title: Toward a Regulatory Framework for the Waterpipe.
abstract: Waterpipe smoking has been dramatically increasing among youth worldwide and in the United States. Despite its general association with misperceptions of reduced harm, evidence suggests this is a harmful and dependence-inducing tobacco use method that represents a threat to public health. Waterpipe products continue to be generally unregulated, which likely has contributed to their spread. The Family Smoking Prevention and Tobacco Control Act of 2009 granted the US Food and Drug Administration (FDA) the authority to regulate waterpipe products, and the FDA finalized a rule extending its authority over waterpipe products in May 2016. This critical step in addressing the alarming increase in waterpipe smoking in the United States has created urgency for research to provide the evidence needed for effective regulatory initiatives for waterpipe products. We aim to stimulate such research by providing a framework that addresses the scope of waterpipe products and their unique context and use patterns. The proposed framework identifies regulatory targets for waterpipe product components (i.e., tobacco, charcoal, and device), the waterpipe café setting, and its marketing environment dominated by Internet promotion.
authors.affiliation: Ramzi G. Salloum is with the Department of Health Outcomes and Policy and the Institute for Child Health Policy, University of Florida College of Medicine, Gainesville. Taghrid Asfar is with the Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL. Wasim Maziak is with the Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.
authors.forename: Ramzi G
authors.initials: RG
authors.lastname: Salloum
authors.affiliation: Ramzi G. Salloum is with the Department of Health Outcomes and Policy and the Institute for Child Health Policy, University of Florida College of Medicine, Gainesville. Taghrid Asfar is with the Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL. Wasim Maziak is with the Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.
authors.forename: Taghrid
authors.initials: T
authors.lastname: Asfar
authors.affiliation: Ramzi G. Salloum is with the Department of Health Outcomes and Policy and the Institute for Child Health Policy, University of Florida College of Medicine, Gainesville. Taghrid Asfar is with the Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL. Wasim Maziak is with the Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.
authors.forename: Wasim
authors.initials: W
authors.lastname: Maziak
mesh_terms: D000293:Adolescent; D040261:Harm Reduction; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D040541:Marketing / Q000379:methods; D011634:Public Health; D012907:Smoking / Q000453:epidemiology / Q000639:trends*; D000074606:Smoking Prevention; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States; D014486:United States Food and Drug Administration / Q000331:legislation & jurisprudence*