Cancer risk in waterpipe smokers: a meta-analysis

Abstract

ObjectivesTo quantify by meta-analysis the relationship between waterpipe smoking and cancer, including cancer of the head and neck, esophagus, stomach, lung and bladder.MethodsWe performed a systematic literature search to identify relevant studies, scored their quality, used fixed and random-effect models to estimate summary relative risks (SRR), evaluated heterogeneity and publication bias.ResultsWe retrieved information from 28 published reports. Considering only highquality studies, waterpipe smoking was associated with increased risk of head and neck cancer (SRR 2.97; 95 % CI 2.26–3.90), esophageal cancer (1.84; 1.42–2.38) and lung cancer (2.22; 1.24–3.97), with no evidence of heterogeneity or publication bias. Increased risk was also observed for stomach and bladder cancer but based mainly on poor-quality studies. For colorectum, liver and for all sites combined risk estimates were elevated, but there were insufficient reports to perform a meta-analysis.ConclusionsContrary to the perception of the relative safety of waterpipe smoking, this meta-analysis provides quantitative estimates of its association with cancers of the head and neck, esophagus and lung. The scarcity and limited quality of available reports point out the need for larger carefully designed studies in well-defined populations.

Factors Influencing Hookah Smoking in High School Students

“…However, the vast majority of these examiners did not know that tobacco was in the nargile (15). A study conducted in Egypt indicates that 26% of boys and 5% of girls consumed nargile, and as many as 22% of Israeli children used nargile once a week (16). Some studies have shown that passive smoking may be related to the level of parents' education and socioeconomic status (SES).…”

Molecular and health effects in the upper respiratory tract associated with tobacco smoking other than cigarettes

“…However, the published data on HNSCC risk in relation to cigar and water‐pipe smoking, compared to cigarette smoking, is limited. The published studies are generally based on male populations, small number of exclusive cigar or water‐pipe smokers and insufficient information is given about frequency and duration of smoking, which limits the possibility of proper determination of cancer risk . Moreover, a part of tobacco smokers are so‐called polytobacco users as they use multiple tobacco products the same time or change their habits when smoking .…”

“…The published studies are generally based on male populations, small number of exclusive cigar or water-pipe smokers and insufficient information is given about frequency and duration of smoking, which limits the possibility of proper determination of cancer risk. 18,[21][22][23][24] Moreover, a part of tobacco smokers are so-called polytobacco users as they use multiple tobacco products the same time or change their habits when smoking. 5 If not recognized properly by investigators this group could contribute to unforeseen diffused results of studies.…”

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“…World Health Organization and cause gastric cancer directly by epigenetic effect and indirectly through inflammatory response) [5,6] b) Smoking [4] (especially waterpipe tobacco smokingSmoking flavored tobacco through a long pipe attached to a water bowl) [7] c) Blood group A [7] d) Proton pump inhibitor (Cause hypergastrinemia which leads to gastrointestinal neoplasia) [7,8] (7) e) Pernicious anemia [7] f) Organ transplant recipient [7] g) Alcohol (production of prostaglandins, lipid peroxidation and the generation of oxygen radical species leads to gastric cancer) [4] h) Overweight and obesity (BMI > 25) (Obesity is associated with low-grade chronic inflammatory state, with increased production of TNF, IL-6, MCP-1 and C-reactive protein.…”

“…Low socioeconomic status [4] iii. Gastro esophageal reflux [7] Purpose Sa-um (Fermented pork fat) [29] Sour pancakes (Fermented local food in China) [30] Bekang (Fermented soya bean) [30] Soda (Alkali)…”