title: Waterpipe industry products and marketing strategies: analysis of an industry trade exhibition.
abstract: BACKGROUND
  Understanding product development and marketing strategies of transnational tobacco companies (TTCs) has been of vital importance in developing an effective tobacco control policy. However, comparatively little is known of the waterpipe tobacco industry, which TTCs have recently entered. This study aimed to gain an understanding of waterpipe tobacco products and marketing strategies by visiting a waterpipe trade exhibition.
  
  
  METHODS
  In April 2014, the first author attended an international waterpipe trade exhibition, recording descriptions of products and collecting all available marketing items. We described the purpose and function of all products, and performed a thematic analysis of messages in marketing material.
  
  
  RESULTS
  We classified waterpipe products into four categories and noted product variation within categories. Electronic waterpipe products (which mimic electronic cigarettes) rarely appeared on waterpipe tobacco marketing material, but were displayed just as widely. Claims of reduced harm, safety and quality were paramount on marketing materials, regardless of whether they were promoting consumption products (tobacco, tobacco substitutes), electronic waterpipes or accessories.
  
  
  CONCLUSIONS
  Waterpipe products are diverse in nature and are marketed as healthy and safe products. Furthermore, the development of electronic waterpipe products appears to be closely connected with the electronic cigarette industry, rather than the waterpipe tobacco manufacturers. Tobacco control policy must evolve to take account of the vast and expanding array of waterpipe products, and potentially also charcoal products developed for waterpipe smokers. We recommend that tobacco substitutes be classified as tobacco products. Continued surveillance of the waterpipe industry is warranted.
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, London, UK Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Jawad
authors.affiliation: Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
authors.forename: Rima T
authors.initials: RT
authors.lastname: Nakkash
authors.affiliation: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Hawkins
authors.affiliation: Department of Internal Medicine, American University of Beirut, Beirut, Lebanon Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Elie A
authors.initials: EA
authors.lastname: Akl
mesh_terms: D003132:Commerce / Q000639:trends*; D006801:Humans; D040541:Marketing / Q000706:statistics & numerical data*; D019064:Product Packaging / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D019460:Tobacco Industry / Q000706:statistics & numerical data*; D062789:Tobacco Products / Q000706:statistics & numerical data*; D064424:Tobacco Use
keywords: Advertising and Promotion; Electronic nicotine delivery devices; Harm Reduction; Non-cigarette tobacco products; Tobacco industry