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Tütün mücadelesi için yeni bir tehdit: aromatik nargile

Year 2011, Volume: 33 Issue: 1, 133 - 143, 14.03.2011

Recep Sezer Yasemin Pıçak

Abstract

Özet

İkibinli yıllar, bir yandan "Dünya Sağlık Örgütü - Tütün Kontrolü Çerçeve Sözleşmesi (DSÖ-TKÇS)"ne dayalı olarak Tütün Kontrolünde yeni ve yükselen bir dönemi başlatırken diğer yandan Tütün Kontrolüne tehdit niteliğinde yeni bir bir eğilime, aromatik nargile salgınına, tanıklık etmektedir. Bu yeni salgın, adına maassel veya aromatik nargile tütünü denen yeni bir nargile ürününe dayalı olup Ortadoğu ülkelerinde 1990'lı yıllarda başlamış, Türkiye'yi de içine almıştır. Bu ürün, tütünün yanı sıra şeker melası, meyva özleri ve gliserin gibi tad, koku ve kolay solunabilirlik sağlayan katkı maddelerini içerir, pekiştirici bir madde olan asetaldehitten de zengindir. Salgının hızla bir Dünya salgınına dönüştüğü özellikle ergenleri ve gençleri etkilediği, nargile kafeler aracılığıyla yayıldığı yaygın olarak bildirilmektedir. Nargile konusunda, Tütün Kontrolünü zorlaştırıcı bir başka yeni gelişme de bitkisel aromatik nargiledir. Bitkisel nargile kullanılan kapalı alanlar, tütünlü nargile kullanım yasağının ihlali için uygun ortamların sürmesine olanak sağlamıştır. Aromatik nargile ürününün duman analizleri son on yılda bir dizi araştırmayla ortaya konmuştur. Bu analizler bu ürünün tehlikeli bir tütün kullanım biçimi olduğunu açıkça göstermektedir. Bir aromatik nargile oturumunda içe çekilen duman miktarı bir sigaradan içe çekilen duman miktarından çok yüksektir. Nargileden solunan duman, sigara dumanına göre, CO, ağır metaller, polisiklik aromatik hidrokarbonlar, uçucu aldehitler gibi bir çok toksik maddeyi önemli ölçüde daha fazla içermektedir. Nargile dumanındaki polisiklik hidrokarbonlar ve karbon monoksit için nargile kömürünün dumanı da önemli bir kaynaktır. Tütün kontrol çalışmaları, tütün salgınını büyütücü bu tehditle mücadeleye önem ve öncelik vermelidir. Bitkisel nargile de, toksik maddelerden zengin dumanıyla, insan sağlığına zarar verebilecek bir üründür. Bitkisel nargilenin kapalı mekanlarda içimi, tütün ürünleri gibi, mevzuatla engellenmelidir. Aromatik nargile ürününün tat ve koku sağlayıcı katkı maddelerini içermesi, DSÖ-TKÇŞ 4. Taraflar Konferansı tavsiyesiyle uyumlu biçimde yasaklanmalıdır.

Anahtar sözcükler: Nargile, tütün, sigara, kontrol

 

Abstract

The 2000s have been witnessing the development of both a more effective concerted action to fight the global tobacco epidemic by virtue of the WHO Framework Convention on Tobacco control (WHO-FCTC), and a new global waterpipe smoking epidemic especially among youths in cafés.  This global waterpipe smoking epidemic that started in the Middle East Countries in the 1990's and has also affected the Turkish youths has been caused by a new tobacco product called maassel or aromatic waterpipe tobacco. This new waterpipe tobacco product is sweetened and flavored by additives such as molasses, glycerin, and fruit-flavored additives which let smoker inhale more easily and make waterpipe smoking more reinforcing. The studies conducted in the last decade showed that this new waterpipe tobacco product is very rich regarding toxic substances in the cigarettes. As a result of recent increase in indoor tobacco smoking bans worlwide, hookah cafes, under the threat of being closed, have introduced a new kind of tobacco-free maassel called herbal narghile. Herbal narghile appears to be a threat to tobacco control and health. Relative to a single cigarette, a single waterpipe tobacco smoking episode causes far greater smoke exposure. Similarly, the smoke inhaled during a waterpipe smoking episode, compared with that inhaled from a single cigarette, contains far greater amounts of CO, heavy metals, polycyclic hydrocarbons, and volatile aldehydes. Burning charcoal smoke during waterpipe use also appears to be an important source for polycyclic hydrocarbons and CO in the mainstream smoke of waterpipe. The waterpipe epidemic that has potential to negatively affect tobacco control should be given emphasis and prirority. Herbal narghile use in closed places should be banned. The use of ingredients that make waterpipe tobacco more attractive (e.g. sweeteners and flavoring agents) should also be prohibited in line with related the recommendation of the WHO-FCTC's Fourth Conference of the Parties.

Key words: Waterpipe, tobacco, smoking, control

Keywords

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References

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  • Jawaid A, Zafar AM, Rehman TU, Nazir MR, Ghafoor ZA, Afzal O, Khan JA. Knowledge, attitudes and practice of university students regarding waterpipe smoking in Pakistan. Int J Tuberc Lung Dis 2008; 12: 1077-84.
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Tütün mücadelesi için yeni bir tehdit: aromatik nargile

Year 2011, Volume: 33 Issue: 1, 133 - 143, 14.03.2011

Recep Sezer Yasemin Pıçak

Abstract

İkibinli yıllar, bir yandan “Dünya Sağlık Örgütü - Tütün Kontrolü Çerçeve Sözleşmesi (DSÖTKÇS)”ne dayalı olarak tütün kontrolünde yeni ve yükselen bir dönemi başlatırken diğer yandan tütün kontrolüne tehdit niteliğinde yeni bir bir eğilime, aromatik nargile salgınına, tanıklık etmektedir. Bu yeni salgın, adına maassel veya aromatik nargile tütünü denen yeni bir nargile ürününe dayalı olup ortadoğu ülkelerinde 1990‟lı yıllarda başlamış, Türkiye‟yi de içine almıştır. Bu ürün, tütünün yanı sıra şeker melası, meyva özleri ve gliserin gibi tad, koku ve kolay solunabilirlik sağlayan katkı maddelerini içerir, pekiştirici bir madde olan asetaldehitten de zengindir. Salgının hızla bir dünya salgınına dönüştüğü özellikle ergenleri ve gençleri etkilediği, nargile kafeler aracılığıyla yayıldığı yaygın olarak bildirilmektedir. Nargile konusunda, tütün kontrolünü zorlaştırıcı bir başka yeni gelişme de bitkisel aromatik nargiledir. Bitkisel nargile kullanılan kapalı alanlar, tütünlü nargile kullanım yasağının ihlali için uygun ortamların sürmesine olanak sağlamıştır. Aromatik nargile ürününün duman analizleri son on yılda bir dizi araştırmayla ortaya konmuştur. Bu analizler bu ürünün tehlikeli bir tütün kullanım biçimi olduğunu açıkça göstermektedir. Bir aromatik nargile oturumunda içe çekilen duman miktarı bir sigaradan içe çekilen duman miktarından çok yüksektir. Nargileden solunan duman, sigara dumanına göre, CO, ağır metaller, polisiklik aromatik hidrokarbonlar, uçucu aldehitler gibi bir çok toksik maddeyi önemli ölçüde daha fazla içermektedir. Nargile dumanındaki polisiklik hidrokarbonlar ve karbon monoksit için nargile kömürünün dumanı da önemli bir kaynaktır. Tütün kontrol çalışmaları, tütün salgınını büyütücü bu tehditle mücadeleye önem ve öncelik vermelidir. Bitkisel nargile de, toksik maddelerden zengin dumanıyla, insan sağlığına zarar verebilecek bir üründür. Bitkisel nargilenin kapalı mekanlarda içimi, tütün ürünleri gibi, mevzuatla engellenmelidir. Aromatik nargile ürününün tat ve koku sağlayıcı katkı maddelerini içermesi, DSÖ-TKÇŞ 4. Taraflar Konferansı tavsiyesiyle uyumlu biçimde yasaklanmalıdır

Keywords

Nargile tütün sigara kontrol

References

  • Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years‟ observations on male British doctors. BMJ 2004 328: 1519.
  • World Health Organization. WHO report on the global tobacco epidemic, 2009: Implementing smoke-free environments. 2009.
  • United States Department of Health and Human Services. The health consequences of smoking: A report of the Surgeon General. 2004.
  • Sezer RE. Türkiye‟nin sigara raporu. Bilim ve Ütopya. Ekim 2006; 12: 43-49.
  • Sezer RE. Dünyada ve Türkiye‟de sigara tüketim eğilimleri. Hipokrat Dergisi 2002; 3: 56-63.
  • Kessler D. A Question of intent: A great American battle with a deadly industry. BBS Publicaffairs NewYork, 2001.
  • Zeltner T, Kessler DA, Martiny A, Randera F. Tobacco Company Strategies to Undermine Tobacco Control Activities at the World Health Organization. Report of the Committee of Experts on Tobacco Industry (http://www.who.int/tobacco/policy/who_inquiry/en/). (accessed on March 01, 2011)
  • American Lung Association. Tobacco Policy Trend Alert - An emerging deadly trend: Waterpipe tobacco use. February 2007.
  • Dugas E, Tremblay M, Low NCP, Cournoyer D, O‟Loughlin J. Water-pipe smoking among North American youths. Pediatrics 2010; 125: 1184-9.
  • Eissenberg T, Shihadeh A. Waterpipe smoking and cigarette smoking: direct comparison of toxicant exposure. Am J Prev Med 2009; 37: 518-23.
  • Jensen PD, Cortes R, Engholm G, Kremers S, Gislum M. Waterpipe use predicts progression to regular cigarette smoking among Danish youth. Subst Use Misuse 2010; 45. 1245-61.
  • Maziak W, Ward KD, Afifi Soweid RA, Eissenberg T. Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tobacco Control 2004; 13: 141
  • Neergaard J, Singh P, Job J, Montgomery S. Waterpipe smoking and nicotine exposure: A review of the current evidence. Nicotine Tob Res 2007; 9: 987-94.
  • Maziak W, Eissenberg T, Ward KD. Patterns of waterpipe use and dependence: implications for intervention development. Pharmacol Biochem Behav 2005; 80: 173-9.
  • Shihadeh A. Investigation of mainstream smoke aerosol of the argileh water pipe. Food Chem Toxicol 2003; 41: 143-52.
  • World Health Organization. The scientific basis of tobacco product regulation: A Report of a WHO Study Group. WHO technical report series, no. 945. World Health Organization İsviçre, 2007.
  • Poyrazoğlu S, Sarli S, Gencer Z, Günay O. Waterpipe (narghile) smoking among medical and non-medical university students in Turkey. Ups J Med Sci 2010; 115: 210-6.
  • Smith-Simone S, Maziak W, Ward KD, Eissenberg T. Waterpipe tobacco smoking: knowledge, attitudes, beliefs, and behavior in two U.S. samples. Nicotine Tob Res 2008; 10: 393-8.
  • Erbaydar NP, Bilir N, Yildiz AN. Knowledge, behaviors and health hazard perception among Turkish narghile (waterpipe)-smokers related to narghile smoking. Pak J Med Sci 2010; 26: 195-200.
  • Akagündüz ÜO. Nargilede şeker kamışı tüterse yasak delinir mi? Zaman Gazetesi. 28 Haziran 2009.( http://www.zaman.com.tr/haber.do?haberno=863597&title=nargilede-sekerkamisi-tuterse-yasak-delinir-mi) (accessed on March 01, 2011)
  • Wikipedia. Hookah Lounge. http://en.wikipedia.org/wiki/Hookah_lounge (accessed on March 01, 2011).
  • Rastam S, Ward KD, Eissenberg T, Maziak W. Estimating the beginning of the waterpipe epidemic. BMC Public Health 2004; 4: 32.
  • Eissenberg T, Ward KD, Smith-Simone S, Maziak W. Waterpipe tobacco smoking on a U.S. College campus: prevalence and correlates. J Adolesc Health 2008; 42:526-9.
  • Primack BA, Sidani J, Agarwal AA, Shadel WG, Donny EC, Eissenberg TE. Prevalence of and associations with waterpipe tobacco smoking among U.S. university students. Ann Behav Med 2008; 36: 81-6.
  • Smith SY, Curbow B, Sillman FA. Harm perception of nicotine products in college freshmen. Nicotine Tob Res 2007; 9: 977-82.
  • Weglicki LS, Templin TN, Rice VH, Jamil H, Hammad A. Comparison of cigarette and water-pipe smoking by Arab and non-Arab-American youth. Am J Prev Med 2008; 35: 334-9.
  • Primack BA, Walsh M, Bryce C, Eissenberg T. Water-pipe tobacco smoking among middle and high school students in Arizona. Pediatrics 2009; 123: e282-8.
  • Health Canada. Youth Smoking Survey 2006-2007: Public Use Microdata. Ottawa, Ontario: Health Canada, 2008.
  • Statistics Canada. Canadian Tobacco Use Monitoring Survey (CTUMS) 2006. Available at: http://www.statcan.gc.ca/cgibin/imdb/p2SV.pl?Function=getSurvey&SurvId=4440&SurvVer=1&InstaId=160 40&InstaVer=14&SDDS=4440&lang=en&db=imdb&adm=8&dis=2. (accessed on March 01, 2011)
  • Pärna K, Usin J, Ringmets I. Cigarette and waterpipe smoking among adolescents in Estonia: HBSC survey results, 1994-2006. BMC Public Health 2008; 8: 392. 31. Baska T, Pudule I, Tilgale N, Warren CW, Lee J, Lea V, Jones NR. Smoking tobacco in waterpipes among adolescents in Europe: the case of Latvia and Slovakia. Tob Control 2008; 17: 432.
  • El-Roueiheb Z, Tamim H, Kanj M, Jabbour S, Alayan I, Musharrafieh U. Cigarette and waterpipe smoking among Lebanese adolescents, a cross-sectional study, 2003-2004. Nicotine Tob Res 2008; 10: 309-14.
  • Jawaid A, Zafar AM, Rehman TU, Nazir MR, Ghafoor ZA, Afzal O, Khan JA. Knowledge, attitudes and practice of university students regarding waterpipe smoking in Pakistan. Int J Tuberc Lung Dis 2008; 12: 1077-84.
  • Jackson D, Aveyard P. Waterpipe smoking in students: Prevalence, risk factors, symptoms of addiction, and smoke intake. Evidence from one British university. BMC Public Health 2008, 8: 174.
  • Maziak W, Eissenberg T, Rastam S, Hammal F, Asfar T, Bachir ME, Fouad MF, Ward KD. Beliefs and attitudes related to narghile (waterpipe) smoking among university students in Syria. Ann Epidemiol 2004; 14: 646-54.
  • Gadalla S, Aboul-Fotouh A, El-Setouhy M, Mikhail N, Abdel-Aziz F, Mohamed MK, Kamal Ael A, Israel E. Prevalence of smoking among rural secondary school students in Qualyobia governorate. J Egypt Soc Parasitol 2003; 33: 103150.
  • Varsano S, Ganz I, Eldor N, Garenkin M. Water-pipe tobacco smoking among school children in Israel: frequencies, habits, and attitudes. Harefuah 2003; 142: 736-41.
  • Warren CW, Lea V, Lee J, Jones NR, Asma S, McKenna M. Change in tobacco use among 13-15 year olds between 1999 and 2008: findings from the Global Youth Tobacco Survey. Glob Health Promot 2009; 16: 38-90.
  • Prignot JJ, Sasco AJ, Poulet E, Gupta PC, Aditama TY. Alternative forms of tobacco use. Int J Tuberc Lung Dis 2008; 12: 718-27.
  • Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü, Küresel Yetişkin Tütün Araştırması Türkiye Raporu. 2010.
  • Kiter G, Ucan ES, Ceylan E, Kilinç O. Water-pipe smoking and pulmonary functions. Respir Med 2000; 94: 891-94.
  • Kandela P. Nargile smoking keeps Arabs in wonderland Lancet 2000; 356: 1175.
  • Maziak W, Rastam S, Ibrahim I, Ward KD, Shihadeh A, Eissenberg T. CO exposure, puff topography, and subjective effects in waterpipe tobacco smokers. Nicotine Tob Res 2009; 11: 806-11.
  • Maziak W, Ward KD, Eissenberg T. Interventions for waterpipe smoking cessation. Cochrane Database Syst Rev 2007; CD005549.
  • Sepetdjian E, Saliba N, Shihadeh A. Carcinogenic PAH in water pipe charcoal products. Food and Chemical Toxicology Doi: 10. 1016/j.fct.2010.08.033.
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There are 61 citations in total.

Details

Primary Language English
Journal Section Reviews
Authors

Recep Sezer

Yasemin Pıçak

Publication Date March 14, 2011
Published in Issue Year 2011Volume: 33 Issue: 1

Cite

AMA Sezer R, Pıçak Y. Tütün mücadelesi için yeni bir tehdit: aromatik nargile. CMJ. March 2011;33(1):133-143.