The tobacco health nexus? Health messages in narghile advertisements.

In many parts of the world, cigarettes are not the only form of tobacco smoked. 2 In the eastern Mediterranean region, narghile (water pipe) is a more traditional form of tobacco consumption. The Lebanon Global Youth Tobacco Survey (GYTS), conducted among schoolchildren in 2005, indicated that 61% were current users of tobacco and 33.9% currently smoked narghile. Research on the narghile smoke constituents suggest it is as harmful—if not more harmful—than cigarettes. 5 Recently, narghile smoking has become ‘‘big business’’ and a variety of marketing techniques are being used to emphasise the enjoyable facet of smoking while disregarding its detrimental health effects. One interesting marketing technique has been the use of health messages to market narghile products. This makes the narghile look like a healthy behaviour, more acceptable and, thus, more attractive for many people. For example, in one advertisement for locally manufactured tobacco, the slogan ‘‘untouched by human hands’’ was used as an indicator of ‘‘the purity’’ of the product. In addition, the product was shown to be manufactured in state-of-the-art machines, indicating a