Grant Number:	5R01TW010654-05 Interpret this number
Primary Investigator:	Maziak, Wasim
Organization:	Florida International University
Project Title:	Translating Evidence and Building Capacity to Support Waterpipe Control in the Eastern Mediterranean
Fiscal Year:	2021

Abstract: In the past decade waterpipe smoking (WP; hookah) has become the No. 1 tobacco use method among youth in the Eastern Mediterranean Region (EMR), yet evidence-based solutions to the WP epidemic continue to lag behind. This is mainly due to 2 factors; 1) the mismatch of policy solutions derived from cigarettes to local tobacco use methods such as the WP; and 2) the lack of understanding of local tobacco control (TC) policy environment and challenges to implementation. On the other hand, the WHO’s Framework Convention on Tobacco Control (FCTC) ratified by most countries in the EMR provides an opportunity to address WP smoking in the region. Supported by program TOBAC since its beginning in 2002, our team at the Syrian Center for Tobacco Studies (SCTS) has been on the forefront of characterizing the WP epidemic and its health and addictive properties. Such groundwork has prepared us to plan for the next stage of translating evidence into policy to support EMR efforts to control the WP epidemic. Given the widespread misperceptions that WP is less harmful and addictive than cigarettes, and the value of health warning labels (HWLs) in communicating smoking-related risks, the development of HWLs is a priority for WP control. Developing HWLs for the WP however, requires their adaptation to its unique multi-part context comprised of tobacco, device and charcoal, while implementation of WP-HWLs requires an understanding of the local policy environment, and strong national partnerships. Building on our ongoing collaboration with Lebanon (American University of Beirut) and Tunisia (University of Tunis), we want to assist these countries in developing and implementing effective HWLs for the WP and in building their national capacity in TC policy research. We will apply a mixed method approach to develop and test HWLs with the involvement of members of the target population comprised mostly of young adults (18-25 years). We will also study the structure and functioning of local health systems in Tunisia and Lebanon, so we can propose a clear roadmap for the implementation of WP-HWLs, and establish partnerships among researchers and policymakers than can facilitate such implementation. This application represents our team’s continuing leadership in responding to the WP epidemic, and in strengthening TC capacity in the EMR. It will help Tunisia and Lebanon, and perhaps other countries develop effective HWLs for WP, and equip them with the means to implement them successfully.




Novel Insights into Young Adults' Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy.
Authors: Nakkash R. , Tleis M. , Chehab S. , Wensong W. , Schmidt M. , Ward K.D. , Maziak W. , Asfar T. .
Source: International journal of environmental research and public health, 2021-07-05; 18(13), .
EPub date: 2021-07-05.
PMID: 34281125
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Markers of oxidative stress and toxicant exposure among young waterpipe smokers in the USA.
Authors: Jebai R. , Ebrahimi Kalan M. , Vargas-Rivera M. , Osibogun O. , Li W. , Gautam P. , Chao M.R. , Hu C.W. , Bursac Z. , Maziak W. .
Source: Environmental science and pollution research international, 2021 Jun; 28(21), p. 26677-26683.
EPub date: 2021-01-25.
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The Effect of Graphic Health Warning Labels Placed on the ENDS Device on Young Adult Users' Experience, Exposure and Intention to Use: A Pilot Study.
Authors: Li W. , Vargas-Rivera M. , Ebrahimi Kalan M. , Ben Taleb Z. , Asfar T. , Osibogun O. , Noar S.M. , Maziak W. .
Source: Health communication, 2021-01-21; , p. 1-8.
EPub date: 2021-01-21.
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Predictors of nicotine dependence among adolescent waterpipe and cigarette smokers: A 6-year longitudinal analysis.
Authors: Ebrahimi Kalan M. , Bahelah R. , Bursac Z. , Ben Taleb Z. , DiFranza J.R. , Tleis M. , Nakkash R. , Jebai R. , Alam M.M. , Cano M.Á. , et al. .
Source: Drug and alcohol dependence, 2020-12-01; 217, p. 108346.
EPub date: 2020-10-12.
PMID: 33075692
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Natural Course of Nicotine Dependence Among Adolescent Waterpipe and Cigarette Smokers.
Authors: Ebrahimi Kalan M. , Behaleh R. , DiFranza J.R. , Bursac Z. , Ben Taleb Z. , Tleis M. , Asfar T. , Nakkash R. , Ward K.D. , Eissenberg T. , et al. .
Source: The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2020 12; 67(6), p. 859-867.
EPub date: 2020-07-02.
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The Syrian Center for Tobacco Studies-13 (SCTS-13): Psychometric evaluation of a waterpipe-specific nicotine dependence instrument.
Authors: Alam M.M. , Ward K.D. , Bahelah R. , Kalan M.E. , Asfar T. , Eissenberg T. , Maziak W. .
Source: Drug and alcohol dependence, 2020-10-01; 215, p. 108192.
EPub date: 2020-07-25.
PMID: 32738447
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Cessation outcomes in adult dual users of e-cigarettes and cigarettes: the Population Assessment of Tobacco and Health cohort study, USA, 2013-2016.
Authors: Osibogun O. , Bursac Z. , Mckee M. , Li T. , Maziak W. .
Source: International journal of public health, 2020 Jul; 65(6), p. 923-936.
EPub date: 2020-07-24.
PMID: 32710136
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Agent-based Modeling in Tobacco Regulatory Science: Exploring 'What if' in Waterpipe Smoking.
Authors: Yang Y. , Ward K.D. , Salloum R.G. , Lindblom E.N. .
Source: Tobacco regulatory science, 2020 May; 6(3), p. 171-178.
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E-Cigarette Use and Regular Cigarette Smoking Among Youth: Population Assessment of Tobacco and Health Study (2013-2016).
Authors: Osibogun O. , Bursac Z. , Maziak W. .
Source: American journal of preventive medicine, 2020 05; 58(5), p. 657-665.
EPub date: 2020-03-05.
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Delphi study among international expert panel to develop waterpipe-specific health warning labels.
Authors: Asfar T. , Schmidt M. , Ebrahimi Kalan M. , Wu W. , Ward K.D. , Nakkash R.T. , Thrasher J. , Eissenberg T. , Ben Romdhane H. , Maziak W. .
Source: Tobacco control, 2020 03; 29(2), p. 159-167.
EPub date: 2019-01-29.
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Effect of flavour manipulation on low and high-frequency waterpipe users' puff topography, toxicant exposures and subjective experiences.
Authors: Maziak W. , Ben Taleb Z. , Ebrahimi Kalan M. , Ward-Peterson M. , Bursac Z. , Osibogun O. , Eissenberg T. .
Source: Tobacco control, 2020 02; 29(Suppl 2), p. s95-s101.
EPub date: 2019-07-20.
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Waterpipe smoking: the pressing need for risk communication.
Authors: Maziak W. , Osibogun O. , Asfar T. .
Source: Expert review of respiratory medicine, 2019 11; 13(11), p. 1109-1119.
EPub date: 2019-09-20.
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Pictorial health warning labels on the waterpipe device are effective in reducing smoking satisfaction, puffing behaviour and exposure to CO: first evidence from a crossover clinical laboratory study.
Authors: Maziak W. , Ben Taleb Z. , Ebrahimi Kalan M. , Eissenberg T. , Thrasher J. , Shihadeh A. , Asfar T. .
Source: Tobacco control, 2019 08; 28(e1), p. e37-e42.
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Strengthening Policy-Relevant Tobacco Research Capacity in Low- and Middle-Income Countries: Challenges, Opportunities, and Lessons Learned.
Authors: Berg C.J. , Thrasher J.F. , Barnoya J. , Cohen J.E. , Maziak W. , Lando H. , Drope J. , Mejia R. , Foley K. , Nakkash R. , et al. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2019-07-17; 21(8), p. 1140-1143.
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Characteristics of Waterpipe Health Warning Labels in the United States.
Authors: Ward K.D. , Kumar J. , Khan Z. , Jiang Y. .
Source: American journal of health behavior, 2019-07-01; 43(4), p. 858-865.
PMID: 31239026
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Determinants of progression of nicotine dependence symptoms in adolescent waterpipe smokers.
Authors: Bahelah R. , Ward K.D. , Ben Taleb Z. , DiFranza J.R. , Eissenberg T. , Jaber R. , Maziak W. .
Source: Tobacco control, 2019 05; 28(3), p. 254-260.
EPub date: 2018-06-12.
PMID: 29895703
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The Gateway Effect of E-cigarettes: Reflections on Main Criticisms.
Authors: Chapman S. , Bareham D. , Maziak W. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2019-04-17; 21(5), p. 695-698.
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Pulmonary Toxicity and the Pathophysiology of Electronic Cigarette, or Vaping Product, Use Associated Lung Injury.
Authors: Chand H.S. , Muthumalage T. , Maziak W. , Rahman I. .
Source: Frontiers in pharmacology, 2019; 10, p. 1619.
EPub date: 2020-01-14.
PMID: 31992985
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How Do Waterpipe Smoking Establishments Attract Smokers? Implications for Policy.
Authors: Asfar T. , Ben Taleb Z. , Osibogun O. , Ruano-Herreria E.C. , Sierra D. , Ward K.D. , Salloum R.G. , Maziak W. .
Source: Substance use & misuse, 2019; 54(4), p. 560-571.
EPub date: 2018-11-15.
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The impact and relevance of tobacco control research in low-and middle-income countries globally and to the US.
Authors: Berg C.J. , Fong G.T. , Thrasher J.F. , Cohen J.E. , Maziak W. , Lando H. , Drope J. , Mejia R. , Barnoya J. , Nakkash R. , et al. .
Source: Addictive behaviors, 2018 12; 87, p. 162-168.
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