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Letters to the Editor The journal publishes both invited and unsolicited letters.
WATERPIPE TOBACCO LABELING AND PACKAGING AND WORLD HEALTH ORGANIZATION FRAMEWORK CONVENTION ON TOBACCO CONTROL (WHO FCTC): A CALL FOR ACTION Sir—In their review paper, Kotnowski & Hammond [1] show tobacco industry attempts to undermine public health policies that would harm their commercial interests. I would like to draw attention to inadequacy in the policies and regulations around waterpipe (WP) promotion and product formulation. WP smoking shows signs of becoming a new epidemic, especially among adolescents and young adults [2–6]. The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Article 11, which regulates packaging and labeling purportedly on all tobacco products, is not well suited to WPs. Unlike cigarettes, WPs come in very different shapes and sizes and therefore issues such as labeling, packaging, textual and pictorial health warnings, as well as standard packaging, present significant challenges necessitating specific and creative policies to tackle them [2]. Labeling and packaging of WP accessories and tobacco show low, if any, compliance with WHO FCTC Article 11 [2,7]. Health warnings, if they exist, cover less than the minimum labeling area of 30% required by FCTC Article 11 [7]. Given the social nature of WP smoking and the variety of cafés and restaurants serving it, many consumers are unaware of the contents of the tobacco served or of the presence of any health warnings on WP tobacco and accessories [2]. Misleading descriptors have also been reported on WP tobacco products and accessories [7]. In order to control the WP epidemic, policies similar to cigarette smoking but suited to WPs should be implemented. There is an urgent need for WHO FCTC guidelines to be revised and incorporate, inter alia, content disclosure, flavored tobacco, labeling and packaging. Declaration of interests None. RAED BAHELAH
Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, University Park AHCII 595-1, 11200 SW 8th Street, Miami, FL 33199, USA. E-mail: [email protected] © 2013 Society for the Study of Addiction
References 1. Kotnowski K., Hammond D. The impact of cigarette pack shape, size and opening: evidence from tobacco company documents. Addiction 2013; 108: 1658–68. 2. Maziak W., Nakkash R., Bahelah R., Husseini A., Fanous N., Eissenberg T. Tobacco in the Arab world: old and new epidemics amidst policy paralysis. Health Policy Plan 2013; doi: 10.1093/heapol/czt055 [E-pub ahead of print]. 3. Khalil J., Afifi R., Fouad F. M., Hammal F., Jarallah Y., Mohammad M. et al. Women and waterpipe tobacco smoking in the eastern mediterranean region: allure or offensiveness. Women Health 2013; 53: 100–16. 4. Ward K. D., Eissenberg T., Gray J. N., Srinivas V., Wilson N., Maziak W. Characteristics of U.S. waterpipe users: a preliminary report. Nicotine Tob Res 2007; 9: 1339–46. 5. Cobb C. O., Khader Y., Nasim A., Eissenberg T. A multiyear survey of waterpipe and cigarette smoking on a US university campus. J Am Coll Health 2012; 60: 521–7. 6. Akl E. A., Gunukula S. K., Aleem S., Obeid R., Abou Jaoude P., Honeine R. et al. The prevalence of waterpipe tobacco smoking among the general and specific populations: a systematic review. BMC Public Health 2011; 11: 244. 7. Nakkahs R., Khalil J. Health warning labelling practices on narghile (shisha, hookah) waterpipe tobacco products and related accessories. Tob Control 2010; 19: 235–39.
ON THE MISMATCH BETWEEN POPULATION DRINKING AND DRINK DRIVING. RESPONSE TO GJERDE ET AL. (2013) We are grateful for the opportunity to respond to the issues that Gjerde et al. [1] raise in connection with our paper published in Addiction [2]. To recapitulate, on the basis of time–series data for Norway and Sweden we reported a strongly significant relation between population drinking and rates of drink driving (DWI). Our analyses focused on the period 1957–89, during which the DWI legislation remained unchanged in both countries. The key message from Gjerde et al. is that DWI need not increase in spite of increasing population drinking. As an example, they point out that per-capita alcohol consumption increased markedly in Norway between 1990 and 2010, whereas DWI decreased during the same period. However, the mismatch between population drinking and DWI seems to reflect a more general pattern. In several countries, including Norway and Sweden, total alcohol consumption has increased during the last decades, without concomitant increases in all alcohol-related harm outcomes [3]. This is intuitively at Addiction, 109, 333–334
This document is a scanned copy of a printed document. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material.
Letters to the Editor The journal publishes both invited and unsolicited letters.
WATERPIPE TOBACCO LABELING AND PACKAGING AND WORLD HEALTH ORGANIZATION FRAMEWORK CONVENTION ON TOBACCO CONTROL (WHO FCTC): A CALL FOR ACTION Sir—In their review paper, Kotnowski & Hammond [1] show tobacco industry attempts to undermine public health policies that would harm their commercial interests. I would like to draw attention to inadequacy in the policies and regulations around waterpipe (WP) promotion and product formulation. WP smoking shows signs of becoming a new epidemic, especially among adolescents and young adults [2–6]. The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Article 11, which regulates packaging and labeling purportedly on all tobacco products, is not well suited to WPs. Unlike cigarettes, WPs come in very different shapes and sizes and therefore issues such as labeling, packaging, textual and pictorial health warnings, as well as standard packaging, present significant challenges necessitating specific and creative policies to tackle them [2]. Labeling and packaging of WP accessories and tobacco show low, if any, compliance with WHO FCTC Article 11 [2,7]. Health warnings, if they exist, cover less than the minimum labeling area of 30% required by FCTC Article 11 [7]. Given the social nature of WP smoking and the variety of cafés and restaurants serving it, many consumers are unaware of the contents of the tobacco served or of the presence of any health warnings on WP tobacco and accessories [2]. Misleading descriptors have also been reported on WP tobacco products and accessories [7]. In order to control the WP epidemic, policies similar to cigarette smoking but suited to WPs should be implemented. There is an urgent need for WHO FCTC guidelines to be revised and incorporate, inter alia, content disclosure, flavored tobacco, labeling and packaging. Declaration of interests None. RAED BAHELAH
Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, University Park AHCII 595-1, 11200 SW 8th Street, Miami, FL 33199, USA. E-mail: [email protected] © 2013 Society for the Study of Addiction
References 1. Kotnowski K., Hammond D. The impact of cigarette pack shape, size and opening: evidence from tobacco company documents. Addiction 2013; 108: 1658–68. 2. Maziak W., Nakkash R., Bahelah R., Husseini A., Fanous N., Eissenberg T. Tobacco in the Arab world: old and new epidemics amidst policy paralysis. Health Policy Plan 2013; doi: 10.1093/heapol/czt055 [E-pub ahead of print]. 3. Khalil J., Afifi R., Fouad F. M., Hammal F., Jarallah Y., Mohammad M. et al. Women and waterpipe tobacco smoking in the eastern mediterranean region: allure or offensiveness. Women Health 2013; 53: 100–16. 4. Ward K. D., Eissenberg T., Gray J. N., Srinivas V., Wilson N., Maziak W. Characteristics of U.S. waterpipe users: a preliminary report. Nicotine Tob Res 2007; 9: 1339–46. 5. Cobb C. O., Khader Y., Nasim A., Eissenberg T. A multiyear survey of waterpipe and cigarette smoking on a US university campus. J Am Coll Health 2012; 60: 521–7. 6. Akl E. A., Gunukula S. K., Aleem S., Obeid R., Abou Jaoude P., Honeine R. et al. The prevalence of waterpipe tobacco smoking among the general and specific populations: a systematic review. BMC Public Health 2011; 11: 244. 7. Nakkahs R., Khalil J. Health warning labelling practices on narghile (shisha, hookah) waterpipe tobacco products and related accessories. Tob Control 2010; 19: 235–39.
ON THE MISMATCH BETWEEN POPULATION DRINKING AND DRINK DRIVING. RESPONSE TO GJERDE ET AL. (2013) We are grateful for the opportunity to respond to the issues that Gjerde et al. [1] raise in connection with our paper published in Addiction [2]. To recapitulate, on the basis of time–series data for Norway and Sweden we reported a strongly significant relation between population drinking and rates of drink driving (DWI). Our analyses focused on the period 1957–89, during which the DWI legislation remained unchanged in both countries. The key message from Gjerde et al. is that DWI need not increase in spite of increasing population drinking. As an example, they point out that per-capita alcohol consumption increased markedly in Norway between 1990 and 2010, whereas DWI decreased during the same period. However, the mismatch between population drinking and DWI seems to reflect a more general pattern. In several countries, including Norway and Sweden, total alcohol consumption has increased during the last decades, without concomitant increases in all alcohol-related harm outcomes [3]. This is intuitively at Addiction, 109, 333–334
This document is a scanned copy of a printed document. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material.
![[WHO Framework Convention on Tobacco Control (FCTC) Article 11: packaging and labelling of tobacco products].](/assets/img/hold.png)
