Unsubstantiated Claims by the Hookah Tobacco Industry to Exempt Flavored Hookah Tobacco Products From Flavor Bans

Introduction:
This text is a commentary on the unsubstantiated claims made by the hookah tobacco industry regarding the cultural and religious significance of hookah tobacco smoking, which has resulted in policy exemptions for flavored hookah tobacco products. The authors aim to address these claims and refute them with relevant literature.

Key Points:

* The National Hookah Community Association was created in 2019 to represent the hookah/shisha industry at the Federal, State, and Local government levels.
* The association represents over 380 businesses and aims to promote understanding of the culture, community, and business of hookah to society and politicians, protect hookah from regulation that threatens the hookah economic and social community, and work with lawmakers to support regulation that supports good practices and high standards in the sector.
* The association argues that prohibiting flavors will take away their centuries-old cultural tradition and their religious freedom. However, traditional hookah tobacco did not play any role in the spiritual or religious culture of Middle Eastern societies.
* The association consists primarily of commercial entities that profit from hookah-based businesses, and the use of traditional tobacco has played a role in spiritual and religious ceremonies among American Indian communities.
* Smoking is prohibited by Muslim scholars, including a specific reference to hookah tobacco smoking.
* The association claims that hookah is unappealing to youth and is unlikely to be smoked by them, but there is overwhelming epidemiological evidence that flavored hookah tobacco is appealing and prevalent among youth and young adults.
* The association argues that restricting flavored hookah sales would result in elimination of the entire product class itself, but lab studies show that unflavored hookah tobacco is available in the market.

Main Message:
The authors argue that there is no cultural or religious significance to flavored hookah tobacco smoking and that the unsubstantiated claims by the hookah tobacco industry are another tobacco industry smokescreen used to justify their profitable marketing of an addictive and harmful product that targets youth. They emphasize that flavors are a primary reason for initiating hookah among US youth and young adults and that flavor bans should comprehensively include all tobacco and nicotine products, including hookah flavored tobacco products, to protect these vulnerable populations from tobacco initiation and lifelong addiction and harm.

Mary Rezk-Hanna, Wasim Maziak, Unsubstantiated Claims by the Hookah Tobacco Industry to Exempt Flavored Hookah Tobacco Products From Flavor Bans, Nicotine & Tobacco Research, Volume 27, Issue 4, April 2025, Pages 773–776, https://doi.org/10.1093/ntr/ntae114