To quantify by meta-analysis the relationship between waterpipe smoking and cancer, including cancer of the head and neck, esophagus, stomach, lung and bladder.
We 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.
We 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.
Contrary 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.
Aljarrah K, Ababneh ZQ, Al-Delaimy WK (2009) Perceptions of hookah smoking harmfulness: predictors and characteristics among current hookah users. Tob Induc Dis 18;5(1):16
Bener A, Moore MA, Ali R et al (2010) Impacts of family history and lifestyle habits on colorectal cancer risk: a case–control study in Qatar. Asian Pac J Cancer Prev 11(4):963–968 PubMed
Chaouachi K (2006) Patologie associate all’uso del narghile. Tabaccologia 1:27–34
Daher N, Saleh R, Jaroudi E et al (2010) Comparison of carcinogen, carbon monoxide, and ultrafine particle emissions from narghile waterpipe and cigarette smoking: sidestream smoke measurements and assessment of second-hand smoke emission factors. Atmos Environ (1994) 44(1):8–14 CrossRef
Gupta D, Boffetta P, Gaborieau V et al (2001) Risk factors of lung cancer in Chandigarh, India. Indian J Med Res 113:142–150 PubMed
Hsairi M, Achour N, Zouari B et al (1993) Etiologic factors in primary bronchial carcinoma in Tunisia. Tunis Med 71(5):265–268 PubMed
Jacob P 3rd, Abu Raddaha AH, Dempsey D et al (2013) Comparison of nicotine and carcinogen exposure with water pipe and cigarette smoking. Cancer Epidemiol Biomark Prev 22(5):765–772 CrossRef
Karajibani M, Montazerifar F, Dashipour A et al (2014) Nutritional risk factors in the gastric cancer patients attending in Imam Ali Hospital, Zahedan, Iran. Rawal Med J 39:19–24
Koul PA, Hajni MR, Sheikh MA et al (2011) Hookah smoking and lung cancer in the Kashmir valley of the Indian subcontinent. Asian Pac J Cancer Prev 12(2):519–524 PubMed
Masters N, Tutt C (2015) Smoking pack years. http://www.smokingpackyears.com. Accessed Oct 2, 2015
Sajid KM, Parveen R, Sabih DE et al (2007) Carcinoembryonic antigen (CEA) levels in hookah smokers, cigarette smokers and non-smokers. J Pak Med Assoc 57(12):595–599 PubMed
U.S. Department of Health and Human Services (2014) The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta. http://www.surgeongeneral.gov/library/reports/50-years-of-progress/exec-summary.pdf. Accessed March 15, 2016
Wells G, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P (2009) The Newcastle–Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-analyses. Available from http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed Mar 15, 2016
- Cancer risk in waterpipe smokers: a meta-analysis
Ahmad Al Mulla
- Springer International Publishing