Third International Conference on Waterpipe Tobacco Smoking Research​: moving towards action

As part of its leading efforts in research and advocacy in the field of tobacco smoking, and with the aim to move towards action, the Faculty of Health Sciences (FHS) organized on 10 and 11 November 2017, the Third International Conference on Waterpipe Tobacco Smoking Conference, with a focus on “Translating waterpipe tobacco smoking research evidence into practice, policy and regulation.”

Held in collaboration with the Syrian Center for Smoking Research and with the support of the National Institute of Drug Abuse in the United States, the Conference brought together more than thirty experts and world renowned researchers from thirteen countries working on tobacco control, waterpipe smoking, and public health advocacy, together with policy makers, civil society organizations, and media. Participants shared recent evidence on interventions aimed at combating waterpipe tobacco smoking in Lebanon and globally; and discussed obstacles and options in translating knowledge and evidence into policies and in enforcing them using the poor enforcement of Law 174 as an example. The Conference was also an ideal opportunity to launch the (World Health Organization) WHO’s Knowledge Hub for Waterpipe Research, which addresses the growing concern about the increasing prevalence and potential health effects of waterpipe tobacco smoking.

During the launching event, a video was presented highlighting the extensive and multidisciplinary research on waterpipe smoking that was carried out at AUB for more than a decade, qualifying it as a key contributor and ultimate platform for knowledge, advocacy, and policy formulation.

Announcing the launch of the Conference, Dr. Rima Nakkash, FHS associate professor and chair of the Tobacco-Free AUB 2018 Task Force, stated that “it is our hope that with the support of all the concerned stakeholders, this conference meets its set objectives in assessing and disseminating the knowledge on waterpipe smoking through virtual platforms of informational exchange, organizing activities to share this information and experiences, and advising regulatory bodies on effective control measures to curb this growing epidemic.”

“It is the new global epidemic, and Lebanese youth smoking prevalence is the highest in the world,” said dean of FHS Dr. Iman Nuwayhid, underlining the need for “health professionals to work together, regardless of their specific field.” “Institutional support is a must for these researchers to take their findings and transform them into actual policies,” stated Dr. Nuwayhid, adding that this support is one of the main advantages and strategic goals of FHS.

Dr. Tibor Szilagyi, team leader of reporting and knowledge management of the WHO Framework Convention on Tobacco Control (FCTC) Secretariat, warned that tobacco consumption is “by far the biggest cause of preventable death worldwide.” He also said that “the results of anti-tobacco measures have been uneven and that in the eastern Mediterranean region, including Lebanon, tobacco consumption remains stubbornly high.”

On another hand, Dr. Szilagyi also praised AUB’s role, expressing the Secretariat delight “to join hands with the AUB and help this project to become a reality. It allows the whole world to benefit from the expertise that AUB has developed over many years in this area.” He continued: “I can think of no better partner for this venture than the distinguished oncologist and AUB President Fadlo Khuri, who has devoted his life to the fight against cancer.”

Also speaking during this event, Dr. Martin Mckee, known as the “champion of public health,” focused on the economic lobbying that is being led by tobacco companies in this field, and that is hindering political decisions and legislations related to tobacco control. “Tobacco is like Malaria, and tobacco industries are the mosquitoes,” stated Dr. Mckee. At the same time, Dr. Mckee said that tobacco companies are also financing misleading research activities. “We need to look into the conflict of interest when studying data from sources related to the tobacco industry,” warned Dr. Mckee.

In the same context, Dr. Yusuf Saloogee also assured that “the main problem is lack of political will, which this is due to pressure of tobacco industries.” Dr. Saloogee highlighted the “need for advocacy and advice for politicians, but also, and more importantly for the public opinion.”

“We need a communication strategy that helps the public understand the real issues confronting the conflicting values or interests, and define a programme for effective action, he stated.

Dr. Saloogee also defied the claims of the tobacco industry that tobacco control would have a negative impact on the economy, as he ensured that, according to the World Bank, smoking control will in fact create jobs and improve the economy and not the opposite.

In a more practical presentation, Dr. Fadi El-Jardali, professor and chairman of the Health Management and Policy Department at FHS, Director of the Knowledge to Policy (K2P) Center, and Co-Director of the WHO Collaborating Center for Evidence Informed Policy and Practice based at AUB, considered that “evidence-based advocacy, citizen consultations and media engagement are critical to achieve impact on waterpipe tobacco policies in the region.”

That same point was highlighted by Scott Sherman and Mark Parascandola, as they considered that bridging the evidence gap in our knowledge about the behavioral and social context around waterpipe tobacco smoking is needed to inform and strengthen proper policies and legislations.

“What is the alternative of waterpipe smoking among youth who are doing this as a social activity and rather think of it as fun? How to move towards action?” asked Sherman, who reflected on misconception as one of the main challenges that tobacco companies are exploiting and even generating to push youth consumers towards waterpipe smoking. 

Following two days of presentations and discussion panels by AUB professors, media professionals and activists, as well as international experts, a ceremony was organized to announce the launch of the WHO Knowledge Hub for Waterpipe Research.

The main goals of this platform is to educate the public about the dangers of WTS with scientific information, to dispel misconceptions about safety, and to urge the regulators to undertake effective control measures on Waterpipe Tobacco Smoking.

Dr. Ghazi Zaatari, Associate Dean for Faculty Affairs at AUB’s Faculty of Medicine, said "the collective expertise on waterpipe smoking at AUB is unparalleled at any other academic institution in the world" StopWaterpipe.”

On the role of AUB in this context, Dr. Zaatari added “AUB scientists and researchers have made valuable contributions to the knowledge on the increasing popularity & patterns of waterpipe use, addictiveness & toxicology of waterpipe tobacco products, & recommendations on policies & regulations.”

“The knowledge hub here is for assessing the situation, sharing knowledge, creating platforms for exchange of this information, holding workshops for regulators – we need to translate this – taking it from one level of knowledge to bring in effective regulations that will ultimately serve humanity,” stated Dr. Zaatari.

Representing AUB president Dr. Fadlo Khuri, Dr. Alan Shihadeh, Dean of the Maroun Semaan Faculty of Engineering and Architecture at AUB, emphasized the multidimensional role of AUB in tobacco control in Lebanon. “Through the efforts of its dedicated faculty members who formed the Tobacco Control Research Group, AUB was the nerve center for the passage of Lebanon’s first comprehensive tobacco control law in 2011, law 174” stated Dr. Shihadeh.

“In the domain of tobacco control, AUB continues to lead, innovate, and serve (…) AUB’s expertise on waterpipe tobacco smoking was developed locally and organically from a soil that has produced a long legacy of engaged scholars who articulate, address, and shape the problems and aspirations of the peoples of the region,” he added.

“Several years ago it became the first university campus in Lebanon to ban smoking except in designated outdoor areas. This January it will become entirely tobacco free, even in its off-campus venues.  And it will be a very cold place for the tobacco industry, which will not be allowed to fund research, nor to recruit students through our career services, nor to promote products directly or indirectly on campus. Our cancer treatment center is over-flowing with the human collateral of the tobacco industry’s decades-long campaigns to hook more consumers, especially youth.”

The conference was preceded by a one-day training workshop on implementation research which highlighted the important role of action-oriented research in supporting effective tobacco control policies and interventions. The workshop was organized by the National Cancer Institute, the National Institute of Drug Abuse in the US, and AUB.

Finally, the participants acknowledged the need to build and strengthen international collaborations and partnerships, while agreeing on an action plan and a set of recommendations such as political lobbying and building popular support against waterpipe smoking, the limitation of flavors in tobacco, increased taxation on different items, as well as the introduction of warning labels.