Prevalence of water pipe smoking in the city of Mashhad (North East of Iran) and its effect on respiratory symptoms and pulmonary function tests

Abstract

Background:The prevalence of water pipe (WP) smoking was studied using a standard questionnaire. Pulmonary function tests were also compared between WP smokers and non-smokers.Materials and Methods:The prevalence of WP smoking was studied using a standard questionnaire. Pulmonary function tests including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximal mid-expiratory flow (MMEF), peak expiratory flow (PEF), maximal expiratory flow at 75%, 50%, and 25% of the FVC (MEF75,50,25) were compared between WP smokers and non-smokers.Results:A total of 673 individuals including 372 males and 301 females were interviewed. The number of WP smokers was 58 (8.6%) including 24 males (6.5%) and 34 females (11.3%). All pulmonary functional test (PFT) values in WP smokers were lower as compared to the non-smokers (P < 0.05 to P < 0.001). The prevalence and severity of respiratory symptoms (RS) in WP smokers were higher than non-smokers (P < 0.05 to P < 0.001). There were negative correlations between PFT values and positive correlation between RS and duration, rate, as well as total smoking (duration X rate) (P < 0.05 to P < 0.001).Conclusion:In this study the prevalence of WP smoking in Mashhad city was evaluated for the first time. The results also showed a significant effect of WP smoking on PFT values and respiratory symptoms.

Health effects associated with waterpipe smoking

“…Studies that evaluated the associations between the total number of WPs, 61 71 total weight of tobacco smoked 62 or WP-years 66 and PF parameters reported a significant moderate negative correlation with FEV 1 r∼−0.35. 61 62 66 71 Other negative correlates of the amount of WP smoked include FVC r∼−0.39, 61 71 FEF25-75, 61 62 71 peak expiratory flow 61 62 71 and FEV 1 /FVC. 62 A significant positive correlation between the amount of WPS and functional residual capacity and residual volume was also reported.…”

“… 21 61–71 These cross-sectional studies were mostly community-based, 61–66 68–71 with one hospital-based study, 67 and were conducted in Iran, 61 71 Tunisia, 62 63 Kuwait, 64 Turkey, 65 66 Syria, 67 68 China 69 and Saudi Arabia. 71 PF was impaired as measured by FEV 1 , 61 63 69–71 FVC, 21 61 70 71 FEV 1 /FVC 66 69 70 or FEF25-75, 61 63 71 while two studies did not demonstrate impairment of these parameters. 64 67 Air trapping was reported in WP smokers in one study, 62 although other PF parameters such as total lung capacity 62 63 and DLCO 65 were not altered.…”

Pulmonary Abnormalities in Young, Light-Use Waterpipe (Hookah) Smokers

“…These older, heavy-use waterpipe smokers have a high frequency of cough and sputum compared with nonsmokers, and these symptoms appear at an earlier age than in cigarette smokers (37,40,41). An important observation in the present study is that a significant proportion of young waterpipe smokers with a history of fewer than four waterpipe sessions per week for less than 5 years have clinical abnormalities, including an increase in cough frequency and sputum production, and, strikingly, 38% have reduced diffusing capacity.…”

“…Researchers in a number of studies have assessed lung function in older, heavy-use waterpipe users and found evidence of reduced lung function parameters, including reduced FVC, FEV 1 , maximal midexpiratory flow, peak expiratory flow, forced expiratory flow, and midexpiratory phase levels, as well as FEV 1 /FVC, compared with nonsmokers, with a correlation between the duration and quantity of waterpipe smoking and the abnormalities of pulmonary function (3,11,37,38). These older, heavy-use waterpipe smokers have a high frequency of cough and sputum compared with nonsmokers, and these symptoms appear at an earlier age than in cigarette smokers (37,40,41).…”

“…Epidemiological studies suggest that 10-48% of adolescents and young persons in middle school, high school, or universities in the United States, Europe, and other countries admit to ever smoking waterpipes and that 10-35% admit to being current waterpipe smokers (2-5, 7). However, most studies of the long-term effects of waterpipe smoking on pulmonary function, cancer prevalence, and other clinical symptoms have studied older (ages 40-60 yr), heavy-use waterpipe smokers (30-60 waterpipe-year history), mostly in waterpipe smokers who already have disease manifestation (2,4,11,(37)(38)(39).…”