Introduction: The use of waterpipe (also known as hookah) increased between 2011 and 2016 in the US and globally, especially among youth and young adults. The aim of this study is to examine the tobacco industry's interest, involvement and role in proliferating waterpipe-like products and its technology.
Methods: We searched the University of California San Francisco Truth Tobacco Industry Documents beginning with the search terms "hookah', 'waterpipe', 'narghile', 'shisha', 'hooka', 'e-hookah', 'electronic hookah', 'water filtration', and 'hubble-bubble' and then expanded the search using snowball sampling. Over 1500 documents were reviewed, and 39 were included in this analysis.
Results: This review focuses on several companies' addition of water to the filter of one cigarette holder and to two cigarettes in an attempt to make these products seem safer. In 1954, the Aquafilter Corporation created and patented a filtered cigarette holder named Aquafilter, which the documents reveal was closely monitored by multiple tobacco companies. In 1965, the American Tobacco Company developed the Waterford cigarette. In 1987, Japan Tobacco patented the Rivage cigarette. Waterford and Rivage were very similar products that contained crushable water capsules designed to "wet" the cigarettes' filter.
Conclusion: Companies have been attempting to incorporate the water filtrating aspect of waterpipe into cigarette products. Ultimately, several tobacco companies adapted the technology from these devices to create cigarettes with crushable flavor capsules. Given the tobacco industry's history of resurrecting products, the industry may attempt to incorporate water filtration and other aspects of waterpipe into future products to attempt to make them appear safer.