Many hookah manufacturers have not complied with FDA-mandated nicotine warning labels, finds study

Since August 2018, the US Meals & Drug Administration has mandated that every one hookah (also called waterpipe tobacco or shisha) producers embody a nicotine warning on their packaging to speak the harms of the tobacco of their merchandise.

However two years after this mandate was carried out, hookah firms’ compliance with this federal regulation remained low, in accordance with a brand new examine led by a Boston College College of Public Well being (BUSPH) researcher.

Published in the journal JAMA Network Open, the examine discovered that solely 3 manufacturers out of 33 manufacturers assessed have been 100% compliant with all warning label necessities, which mandated a spread of placement and formatting components.

The examine is the primary to look at this compliance with warning necessities on hookah packaging within the nation.

Warning labels on hookah packaging are significantly vital as a result of, regardless of frequent perception, hookah smoking shouldn’t be safer than cigarette smoking. Hookah tobacco smoke comprises lots of the similar dangerous parts present in cigarette smoke, together with nicotine, tar, heavy metals, and carbon monoxide.

However individuals who smoke hookah might inhale as a lot as 70 occasions extra tar and 11 occasions extra carbon monoxide from water pipes than from cigarettes, due partly to the size of hookah smoking classes, which usually final a minimum of one hour.

These poisonous exposures can improve hookah people who smoke’ danger of growing cancers, coronary heart illness, respiratory points, and blood strain issues, in accordance with the FDA and Facilities for Illness Management & Prevention.

“We all know that warnings are an efficient solution to talk to folks the harms related to smoking all forms of tobacco, however to be efficient, they have to exist, to start with,” says examine lead and corresponding creator Dr. Jennifer Ross, affiliate professor of well being regulation, coverage & administration at BUSPH.

“We hope this examine will convey consideration to the low ranges of compliance amongst hookah producers in order that further motion could be taken to extend compliance. We additionally hope that these findings will result in efforts to extend additional the impression of warnings for hookah, similar to implementing extra warnings and in additional places to extend folks’s publicity to the warning labels.”

Youthful folks, specifically, may gain advantage from these warnings, as an estimated 1 in 6 younger adults ages 19-30 years reported that they’d smoked hookah throughout the final 12 months in 2018. Hookah smoking is commonly marketed to this demographic as a calming, social exercise that includes quite a lot of fruit-flavored tobacco.

“Younger folks typically have misperceptions concerning the risks of smoking tobacco in a hookah, similar to considering that the water within the waterpipe ‘purifies’ the tobacco, which isn’t true,” Dr. Ross says.

For the examine, Dr. Ross and colleagues from Wake Forest College College of Medication and East Carolina College recognized all hookah manufacturers out there for on-line buy in 2020—a complete of 66. They narrowed their evaluation to 33 manufacturers, together with a complete of 181 packages, based mostly on a mix of the very best product prevalence and random choice.