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Int J Environ Res Public Health. 2015 Dec 8;12(12):15559-66. doi: 10.3390/ijerph121215004.

Waterpipe Tobacco Smoking in Turkey: Policy Implications and Trends from the Global Adult Tobacco Survey (GATS).

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Rector of Health Science University, Istanbul 34688, Turkey.
Former Head of the Commission on Health, Family, Labour and Social Affairs of the Grand National Assembly of Turkey, Ankara 06543, Turkey.
World Health Organization Country Office, Ankara 06610, Turkey.
Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Healis Sekhsaria Institute for Public Health, Navi Mumbai 400701, India.
Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.


Waterpipe tobacco smoking (WTS) is an emerging tobacco product globally, especially among adolescents and young adults who may perceive WTS as a safe alternative to smoking cigarettes. Monitoring the use of WTS in Turkey in relation to the tobacco control policy context is important to ensure that WTS does not become a major public health issue in Turkey. The Global Adult Tobacco Survey (GATS) was conducted in Turkey in 2008 and was repeated in 2012. GATS provided prevalence estimates on current WTS and change over time. Other indicators of WTS were also obtained, such as age of initiation and location of use. Among persons aged 15 and older in Turkey, the current prevalence of WTS decreased from 2.3% in 2008 to 0.8% in 2012, representing a 65% relative decline. Among males, WTS decreased from 4.0% to 1.1% (72% relative decline). While the overall smoking prevalence decreased among females, there was no change in the rate of WTS (0.7% in 2008 vs. 0.5% in 2012), though the WTS prevalence rate was already low in 2008. Comprehensive tobacco control efforts have been successful in reducing the overall smoking prevalence in Turkey, which includes the reduction of cigarette smoking and WTS. However, it is important to continue monitoring the use of waterpipes in Turkey and targeting tobacco control efforts to certain groups that may be vulnerable to future WTS marketing (e.g., youth, women).


Turkey; shisha; tobacco smoking; waterpipe

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