.1%, Estonia 21.9%). These countries also recorded greater than 10% prevalence of dual waterpipe and cigarette use. In a meta-analysis, higher odds of waterpipe tobacco smoking were found among males (Adjusted odds ratio [AOR] = 1.37, 95% confidence interval [CI] = 1.18% to 1.59%), cigarette users (AOR = 6.95, 95% CI = 5.74% to 8.42%), those whose parents (AOR = 1.54, 95% CI = 1.31% to 1.82%) or peers smoked (AOR = 3.53, 95% CI = 2.97% to 4.20%) and those whose parents had higher educational attainment (Father, AOR = 1.47, 95% CI = 1.14% to 1.89%; Mother, AOR = 1.62, 95% CI = 1.07% to 2.46%). We report on regional- and country income-level differences.Conclusions: Waterpipe tobacco smoking, including dual waterpipe and cigarette use, is alarmingly high in several Eastern Mediterranean and Eastern European countries. Ongoing waterpipe tobacco smoking surveillance is warranted.
Shipman KE, Jawad M, Sullivan KM, et al., 2015, Effect of chronic kidney disease on A1C in individuals being screened for diabetes, PRIMARY CARE DIABETES, Vol: 9, Pages: 142-146, ISSN: 1751-9918
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- Citations: 6
Jawad M, Nakkash RT, Mahfoud Z, et al., 2015, Parental smoking and exposure to environmental tobacco smoke are associated with waterpipe smoking among youth: results from a national survey in Lebanon, PUBLIC HEALTH, Vol: 129, Pages: 370-376, ISSN: 0033-3506
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- Citations: 35
Nunn R, Jawad M, Cruickshank H, et al., 2015, Perspectives on Ebola screening at ports of entry in the UK, PERSPECTIVES IN PUBLIC HEALTH, Vol: 135, Pages: 66-67, ISSN: 1757-9139
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- Citations: 3
Jawad M, Bakir AM, Ali M, et al., 2015, Key health themes and reporting of numerical cigarette-waterpipe equivalence in online news articles reporting on waterpipe tobacco smoking: a content analysis, TOBACCO CONTROL, Vol: 24, Pages: 43-47, ISSN: 0964-4563
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- Citations: 10
Al-Bakri A, Jawad M, Salameh P, et al., 2015, Opportunistic insights into occupational health hazards associated with waterpipe tobacco smoking premises in the United Kingdom., Asian Pac J Cancer Prev, Vol: 16, Pages: 621-626
BACKGROUND: Smokefree laws aim to protect employees and the public from the dangers of secondhand smoke. Waterpipe premises have significantly increased in number in the last decade, with anecdotal reports of poor compliance with the smokefree law. The literature is bereft of information pertaining to waterpipe premise employees. This study aimed to opportunistically gather knowledge about the occupational health hazards associated with working in waterpipe premises in London, England. MATERIALS AND METHODS: Employees from seven convenience-sampled, smokefree-compliant waterpipe premises in London were observed for occupational activities. Opportunistic carbon monoxide (CO) measurements were made among those with whom a rapport had developed. Observations were thematically coded and analysed. RESULTS: Occupational hazards mainly included environmental smoke exposure. Waterpipe-serving employees were required to draw several puffs soon after igniting the coals, thereby providing quality assurance of the product. Median CO levels were 27.5 ppm (range 21-55 ppm) among these employees. Self-reported employee health was poor, with some suggestion that working patterns and smoke exposure was a contributory factor. CONCLUSIONS: The smokefree law in England does not appear to protect waterpipe premise employees from high levels of CO. Continued concerns surrounding chronic smoke exposure may contribute to poor self-reported physical and mental wellbeing.
Jawad M, 2015, Waterpipe Tobacco Smoking: A Less Harmful Alternative?, TOBACCO EPIDEMIC, 2ND EDITION, Vol: 42, Pages: 252-257, ISSN: 1422-2140
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- Citations: 1
Jawad M, 2014, WATERPIPE TOBACCO SMOKING Waterpipe tobacco smoking may undermine the progress made in curbing cigarette smoking, BMJ-BRITISH MEDICAL JOURNAL, Vol: 349, ISSN: 1756-1833
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- Citations: 2
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