A framework for researching the waterpipe tobacco business sector in the United States

Introduction The waterpipe tobacco sector is a fragmented and multifaceted part of the tobacco industry, including shisha tobacco, hookah devices, and the hospitality industry. Information on this sector's business structure and its actors is limited. This study aims to develop a framework for understanding the scope, business entities, and key actors in the waterpipe sector in the United States that can facilitate research and public health interventions. Methods We first identified a sample of 87 waterpipe-related business entities through internet searches and business intelligence reports provided by marketing research companies. Using grounded theory, we then identified key business components and themes within the waterpipe sector, which we iteratively refined through successive rounds of analysis. Results We identified and defined eight domains in the waterpipe tobacco sector: 1) waterpipe tobacco growers, 2) shisha tobacco manufacturers, 3) hookah device and accessories manufacturers, 4) waterpipe charcoal manufacturers, 5) shisha/ hookah/charcoal resellers or retailers, 6) waterpipe tobacco service providers and the hospitality sector, 7) waterpipe tobacco networks and trade associations, and 8) aggregated sales. Within these 8 domains, 46 fields of information were identified to construct a detailed information grid for the waterpipe tobacco sector. Conclusions This comprehensive framework and information grid offer a reference base for research, monitoring, and understanding of the waterpipe tobacco sector. Additionally, it can support efforts to improve regulation of the sector in the United States.