Jawad Mohammed, El Kadi Lama, Mugharbil Sanaa, Nakkash Rima
Department of Primary Care and Public Health, Imperial College London, London, UK.
Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Tob Control. 2015 Mar;24 Suppl 1(Suppl 1):i60-i65. doi: 10.1136/tobaccocontrol-2014-051911. Epub 2014 Dec 30.
(1) To review how current global tobacco control policies address regulation of waterpipe tobacco smoking (WTS). (2) To identify features associated with enactment and enforcement of WTS legislation.
(1) Legislations compiled by Tobacco Control Laws (www.tobaccocontrollaws.org). (2) Weekly news articles by 'Google Alerts' (www.google.com/alerts) from July 2013 to August 2014.
(1) Countries containing legislative reviews, written by legal experts, were included. Countries prohibiting tobacco sales were excluded. (2) News articles discussing aspects of the WHO FCTC were included. News articles related to electronic-waterpipe, crime, smuggling, opinion pieces or brief mentions of WTS were excluded.
(1) Two reviewers independently abstracted the definition of "tobacco product" and/or "smoking". Four tobacco control domains (smokefree law, misleading descriptors, health warning labels and advertising/promotion/sponsorship) were assigned one of four categories based on the degree to which WTS had specific legislation. (2) Two investigators independently assigned at least one theme and associated subtheme to each news article.
(1) Reviewed legislations of 62 countries showed that most do not address WTS regulation but instead rely on generic tobacco/smoking definitions to cover all tobacco products. Where WTS was specifically addressed, no additional legislative guidance accounted for the unique way it is smoked, except for in one country specifying health warnings on waterpipe apparatuses (2) News articles mainly reported on noncompliance with public smoking bans, especially in India, Pakistan and the UK.
A regulatory framework evaluated for effectiveness and tailored for the specificities of WTS needs to be developed.
（1）回顾当前全球烟草控制政策如何处理水烟吸食（WTS）的监管问题。（2）确定与WTS立法的制定和执行相关的特征。
（1）由烟草控制法律（www.tobaccocontrollaws.org）汇编的法规。（2）2013年7月至2014年8月“谷歌快讯”（www.google.com/alerts）的每周新闻文章。
（1）纳入包含由法律专家撰写的立法审查的国家。禁止烟草销售的国家被排除。（2）纳入讨论《世界卫生组织烟草控制框架公约》各方面的新闻文章。与电子水烟、犯罪、走私、评论文章或对WTS的简短提及相关的新闻文章被排除。
（1）两名审查员独立提取“烟草制品”和/或“吸烟”的定义。根据WTS拥有特定立法的程度，将四个烟草控制领域（无烟法律、误导性描述词、健康警示标签以及广告/促销/赞助）分为四类。（2）两名研究人员独立为每篇新闻文章指定至少一个主题及相关子主题。
（1）对62个国家的法规审查表明，大多数国家未涉及WTS监管，而是依赖通用的烟草/吸烟定义来涵盖所有烟草制品。在专门涉及WTS的地方，除了一个国家规定对水烟器具设置健康警示外，没有额外的立法指南考虑到其独特的吸食方式。（2）新闻文章主要报道了违反公共吸烟禁令的情况，尤其是在印度、巴基斯坦和英国。
需要制定一个评估有效性并针对WTS具体情况量身定制的监管框架。
