All in the - American University of Beirut

in with more evidence-based research. This time it wasa study by FHS Associate Dean and Professor Rima Afifiand Nakkash evaluating the impact of pictorial warningson cigarette packs that proved that pictorial warnings aremore effective than textual warnings.AUB’s IFI also contributed in issuing a paper byFAFS Assistant Professor Jad Chaaban and FAS AssistantProfessor Nisreen Salti—both TCRG members—thatdocumented the social costs of tobacco consumption inLebanon. Some of Chaaban and Salti’s findings are quitealarming: smoking-related diseases cost about $146.7million per year; the aggregate cost of environmentaldegradation totals $13.2 million; and working inefficiencydue to smoking costs are $102 million per year.One of the explanations for the high number ofsmokers in Lebanon is the popularity of the nargileh(also known as the waterpipe). Although manyindividuals believe that the nargileh is not nearly asharmful as cigarettes, the evidence suggests that theyare wrong. Writing in the American Journal of PreventiveMedicine, Virginia Commonwealth University ProfessorThomas Eissenberg and FEA Associate Professor AlanShihadeh note that “despite the lack of waterpipespecific epidemiologic studies of health risk, the weightof the evidence… suggests that waterpipe tobaccosmoking is likely associated with many of the sametobacco-caused diseases as cigarette smoking, includingcancer, cardiovascular and lung disease, and nicotinedependence.” Shihadeh and Eissenberg, who are currentlycollaborating on grants funded by the US National CancerInstitute and the National Institute on Drug Abuse, havedemonstrated that “relative to a cigarette, a 45-minutewaterpipe tobacco smoking episode generates more than40 times the smoke volume.”FM Associate Dean Ghazi Zaatari, a TCRG memberand chair of the World Health Organization Study Groupon Tobacco Product Regulation, says that one of theTCRG’s most important contributions is the research itis doing related to the nargileh. “We have only limitedknowledge,” Zaatari explains, “both about the contentsand emissions of toxicants and carcinogens in waterpipesmoke and also about the extent that it is taken upby the human body. There is a need to demonstratethe carcinogenic effect, the biological pathways to thiseffect, and the harm that is associated with the use ofthe waterpipe. We also need to assess the addictivenessof waterpipe smoking, the social issues that promote theuse of this form of tobacco—especially among youngpeople—and the health effects related to the secondhand smoke that is caused by the large volume ofsmoke generated by the use of flavored and sweetenedwaterpipe tobacco products.”Although passage of the new law that regulatesall tobacco products including the narghileh is reasonto celebrate, the TCRG and its partners recognize thatthere is still a lot of work to be done to ensure that it isproperly enforced. This is a concern for some restaurantowners such as Christine Sfeir (BS ’94) who, although shedescribes the law as a “good thing to do,” is worried thatit will hurt businesses like hers that “work by the book.”Hmaidan, however, says that if international experience isany guide, the new legislation may help many businessesas customers such as Shihadeh and his family, who havebeen driven away by cigarette smoke, return. “As a Beirutresident and a parent of young children, I am thrilledat the prospect of being able to take them out for mealswithout the constant worry that I’m doing them harm byexposing them to second hand smoke,” he says.Learn more about the TCRG at www.aub.edu.lb/units/tcrg26 MainGate Fall 2011 | www.aub.edu.lb/maingate