FHS to lead a study on the Economics of Waterpipe Tobacco Smoking in Lebanon, Jordan, Palestine, and Egypt

​Dr. Rima Nakkash, Associate Professor at AUB Faculty of Health Sciences (FHS), Associate Director of its Knowledge to Policy (K2P) Center and the WHO Waterpipe Tobacco Smoking Knowledge Hub, was granted by the International Development Research Centre (IDRC) 800,000$ to lead a four-year multi-country study (Lebanon, Jordan, Palestine and Egypt), on the different economic aspects of waterpipe tobacco smoking.

Entitled “Eastern Mediterranean Consortium on the Economics of Waterpipe Tobacco Smoking (ECON-WTS): Capacity Building and Knowledge Translation", the study aims to estimate the price elasticity of demand for waterpipe tobacco smoking (WTS) and the cross-price elasticity between cigarettes and WTS and model the impact of fiscal policies for waterpipe tobacco control on WTS rates, health care costs, and public revenues. It aspires to develop a toolkit to guide researchers conducting analyses on the economics of WTS, and develop and evaluate strategies to disseminate knowledge about the economic impact of waterpipe tobacco control policies to government agencies, policymakers, and advocates.

Dr. Rima Nakkash will lead the study along with co-PI Dr. Ramzi Salloum, Assistant Professor at the University of Florida (USA) and a Research Affiliate at AUB Faculty of Health Sciences. At a regional level, the study will be co-lead by PI's from the Jordan University of Science and Technology ,Dr. Yousef Khader (Jordan), Birzeit University ,Dr. Niveen Abu-Rmeileh (Palestine) and Ain Shams University, Dr. Aya Mostafa (Egypt). The co- investigators on the team are Dr. Fadi El Jardali, Professor and Chair of the AUB Department of Health Management and Policy and Director of the Knowledge to Policy (K2P) Center; Dr. Ali Chalak, Associate Professor at AUB Department of Agriculture, Faculty of Agriculture and Food Sciences; Dr. Mohammed Jawad, an NIHR Academic Clinical Fellow in Public Health Medicine at the Imperial College London (UK) and a Research Affiliate at AUB; Dr. Nihaya Al-Sheyab, an Associate Professor and Vice Dean at Jordan University of Science and Technology (JUST) Faculty of Nursing; Dr. Sameera Awawda from Birzeit University (Palestine); and Dr. Gihan Elsisi, Director of the Pharmacoeconomic Unit at the Ministry of Health and Population in Egypt.

The long-term goal of this project is achieve implementation of effective fiscal and economic policies that reduce the burden of WTS and improve population health throughout the EMR. We will accomplish this goal with a lasting regional consortium that supports knowledge translation and dissemination of research on the economics of tobacco control. Comprehensive estimates of the cost of smoking at the country- and regional-levels is a high priority. These estimates are important for documenting the economic burden of tobacco use, designing effective tobacco control programs, and identifying the health care needs of vulnerable populations. The proposed project will build upon ongoing collaborations in the EMR to advance capacity building and generate new economic evidence to advance WTS control policies.

This initiative builds on previous achievements and the work done by FHS in the field of Waterpipe Tobacco Smoking research, including hosting the third international conference on Waterpipe tobacco smoking and the launching of the World Health Organization (WHO) Knowledge Hub for Waterpipe research.

Through this study, AUB and its regional partners in Jordan, Palestine, and Egypt will strengthen multidisciplinary and multi-institutional leadership in generating economic evidence to support waterpipe tobacco control through the Eastern Mediterranean Consortium on the economics of Waterpipe Tobacco Smoking (ECON-WTS).

WTS rates in the EMR may be the highest worldwide, particularly among youth, sometimes exceeding cigarette smoking rates. Evidence associates WTS with nicotine dependence and smoking-related diseases including cancer, cardiovascular disease, lung disease, and adverse pregnancy outcomes. In spite of its harm, the rising prevalence of WTS has been met with a poor regulatory response globally.