Waterpipe smoking and cancer: systematic review and meta-analysis

Montazeri, Zahra; Nyiraneza, Christine; El-Katerji, Hoda; Little, Julian

doi:10.1136/tobaccocontrol-2015-052758

Cited by 126 publications

(86 citation statements)

References 41 publications

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“…This is in agreement with most of the available literature that suggests that WTS is likely associated with many of the same tobacco-caused diseases as cigarette smoking, including cardiovascular and lung diseases, and cancer [10-13]. With respect to cardiovascular health effects, WTS has been shown to be associated with increases in heart rates and altered blood pressure indices [14-17].…”

Section: Discussionsupporting

confidence: 78%

“…Therefore, providing science-based evidence of the health effects of waterpipe smoke might contribute to overcoming the spread of this form of smoking [8, 9]. Previous literature has shown that, similar to cigarette smoking, WTS is likely associated with cardiovascular and lung diseases as well as cancer [10-13]. For example, WTS has been shown to be associated with increases in heart rates and to alter blood pressure indices [14-17].…”

Section: Introductionmentioning

confidence: 99%

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Waterpipe Smoking Is Associated with Changes in Fibrinogen, FVII, and FVIII Levels

2018

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Cigarette smoking has been shown to be associated with changes in coagulation factors in the circulation and the subsequent thrombosis development. In this study, the impact of waterpipe smoking on the levels of fibrinogen, factor VII (FVII), and factor VIII (FVIII) was investigated. In addition, the effects of waterpipe smoking were compared to those of cigarette smoking and never smokers. A total of 80 male smokers (40 cigarette smokers and 40 waterpipe smokers) and 40 apparently healthy never smokers were recruited in the study. Both waterpipe smoking and cigarette smoking induced significant increases in the plasma levels of fibrinogen, factor VII, and factor VIII (p < 0.01). The magnitude of the increase in fibrinogen levels induced by waterpipe smoking was higher than that induced by cigarette smoking (p < 0.01), while similar increases were observed in other factors (p > 0.05). In addition, in the waterpipe group, the magnitude of the increase in fibrinogen and factor VIII was higher in the smokers with more than 3 years of use (p < 0.05). In conclusion, similar to cigarette smoking, waterpipe smoking modulates the levels of coagulation factors, suggesting its thrombotic potential.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Waterpipe Smoking Is Associated with Changes in Fibrinogen, FVII, and FVIII Levels

2018

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“…Participants largely did not view WTS to be addictive and overall they tended to favor messages conveying health harms associated with long-term WTS, to motivate cessation. This suggests that messages could make the addictiveness of WTS more salient and resonate with young adult waterpipe users by explicitly linking addiction to health harms associated with long-term use, such as cancer 10 . Additionally, conveying information such as nicotine content in waterpipe tobacco 13 would be consistent with participants' responses, which indicated they recognize common nicotine dependence symptoms.…”

Section: Tobacco Prevention and Cessationmentioning

confidence: 99%

“…The amount of smoke inhaled by a single waterpipe session lasting 30 to 60 minutes can equal that produced by 100 or more cigarettes 2 . Smoke inhaled by waterpipe users contains heavy metals, carcinogenic hydrocarbons 3 , volatile aldehydes 4 , carbon monoxide [5][6][7] , and nicotine 6-8. Inhalation of these toxins is likely to be the reason why WTS has been related to cancer, poor pulmonary function, and heart disease [9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Young adult waterpipe tobacco users’ perceived addictiveness of waterpipe tobacco

Mays¹,

Tercyak²,

Rehberg³

et al. 2017

Tob. Prev. Cessation

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INTRODUCTION Young adults generally do not perceive waterpipe tobacco smoking (WTS) to be addictive. Underlying reasons for these false perceptions have received limited research attention and little is known about effective WTS prevention messaging. This study examined perceptions of the addictiveness of WTS among young adults and ascertained their feedback on WTS prevention message content. METHODS Young adult (n=44, Mean [M] age 25.3, SD 2.7, range 18-30) waterpipe tobacco users were recruited online for a cross-sectional survey. Closed-ended measures assessed demographics, waterpipe use, other tobacco consumption, and perceived addictiveness of WTS. Open-ended items assessed perceptions of WTS and ascertained feedback on WTS prevention message content. Quantitative data were analyzed descriptively. Open-ended data were coded to identify emerging themes. RESULTS Participants reported low perceived addictiveness of WTS (Mean 2.0, SD 0.9, range 1-not at all, 4 -very), perceived chances of becoming addicted (Mean 3.0, SD 1.6, range 1-no chance, 7-certain), and desire to quit (Mean 3.0, SD 1.8, range 1-not at all, 7-very). In openended responses, participants indicated social WTS does not lead to addiction and believe it is easy to quit. Some expressed concerns that WTS addiction may lead to health harms, social stigma, and financial costs. Participants indicated messages using vivid imagery and conveying negative health effects could motivate cessation. CONCLUSIONS Young adults view that WTS is not addictive, particularly related to use in social settings. Research can build from this study by developing and testing messages to motivate WTS cessation in young adults.

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“…The tobacco mixture contains significant levels of nicotine, known for its addictive properties, as well as tobacco-specific nitrosamines, volatile aldehydes, heavy metals and “tar,” which cause respiratory diseases and cancer [3, 4]. Tobacco-like adverse health effects from waterpipe tobacco smoking are, therefore, expected and well-documented in a recent meta-analysis, which revealed a positive association between waterpipe tobacco smoking and lung (odds ratio (OR) 4.6, 95% CI 2.6–8.0) and esophageal (OR 3.6, 95% CI 1.4–9.4) cancers [5]. As with cigarettes, nicotine dependence is a key feature of regular waterpipe tobacco smokers who exhibit cravings, withdrawal symptoms and other nicotine-modulated behaviors [6, 7].…”

Section: Introductionmentioning

confidence: 99%

The efficacy of varenicline in achieving abstinence among waterpipe tobacco smokers – study protocol for a randomized controlled trial

Zahid¹,

Dogar

Mansoor³

et al. 2017

Trials

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BackgroundWaterpipe tobacco smoking has increased among youth across the globe including in the US, and it continues as a common and traditional form of smoking tobacco in Pakistan. A range of behavioral and pharmacological therapies are available to support people in quitting cigarette smoking; however, little evidence exists for the efficacy of these therapies in achieving abstinence among waterpipe tobacco smokers. The objective of this study is to assess the efficacy of varenicline when added to behavioral support for waterpipe tobacco smoking cessation, by measuring biochemically validated continuous abstinence in waterpipe tobacco smokers.Methods/designThis is a two-arm, double-blind, placebo-controlled randomized trial conducted in four districts in Punjab, Pakistan. Study participants include adults using a waterpipe (with or without concomitant cigarette, bidi or other forms of tobacco smoking) on a daily basis for at least 6 months and who are willing to quit. We will individually randomize 510 participants to one of the two arms of the trial. Participants in the intervention arm will receive varenicline and behavioral support and those in the control arm will receive placebo and behavioral support. The primary outcome will be continuous abstinence for at least 6 months (week 25) which is biochemically verified by a carbon monoxide level of <10 ppm. Secondary outcomes will include biochemically verified 7-day point abstinence at 5, 12 and 25 weeks and any lapses and relapses between the different assessment points. Tertiary outcomes will include assessment of withdrawal symptoms using the Mood and Physical Symptoms Scale (MPSS), smoking dependency using the Lebanon Waterpipe Dependency Scale (LWDS-11) and monitoring adverse outcomes.DiscussionThis is an efficacy trial and would require a subsequent effectiveness trial for a definitive evaluation of the intervention.Trial registrationISRCTN, ISRCTN94103375. Registered on 1 December 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1761-y) contains supplementary material, which is available to authorized users.

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Waterpipe smoking and cancer: systematic review and meta-analysis

Cited by 126 publications

References 41 publications

Waterpipe Smoking Is Associated with Changes in Fibrinogen, FVII, and FVIII Levels

Waterpipe Smoking Is Associated with Changes in Fibrinogen, FVII, and FVIII Levels

Young adult waterpipe tobacco users’ perceived addictiveness of waterpipe tobacco

The efficacy of varenicline in achieving abstinence among waterpipe tobacco smokers – study protocol for a randomized controlled trial

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