Circumventing tobacco control and safety policies to promote waterpipe use in smoking venues: The perspective of staff in waterpipe smoking venues

Jung Jae Lee, Karly Cheuk Yin Yeung, Man Ping Wang, Sally Thorne, Henry Sau Chai Tong, Vienna Lai

Research output: Contribution to journalArticlepeer-review

1 Citation (SciVal)


Objective: To understand Hong Kong waterpipe smoking (WPS) sales and promotion, including strategies to avoid policy enforcement, from the perspective of WPS venue staff. Methods: Qualitative interviews and observations were guided by interpretive description. 20 WPS venue staff who were responsible for preparing and serving waterpipes to patrons and had worked at the bar for at least 3 months were recruited. In-depth semistructured interviews with WPS venue staff were conducted, in addition to covert and participant observations in 10 WPS venues in Hong Kong. Interpretive description involving constant comparative analysis of qualitative data was adopted to facilitate an inductive analytic approach to generate findings. Results: Two primary themes emerged from analyses of interview and observation data: strategies to avoid law enforcement, and perceived health and safety concerns linked to working and smoking in waterpipe venues. The findings suggest that many Hong Kong venues may be failing to comply with tobacco control policies and developing strategies to circumvent law enforcement. Moreover, waterpipe preparation, allowance of WPS and burning of charcoal in indoor areas were perceived as negatively affecting the health and safety of staff and customers. Conclusions: The study provides preliminary evidence indicating the ineffectiveness of current tobacco control policy on WPS. Due to its risks to health and safety, and the need to sustain tobacco control efforts for their intended purpose, waterpipe-specific regulations and stricter surveillance on waterpipe sales and promotion are urgently required.

Original languageEnglish
Pages (from-to)509-512
JournalTobacco Control
Issue number4
Early online date9 Nov 2021
Publication statusPublished - 20 Jun 2023
Externally publishedYes

Bibliographical note

Funding Information:
The authors received a research grant from the Hong Kong Council on Smoking and Health for the conduct of the study.


  • end game
  • non-cigarette tobacco products
  • public policy
  • surveillance and monitoring
  • taxation

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health


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