Can users of waterpipe be helped to quit by smoking cessation interventions

Waterpipe smoking is a traditional method of tobacco use, especially in the Eastern Mediterranean Region. Its use is now spreading worldwide. It is smoked socially, and is often shared between friends or family at home, or in bars and cafes that provide waterpipes to patrons. In the absence of relevant data, many waterpipe tobacco smokers believe that this form of tobacco use is less lethal and addictive than other methods of tobacco smoking, because the smoke passes through water on its way to the user. At least in some cultures, women and girls are more likely to use a waterpipe than to use other forms of tobacco, and it is popular among younger smokers. Current evidence suggests that waterpipe smoking may be as addictive as other forms of tobacco use, and may also carry similar or greater risks to health. We searched for controlled trials in the Cochrane Tobacco Addiction Review Group specialized register, in February 2011. We also searched a number of electronic databases, including MEDLINE, EMBASE, PsycINFO and CINAHL, using a variety of names and spellings ('waterpipe' or 'narghile' or 'arghile' or 'shisha' or 'goza' or 'narkeela' or 'hookah' or 'hubble bubble'). We searched for published and unpublished trials in any language, and especially in areas where waterpipe use is widespread. We have not found any completed trials of smoking cessation interventions among waterpipe users. The authors of this review are conducting a pilot study of waterpipe smoking cessation, which will be reported in future updates. More research is needed on this tobacco use method's addictive properties, and on its associated health risks, both for users and exposed non-smokers. Evidence-based information about waterpipe should be collected and circulated to discourage the uptake and spread of its use so that it is no longer seen as normal or 'cool'. Effective treatments should be developed to help waterpipe smokers quit.