Smoking Dokha Tobacco Through a Midwakh Pipe: An Alternative Tobacco Product Endemic to the Arabian/Persian Gulf

Dokha, a form of tobacco smoked through a midwakh pipe, is commonly used through the Arabian/Persian Gulf region. Despite its high prevalence, little is known about this and how use differs from cigarettes or hookah. Users smoke a bowl of dokha in one or two quick puffs, giving rise to the name (dokha means “dizzy” in Arabic). Reports have started arising of its use outside of the Gulf region, raising concern about it reaching epidemic proportions like hookah smoking has over the last two to three decades. There are case reports of seizures among people smoking midwakh heavily, but little is known about other adverse effects from smoking it. Additional studies are needed to understand patterns of midwakh use, biological and physiological effects of smoking, chemical properties of the tobacco itself, and policies regarding access and use.