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Use & Misuse of Water-filtered Tobacco Smoking Pipes in the World. Consequences for Public Health, Research & Research Ethics.

Chaouachi K - Open Med Chem J (2015)

Bottom Line: We also found that, for more than one decade, two other main methodological problems are: 1) the long-lived unwillingness to distinguish between use and misuse; 2) the consistent unethical rejection of biomedical negative results which, interestingly, are quantitatively and qualitatively much more instructive than the positive ones. the great majority of WFTSP toxicity studies have actually measured, voluntarily or not, their misuse aspects, not the use in itself.This is in contradiction with both the harm reduction and public health doctrines.The publication of negative results should be encouraged instead of being stifled.

View Article: PubMed Central - PubMed

Affiliation: DIU Tabacologie, Université Paris XI, France.

ABSTRACT

Background: The traditional definition of an "epidemic" has been revisited by antismoking researchers. After 400 years, Doctors would have realized that one aspect of an ancient cultural daily practice of Asian and African societies was in fact a "global "epidemic". This needed further investigation particularly if one keeps in his mind the health aspects surrounding barbecues.

Method: Here, up-to-date biomedical results are dialectically confronted with anthropological findings, hence in real life, in order to highlight the extent of the global confusion: from the new definition of an "epidemic" and "prevalence" to the myth of "nicotine "addiction" and other themes in relation to water filtered tobacco smoking pipes (WFTSPs).

Results: We found that over the last decade, many publications, -particularly reviews, "meta-analyses" and "systematic reviews"- on (WFTSPs), have actually contributed to fuelling the greatest mix-up ever witnessed in biomedical research. One main reason for such a situation has been the absolute lack of critical analysis of the available literature and the uncritical use of citations (one seriously flawed review has been cited up to 200 times). Another main reason has been to take as granted a biased smoking robot designed at the US American of Beirut whose measured yields of toxic chemicals may differ dozens of times from others' based on the same "protocol". We also found that, for more than one decade, two other main methodological problems are: 1) the long-lived unwillingness to distinguish between use and misuse; 2) the consistent unethical rejection of biomedical negative results which, interestingly, are quantitatively and qualitatively much more instructive than the positive ones.

Conclusion: the great majority of WFTSP toxicity studies have actually measured, voluntarily or not, their misuse aspects, not the use in itself. This is in contradiction with both the harm reduction and public health doctrines. The publication of negative results should be encouraged instead of being stifled.

No MeSH data available.


Related in: MedlinePlus

Moassel (tabamel), a mixed product between tumbak and jurak (see reference book) [1]. The chemistry of its smoke is completely different from that of tumbak whose study has been prevented by the use of the unscientific confusion-fuelling neologism ««waterpipe»». Main characteristic: no direct contact between the charcoal and the smoking mixture.
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Figure 2: Moassel (tabamel), a mixed product between tumbak and jurak (see reference book) [1]. The chemistry of its smoke is completely different from that of tumbak whose study has been prevented by the use of the unscientific confusion-fuelling neologism ««waterpipe»». Main characteristic: no direct contact between the charcoal and the smoking mixture.

Mentions: Overlooking the striking diversity of WFTSPs represents a serious ethical and methodological error since all water pipes (in two words) of the world have almost nothing in common but that ««waterpipe»» name arbitrarily imposed one decade ago [5]. From there, ««waterpipe»»-labelled clinical studies, or those carried out in a “real” “natural” environment, have generally mixed up different products used by the smokers: e.g., plain tobacco of the tumbak, ajamy or tutun type with the popular flavoured moassel (tabamel), etc (See Figs. 1, 2, 3). Yet, the smoke chemistry of both (or more) types is completely different in each case and results in different health effects. What did also exacerbate the global confusion, is that the corresponding researchers, in an endeavour to demonstrate that the claimed health effects (e.g., on lung function) are supported by other studies, often blindly refer to the above mentioned US-AUB' smoking robot. Yet, they do not realise, or simply wish to ignore, how biased are the corresponding procedures which led to the imposition of the puffing machine in question [6, 7]. Indeed, it was recently stressed how two smoking machines, in two different laboratories from two different countries (Germany and Lebanon) could produce acrolein and benzo[a]pyrene levels 66 and 20 times different, respectively, in each case [5]. Yet, the two robots were set with similar (biased) parameters: notably an exaggerated inter-puff time interval of 17s/20s; the charcoal (non-natural) literally burning the flavoured smoking mixture instead of just heating it (because of its arbitrarily fixed position atop the bowl, for one full hour). More recently, such a hazardous chemical as phenol was quantified at levels 18 times lower than those previously produced by the US-AUB's robot (3.21µg vs. 58.03µg) [8]. Interestingly, a common cigarette, used as a reference in similar experiments, generates (in only a few minutes) two times the phenol level produced by a shisha (over one full hour)… If one also bears in mind that while a common cigarette smoker may consume 20 units a day, and that shisha is generally smoked, according to recent epidemiological data, 1 to 3 times per week (i.e. a frequency of 0.14 to 0.43 pipe per day), then the abuse of toxicity comparisons between cigarettes and WFTSPs is blindingly obvious.


Use & Misuse of Water-filtered Tobacco Smoking Pipes in the World. Consequences for Public Health, Research & Research Ethics.

Chaouachi K - Open Med Chem J (2015)

Moassel (tabamel), a mixed product between tumbak and jurak (see reference book) [1]. The chemistry of its smoke is completely different from that of tumbak whose study has been prevented by the use of the unscientific confusion-fuelling neologism ««waterpipe»». Main characteristic: no direct contact between the charcoal and the smoking mixture.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384226&req=5

Figure 2: Moassel (tabamel), a mixed product between tumbak and jurak (see reference book) [1]. The chemistry of its smoke is completely different from that of tumbak whose study has been prevented by the use of the unscientific confusion-fuelling neologism ««waterpipe»». Main characteristic: no direct contact between the charcoal and the smoking mixture.
Mentions: Overlooking the striking diversity of WFTSPs represents a serious ethical and methodological error since all water pipes (in two words) of the world have almost nothing in common but that ««waterpipe»» name arbitrarily imposed one decade ago [5]. From there, ««waterpipe»»-labelled clinical studies, or those carried out in a “real” “natural” environment, have generally mixed up different products used by the smokers: e.g., plain tobacco of the tumbak, ajamy or tutun type with the popular flavoured moassel (tabamel), etc (See Figs. 1, 2, 3). Yet, the smoke chemistry of both (or more) types is completely different in each case and results in different health effects. What did also exacerbate the global confusion, is that the corresponding researchers, in an endeavour to demonstrate that the claimed health effects (e.g., on lung function) are supported by other studies, often blindly refer to the above mentioned US-AUB' smoking robot. Yet, they do not realise, or simply wish to ignore, how biased are the corresponding procedures which led to the imposition of the puffing machine in question [6, 7]. Indeed, it was recently stressed how two smoking machines, in two different laboratories from two different countries (Germany and Lebanon) could produce acrolein and benzo[a]pyrene levels 66 and 20 times different, respectively, in each case [5]. Yet, the two robots were set with similar (biased) parameters: notably an exaggerated inter-puff time interval of 17s/20s; the charcoal (non-natural) literally burning the flavoured smoking mixture instead of just heating it (because of its arbitrarily fixed position atop the bowl, for one full hour). More recently, such a hazardous chemical as phenol was quantified at levels 18 times lower than those previously produced by the US-AUB's robot (3.21µg vs. 58.03µg) [8]. Interestingly, a common cigarette, used as a reference in similar experiments, generates (in only a few minutes) two times the phenol level produced by a shisha (over one full hour)… If one also bears in mind that while a common cigarette smoker may consume 20 units a day, and that shisha is generally smoked, according to recent epidemiological data, 1 to 3 times per week (i.e. a frequency of 0.14 to 0.43 pipe per day), then the abuse of toxicity comparisons between cigarettes and WFTSPs is blindingly obvious.

Bottom Line: We also found that, for more than one decade, two other main methodological problems are: 1) the long-lived unwillingness to distinguish between use and misuse; 2) the consistent unethical rejection of biomedical negative results which, interestingly, are quantitatively and qualitatively much more instructive than the positive ones. the great majority of WFTSP toxicity studies have actually measured, voluntarily or not, their misuse aspects, not the use in itself.This is in contradiction with both the harm reduction and public health doctrines.The publication of negative results should be encouraged instead of being stifled.

View Article: PubMed Central - PubMed

Affiliation: DIU Tabacologie, Université Paris XI, France.

ABSTRACT

Background: The traditional definition of an "epidemic" has been revisited by antismoking researchers. After 400 years, Doctors would have realized that one aspect of an ancient cultural daily practice of Asian and African societies was in fact a "global "epidemic". This needed further investigation particularly if one keeps in his mind the health aspects surrounding barbecues.

Method: Here, up-to-date biomedical results are dialectically confronted with anthropological findings, hence in real life, in order to highlight the extent of the global confusion: from the new definition of an "epidemic" and "prevalence" to the myth of "nicotine "addiction" and other themes in relation to water filtered tobacco smoking pipes (WFTSPs).

Results: We found that over the last decade, many publications, -particularly reviews, "meta-analyses" and "systematic reviews"- on (WFTSPs), have actually contributed to fuelling the greatest mix-up ever witnessed in biomedical research. One main reason for such a situation has been the absolute lack of critical analysis of the available literature and the uncritical use of citations (one seriously flawed review has been cited up to 200 times). Another main reason has been to take as granted a biased smoking robot designed at the US American of Beirut whose measured yields of toxic chemicals may differ dozens of times from others' based on the same "protocol". We also found that, for more than one decade, two other main methodological problems are: 1) the long-lived unwillingness to distinguish between use and misuse; 2) the consistent unethical rejection of biomedical negative results which, interestingly, are quantitatively and qualitatively much more instructive than the positive ones.

Conclusion: the great majority of WFTSP toxicity studies have actually measured, voluntarily or not, their misuse aspects, not the use in itself. This is in contradiction with both the harm reduction and public health doctrines. The publication of negative results should be encouraged instead of being stifled.

No MeSH data available.


Related in: MedlinePlus