Department of Primary Care and Public Health, Imperial College London, London, UK.
Addiction. 2013 Nov;108(11):1873-84. doi: 10.1111/add.12265. Epub 2013 Jul 17.
Waterpipe tobacco smoking (WTS) popularity is increasing world-wide, and health effects are emerging in the light of evidence that WTS is perceived by users as less harmful than cigarette smoking. However, there remains a paucity of available evidence from which to draw firm conclusions about its public health significance.
This narrative review aims to summarize WTS literature to date to inform tobacco control specialists and health-care professionals about this phenomenon and help them to assess whether or not WTS should become a public health priority.
Standard electronic databases as well as conference proceedings and personal libraries were searched in English, French and Arabic with inclusive terminology for the variety of names given to WTS.
Waterpipe smoke contains significant levels of toxins, some of which are known to be carcinogenic to humans. Recent epidemiological trends have established an increasing prevalence of WTS in the Middle East and the United States, particularly among adolescents. It is used commonly across multiple ethnicities and both genders with less of a social gradient than cigarette smoking. Attitudes and beliefs have been researched widely and several reasons for believing it is less harmful than cigarette smoking include water filtration and social acceptability. A wide range of diseases have been associated with WTS, but research in this area is relatively underdeveloped and a better evidence base is needed. Worryingly, the waterpipe industry, including waterpipe cafes, operates in an almost completely unregulated market and employs deceptive marketing techniques to attract new users.
Waterpipe tobacco smoking (WTS) appears to be on the increase, especially among younger users, and therefore represents a potential public health concern. While legislators should consider enforcing and extending existing tobacco laws to a growing WTS industry, further research is required to fill gaps in the literature and provide evidence-based interventions for tobacco control specialists and health-care professionals.
水烟烟草的使用（WTS）在全球范围内日益流行，而随着水烟烟草被使用者认为比香烟危害小的证据出现，其健康影响也逐渐浮现。然而，目前仍然缺乏足够的证据来对其公共卫生意义作出明确的结论。
本综述旨在总结迄今为止关于 WTS 的文献，使烟草控制专家和卫生保健专业人员了解这一现象，并帮助他们评估 WTS 是否应该成为公共卫生的重点。
使用英文、法文和阿拉伯文的标准电子数据库以及会议记录和个人图书馆，以包容各种名称的术语搜索 WTS 文献。
水烟烟雾中含有大量毒素，其中一些被认为对人类具有致癌性。最近的流行病学趋势表明，中东和美国的 WTS 使用率不断上升，尤其是在青少年中。它在多个种族和性别中都被广泛使用，而且社会阶层差异比香烟吸烟小。人们对其态度和信念进行了广泛的研究，认为其危害小于香烟的原因包括水过滤和社会可接受性。已经有多种疾病与 WTS 相关，但该领域的研究相对薄弱，需要更好的证据基础。令人担忧的是，包括水烟咖啡馆在内的水烟烟草行业在一个几乎完全不受监管的市场中运作，并采用欺骗性的营销策略来吸引新用户。
水烟烟草的使用（WTS）似乎在增加，尤其是在年轻用户中，因此代表了一个潜在的公共卫生问题。虽然立法者应该考虑将现有的烟草法扩展到不断增长的 WTS 行业，但需要进一步研究来填补文献中的空白，并为烟草控制专家和卫生保健专业人员提供基于证据的干预措施。
