The US-American University of Beirut and the Juicy Business of Systematically Flawed ““Systematic Reviews”” on ««Waterpipe»»

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The most recent of a series of five so-called ««systematic reviews»» on “««waterpipe»» tobacco smoking” authored by a team led by Elie Akl at the University of New York at Buffalo (USA), is now available in the Harm Reduction Journal [1][2-5].

The scope of the manipulation is, once again, so wide that this “whistle-blowing” note was deemed necessary even more that one may wonder what has changed so that a journal like the above one now accepts articles which not only are pseudo-scientific but also have nothing to do with harm reduction…

Two years back, we immediately published an initial criticism when such pseudo-scientific materials began to be made public by the same team [6]. Given the persistence of the authors who are obviously implementing a clear prohibitionist agenda, we succeeded in exposing the main flaws of their “products” in Chest, the very journal in which one of their papers appeared [7]. Given that Chest is viewed as an internationally prestigious medical title (with a high ranking “impact factor”), Akl and colleagues’ friends (antismoking activists of the Globalink network funded by pharmaceutical companies) desperately intended to get the journal withdraw (“un-publish”) our “embarrassing” critique on grounds of libellous accusations (as a usual method endorsed in their sordid world); in vain [8]…

Consequently, the main previously criticised points are still very relevant. The “new” one is the methodological flaw which appears in the very objective of the new ««systematic review»»: “to systematically review the medical literature for motives, beliefs and attitudes towards waterpipe tobacco smoking”[1]…

Our question here is: are medical sciences (and medical sciences exclusively) the most appropriate ones for such a rather psycho-sociological or anthropological “objective” (“motives”, “beliefs”, “attitudes”)? Experienced readers will quickly understand the reason behind such a trick.

“Public Health” Business under the Mask of “Motives, Beliefs and Attitudes” Surveys

Amazingly again but expectedly from our side, there is a heavy focus on health concerns with many precautionary words such as: « likely », « it is possible », etc., betraying the authors’ mental state of confusion … Would some observant scientist have shaken deep-rooted “consensual” “convictions”; for instance, that one hookah equals 100 or 200 cigarettes?  Once again, such a contradiction –for which not only the authors but also the ««peer-reviewers»» of the journal are equally accountable- shows to what extent the hookah (shisha, narghile) issue has got “medicalised” from the very beginning, i.e. year 2002 [9].

Another methodological artefact worth mentioning here is what can be read in the review about the so-called “perceived health hazards”: “a large majority of respondents were aware of the negative health effects of waterpipe smoking”[1]. The trick here is that what has been actually measured is the expected brainwashing effect (on naïve respondents) of what mainstream media have been previously publishing for one decade on the issue: e.g., interviews with carefully selected ««waterpipe»» “experts” in accordance with a global prohibition agenda [9]. For instance, one can remember the famous “interview”, on the eve of the UK ban, by ASH with Akl’s colleagues from the US-heavily funded anti ««waterpipe»» programmes at the US-University of Beirut (US-AUB) and the US-Syrian centre in Aleppo (US-SCTS)[10]. And they name such artefacts “science”…

As for the “”systematically reviewed”” “studies” by the authors, it almost seems needless to say here that 95% of them are carefully selected flawed papers published (and, most of the time,  ««peer-reviewed»») by notorious antismoking activists affiliated with the Globalink industry/US-AUB/ US-SCTS.

Back to Hookah’s Original “Glamour” and “««Systematic Reviews»» on ««Waterpipe»»” as a Juicy Business ($ 169,000 Grant from the WHO)

Akl et al’s conclusion and the « implications for public health policy” of their new ««systematic review»» is quite clear: “Public health authorities should scale-up efforts to combat the waterpipe epidemic” and even refer to a supposed “lack of media campaigns about waterpipe”[1], as if nothing had happened for more than one decade now [11]…

However, the “last straw” is the following “recommendation”: “Public health interventions should aim to “deglamourize and renormalize” waterpipe smoking”[1]… Indeed, what does “renormalize” mean: going back to the original glamour, that of the glorious days of yore of hookah, i.e. before year 2002 [9][12]?

One detail of interesting importance is that one of our publications is amazingly cited [13]; however, and expectedly, on the pretext of “objectivity” and out of its context since we never stated that “waterpipe tobacco smoking is traditional to region of the Middle East”[1]. On the one hand, we were the first to expose the ««waterpipe»» nominalistic fraud and its global consequences [7]. On the other, we never said that the tradition was limited to the Middle East, only. This is a one-decade old trick used by the US-AUB and US-SCTS teams to justify (once again in the name of “public health”) the existence of their entities in… the Middle East…

15REASONSTABLEReaders interested in a scientifically sound non-militant approach to such triadic things pedantically named “motives, beliefs and attitudes” in relation to hookah (shisha, narghile and other types of water pipes), are invited to consider our censored pioneering academic peer-reviewed publications on this issue, including a table published online in a prestigious public health journal [14-16], and not less than a 450-page 850-footnote transdisciplinary doctoral thesis defended in a French university…

It appears that “««systematic reviews»» on ««waterpipe»» tobacco smoking” are a juicy business, according to news from the US-American University of Beirut itself: The World Health Organization (Alliance for Health Policy and Systems Research) has granted the Faculties of Medicine (FM) and Health Sciences (FHS) at the American University of Beirut (AUB) a $168,876 fund to establish a WHO Center for Systematic Reviews of Health Policy and Systems Research. Dr Elie Akl, who specializes in internal medicine and preventive medicine, and Fadi Jardali, associate professor of health policy and management at the Faculty of Health Sciences, are the co-principal investigators of this two-year project that will start on June 1, 2013” [17]

How has the world eventually reached such a situation in which “public health” has been hijacked by the godfathers of pharmaceutical companies and their agents within the WHO (World Health Organisation) and other organisations on the pretext of protecting the health of populations against “global threats” (such as hookah (shisha, narghile) smoking)? Tentative responses can be found in the following articles:

-an interview on world tobacco policy, by an insider [18];

-a critique of a paper on ““Arab Spring”” in which public health researchers close to the US-American University of Beirut (among them Adam Coutts and Wasim Maziak) deny the reality of one million Iraqi deaths [19];

-an analysis of the 10 myths which spur global wide use of hookah (shisha, narghile) smoking. In particular, this paper highlights the geopolitical agenda of the US-American University of Beirut [9].

Bibliographical references:

[1] Akl EA, Jawad M, Lam WY, Co CN, Obeid R, Irani J. Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review. Harm Reduct J. 2013 Jul 2;10(1):12. [Epub ahead of print]

[2] Akl EA, Gunukula SK, Aleem S, Obeid R, Abou Jaoude P, Honeine R, Irani J. The prevalence of waterpipe tobacco smoking among the general and specific populations: a systematic review. BMC Public Health. 2011 Apr 19;11(1):244.

[3] Raad D, Gaddam S, Schunemann HJ, Irani J, Abou Jaoude P, Honeine R, Akl EA. Effects of waterpipe tobacco smoking on lung function: a systematic review and meta-analysis. Chest. published 29 July 2010. Doi: 10.1378/chest.10-0991

[4] Akl EA, Aleem S, Gunukula SK, Honeine R, Abou Jaoude P, Irani J. Survey instruments used in clinical and epidemiological research on waterpipe tobacco smoking: a systematic review. BMC Public Health. 2010 Jul 13;10(1):415.

[5] Akl E, Gaddam S, Gunukula SK, Honeine R, Abou Jaoude P, Irani J. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. International Journal of Epidemiology. Int J Epidemiol. 2010 Jun;39(3):834-57. Doi:10.1093/ije/dyq002

[6] Chaouachi K. Systematic Errors and Biases in “Systematic Review”on ““Waterpipe””. May 12, 2011

[7] Chaouachi K. More Rigor Needed in Systematic Reviews on “Waterpipe” (Hookah, Narghile, Shisha) Smoking. Chest May 2011 139:5 1250-1251. Doi:10.1378/chest.10-2864

[8] Chaouachi K. Letter to the Editors of the Chest Journal further to a Request by Akl and colleagues’s Friends to get an already published peer-reviewed article, critical of their unscientific methods, withdrawn (i.e. “unpublished”). 5 Dec 2011

[9] Chaouachi K. Ten Post-11/9 Great Myths about Hookah (Shisha, Narghile) Smoking & Public Health. 12 May 2012

[10] ASH (Action on Smoking and Health). ““Shisha 200 times worse than a cigarette” say Middle East experts””. 27 March 2007 (prepared by Martin Dockrell)(accessed 13 June, 2008) [based, among others, on an interview with Wasim Maziak and Alan Shihadeh, respectively heads of the US-“Syrian Centre for Tobacco Studies” and US-American University of Beirut centre] Sub-heading: “Three leading experts from across the Middle East have warned that excluding “shisha bars” when England goes smokefree on July 1 could worsen the grave inequalities in health that already affect ethnic minorities”. (note: none of the experts worked or live in the UK).

[11] Chaouachi K. False positive result in study on hookah smoking and cancer in Kashmir: measuring risk of poor hygiene is not the same as measuring risk of inhaling water filtered tobacco smoke all over the world. Br J Cancer. 2013 Apr 2;108(6):1389-90. doi: 10.1038/bjc.2013.98. Epub 2013 Mar 7.

[12] Chaouachi K. Ce qu’il faut savoir sur le narguilé (shisha): histoire, culture et santé [Hookah & Health 2013 : What You Should Know] . 8 juillet 2013

“A la veille de Ramadan, l’auteur propose un article sur le narguilé ou shisha, des points de vue de l’histoire, de la tradition et de la culture, mais aussi son degré de nocivité et les précautions requises pour s’en protéger”

[13] Chaouachi K. The medical consequences of narghile (hookah, shisha) use in the world. Rev Epidemiol Sante Publique 2007, 55(3):165–70.

[14] Chaouachi K. Hookah (Shisha, Narghile) Smoking and Environmental Tobacco Smoke (ETS). A Critical Review of the Relevant Literature and the Public Health Consequences. Int. J. Environ. Res. Public Health 2009; 6(2):798-843.

[15] Chaouachi K. The 15 Reasons behind the World Upsurge in Hookah (Narghile, Shisha) Smoking. Originally published in the 4th part of the Tetralogy on Hookah and Health: Chaouachi K. Narghilé: un problema di Sanità Pubblica [16].

[16] Chaouachi K. Tabaccologia. SITAB (the official Journal of the Italian Society of Tobaccology); Bologna, Italy: 2005–2006. Tetralogy on Narghile (Hookah, Shisha) and Health. Part 1: Presentation (Tabaccologia 2005; 1, 39–47); Part 2: Chemistry (Tabaccologia 2005; 3, 27–33); Part 3: Diseases (Tabaccologia 2006; 1, 27–34); Part 4: Public Health and Prevention (Tabaccologia 2006; 4, 29–38.

[17] WHO Center for Systematic Reviews of Health Policy and Systems Research established at AUB. 28 May 2013

[18] Snowdon C. A Global Prison ? [An interview with Kamal Chaouachi]. Velvet Glove, Iron Fist 2009 (8 Apr 2009)

[19] Chaouachi K. ““Arab Spring””. Public Health Researchers from Universities of Cambridge, Florida & London School of Hygiene, Deny the Reality of One Million Iraqi Deaths – in pro-NATO Paper [««Printemps arabe»». Dans un article pro-OTAN, des chercheurs en santé publique des universités de Cambridge, Floride et de l’Ecole d’Hygiène de Londres nient la mort d’un million de personnes en Irak]. 10 April 2013

(image: from ladypic)

Post-scriptum: One of the direct results of such papers can be found in the following piece of news showing how religious leaders of the world are manipulated by trusting in such pseudo-science instead of considering the sound independent related science of all researchers of the world before year 2002 (beginning of the global crusade against hookah smoking).

National Fatwa Committee Bans Shisha Smoking. 19 July 2013

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