Pulmonary functions of narghile smokers compared to cigarette smokers: a case–control study

Abstract

BackgroundStudies of the lung function profiles of exclusive narghile smokers (ENS) are few, have some methodological limits, and present contradictory conclusions. The present study aimed to compare the plethysmographic profiles of ENS with age- and height-matched exclusive cigarette smokers (ECS).MethodsMales aged 35–60 living in Sousse, Tunisia, who have been smoking narghile exclusively for more than 10 narghile-years (n=36) or cigarettes exclusively for more than 10 pack-years (n=106) were recruited to participate in this case–control study. The anthropometric and plethysmographic data were measured according to international recommendations using a body plethysmograph (ZAN 500 Body II, Meβgreräte GmbH, Germany). Large-airway-obstructive-ventilatory-defect (LAOVD) was defined as: first second forced expiratory volume/forced vital capacity (FEV1/FVC) below the lower-limit-of-normal (LLN). Restrictive-ventilatory-defect (RVD) was defined as total lung capacity < LLN. Lung hyperinflation was defined as residual volume > upper-limit-of-normal. Student t-test and χ2 test were used to compare plethysmographic data and profiles of the two groups.ResultsThe subjects in the ENS and ECS groups are well matched in age (45±7 vs. 47±5 years) and height (1.73±0.06 vs. 1.72±0.06 m) and used similar quantities of tobacco (36±22 narghile-years vs. 35±19 pack-years). Compared to the ENS group, the ECS group had significantly lower FEV1 (84±12 vs. 60±21%), FVC (90±12 vs. 76±18%), and FEV1/FVC (99±7 vs. 83±17%). The two groups had similar percentages of RVD (31 vs. 36%), while the ECS group had a significantly higher percentage of LAOVD (8 vs. 58%) and lung hyperinflation (36 vs.57%).ConclusionChronic exclusive narghile smoking has less adverse effects on pulmonary function tests than chronic exclusive cigarette smoking.

Investigation of Exclusive Narghile Smokers: Deficiency and Incapacity Measured by Spirometry and 6-Minute Walk Test

“…We had a database of ENS who had previously participated in studies analyzing their spirometric profiles. 17,18 We contacted those who met the inclusion criteria. An article was published in a weekly newspaper announcing the need for recruitment of ENS.…”

“…This chronic harmful effect, similar to that induced by cigarette smoking, was described previously in several studies. 7,10,[13][14][15][16][17][18][19][20][21][22] Evaluation of Incapacity. Studies on maximal and submaximal aerobic capacities of ENS are rare.…”

“…7,10,[13][14][15][16][17][18][19][20][21]25,29 An example of an acute effect is that a single 30-min session of narghile smoking induced a significant increase in breathing frequency of 2 Ϯ 2 breaths/min. 29 An example of a chronic effect is that of 110 ENS with a Ͼ 1 narghile-year history, 14% had small-airway obstructive ventilatory defects, and 6% had large-airway obstructive ventilatory defects with a significantly higher estimated lung age compared with chronological lung age (47 Ϯ 18 vs 34 Ϯ 10 y).…”

“…[1][2][3][4][5] It is suspected to be a risk factor for a number of acute and chronic tobacco-related defects and/or diseases. [1][2][3][4][5][6][7][8] Among the deleterious effects of narghile use, the chronic cardiorespiratory defects are prominent: [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] exclusive narghile smokers (ENS) have been shown to exhibit worse respiratory and cardiac profiles than healthy non-smokers (HNS) (eg, higher heart rate and systolic (SBP) and diastolic (DBP) blood pressures and lower lung flows and/or volumes). In addition, studies have demonstrated acute (immediate) effects of narghile smoke in the form of increased heart rate, breathing frequency, expired carbon monoxide, SBP, or DBP and a decline in lung function.…”

A Multifactoral Analysis of 1452 Patients for Smoking Sensation. An Outpatient Lab Experience

“…Additionally, different types of smoking tobacco have been found to be associated with different adverse effects on pulmonary functions. In specific narghile smokers have been found to have their pulmonary functions less decreased when compared to the same smoking habit as those smoking other types of tobacco 64. Several pharmacological and non-pharmacological methods are being used for smoking cessation 31, 65.…”