Health promotion in the poly-tobacco market

I read with interest Morgan et al’s review entitled ‘How people think about the chemicals in cigarette smoke: a systematic review’ (Morgan, Byron, Baig, Stepanov, & Brewer, 2017), and agree that describing the chemical composition of smoke to the public has the potential to change behaviour and lead to reduced cigarette use. I note, however, that the authors were not mindful that consumers, particularly young people, could be exposed to and use tobacco products beyond cigarettes, which can make tobacco-based health promotion in the current climate challenging. For example, past-30 day waterpipe tobacco use (commonly known as hookah, shisha or narghile) is reported by 5.4% of Canadian youth (Minaker, Shuh, Burkhalter, & Manske, 2015) and 11.4% of US youth (Manderski, Michelle, Hrywna, & Delnevo, 2012), and it is commonly viewed as less harmful than cigarettes (Akl, Jawad, Lam, Obeid, & Irani, 2013; Akl et al., 2015). …