Article Text

Download PDFPDF
Building the evidence base for waterpipe regulation and policy
  1. Wasim Maziak1,
  2. Eva Sharma2
  1. 1Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
  2. 2Westat Inc, Rockville, Maryland, USA
  1. Correspondence to Dr Wasim Maziak, College of Public Health, Florida International University, Miami, FL 33174, USA; wmaziak{at}


Waterpipe (hookah, shisha, narghileh) smoking is emerging as an epidemic, particularly among young people in the USA and globally. Unlike cigarettes, waterpipe smoking involves several components (eg, tobacco, charcoal, device and venues) and is characterised by unique smoking patterns that expose smokers to significant amounts of nicotine and other toxic substances. With the rising prevalence of use among young people and continuing misperceptions about waterpipe’s harmful nature, a better understanding of health risks associated with waterpipe smoking is warranted. In response to waterpipe’s rising trends, a Deeming Rule that extended the US Food and Drug Administration’s (FDA) regulatory authority to all tobacco products was issued in 2016. This rule includes waterpipe tobacco, components and parts. This development created the need for evidence to guide the FDA into best evidence-based strategies to limit waterpipe’s spread among young people and harm to public health. This special issue presents some of the studies that were funded under the ‘Chemistry, Toxicology, and Addiction Research on Waterpipe Tobacco’ programme to inform promising regulatory action on waterpipe products. In this preamble, we briefly summarise findings from these studies and discusses their policy and regulatory implications for different waterpipe products and components.

  • toxicology
  • addiction
  • non-cigarette tobacco products
View Full Text

Statistics from


  • Contributors Both authors made substantial contributions to the commentary.

  • Funding This special issue and the authors’ effort on this project were supported by the Center for Evaluation and Coordination of Training and Research award (5U54CA189222) from the National Cancer Institute and the US Food and Drug Administration. The grants that support the research presented in this issue are cited in the individual articles. This supplement was sponsored by the Center for the Evaluation and Coordination of Training and Research for Tobacco Regulatory Science (5U54CA189222).

  • Disclaimer The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of Westat, the National Institutes of Health, or the US Food and Drug Administration.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.