Gaining Insights Into the Waterpipe Tobacco Industry: Participant Observation and a Cross-Sectional Survey of Products at a Trade Exhibition

Abstract

Introduction: The rise in waterpipe tobacco smoking has been accompanied by the emergence ofa diverse range of products, such as herbal waterpipe tobacco substitutes and electronic waterpipes.The aims of this study were to assess the extent to which emerging waterpipe products arebeing developed by waterpipe tobacco companies themselves, to understand the key characteristicsof the main market players, and to examine the connections between producers of differentproduct categories.Methods: In 2014, one researcher attended an international waterpipe trade exhibition in Germany,conducting a survey of products at exhibition stands, and gathering qualitative data on exhibitorsand products using participant observation. Cross-tabulations and chi-square tests identified theassociation between waterpipe tobacco, waterpipe tobacco substitutes, and electronic waterpipeproducts. We thematically analyzed field notes into information about exhibitors and products.Results: Of 97 exhibitors, 55 displayed waterpipe-related products. Of these, nearly half (45%)displayed electronic waterpipe products, 38% displayed waterpipe tobacco and 23% displayedwaterpipe tobacco substitutes. There was an inverse association between the display of waterpipetobacco and electronic waterpipe products, and a positive association between the displayof waterpipe tobacco and waterpipe tobacco substitutes. We found that Japan Tobacco Inc, PhilipMorris, and British American Tobacco were partnered or affiliated with exhibitors displaying waterpipe-related products.Conclusions: Electronic waterpipe products were the main feature of this exhibition. Waterpipetobacco substitutes are likely to be produced by the waterpipe tobacco industry whereas electronicwaterpipes are not. There is a developing interest in waterpipe-related products by transnationaltobacco corporations. Further industry surveillance is warranted. © The Author 2015.