Top

International Journal of Public Health

Published in:

Open Access 01-01-2017 | Original Article

Cancer risk in waterpipe smokers: a meta-analysis

Authors: Ravinder Mamtani, Sohaila Cheema, Javaid Sheikh, Ahmad Al Mulla, Albert Lowenfels, Patrick Maisonneuve

Published in: International Journal of Public Health | Issue 1/2017

Abstract

Objectives

To quantify by meta-analysis the relationship between waterpipe smoking and cancer, including cancer of the head and neck, esophagus, stomach, lung and bladder.

Methods

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.

Results

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.

Conclusions

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.

Akl EA, Gaddam S, Gunukula SK et al (2010) The effects of waterpipe tobacco smoking on health outcomes: a systematic review. Int J Epidemiol 39(3):834–857CrossRefPubMed

Al Ali R, Rastam S, Ibrahim I et al (2015) A comparative study of systemic carcinogen exposure in waterpipe smokers, cigarette smokers and non-smokers. Tob Control 24(2):125–127CrossRefPubMed

Al Mulla A, Fanous N, Seidenberg AB et al (2015) Secondhand smoke emission levels in waterpipe cafes in Doha, Qatar. Tob Control 24(e3):e227–e231CrossRefPubMed

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

Amr S, Dawson R, Saleh DA et al (2014) Agricultural workers and urinary bladder cancer risk in Egypt. Arch Environ Occup Health 69(1):3–10CrossRefPubMed

Aoun J, Saleh N, Waked M et al (2013) Lung cancer correlates in Lebanese adults: a pilot case–control study. J Epidemiol Glob Health 3(4):235–244CrossRefPubMed

Azizi H, Esmaeili ED (2015) Stressful life events and risk of colorectal cancer: a case–control study of Iran. Asian Pac J Cancer Prev 16(6):2403–2407CrossRefPubMed

Bedwani R, el-Khwsky F, Renganathan E et al (1997) Epidemiology of bladder cancer in Alexandria, Egypt: tobacco smoking. Int J Cancer 73(1):64–67CrossRefPubMed

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):963–968PubMed

Chaouachi K (2006) Patologie associate all’uso del narghile. Tabaccologia 1:27–34

Cook-Mozaffari PJ, Azordegan F, Day NE et al (1979) Oesophageal cancer studies in the Caspian Littoral of Iran: results of a case-control study. Br J Cancer 39(3):293–309CrossRefPubMedPubMedCentral

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):8–14CrossRef

Dar NA, Bhat GA, Shah IA et al (2012) Hookah smoking, nass chewing, and oesophageal squamous cell carcinoma in Kashmir, India. Br J Cancer 107(9):1618–1623CrossRefPubMedPubMedCentral

El-Zaatari ZM, Chami HA, Zaatari GS (2015) Health effects associated with waterpipe smoking. Tob Control 24(suppl 1):i31–i43CrossRefPubMedPubMedCentral

Engel LS, Chow WH, Vaughan TL et al (2003) Population attributable risks of esophageal and gastric cancers. J Natl Cancer Inst 95(18):1404–1413CrossRefPubMed

Feki-Tounsi M, Olmedo P, Gil F et al (2013) Cadmium in blood of Tunisian men and risk of bladder cancer: interactions with arsenic exposure and smoking. Environ Sci Pollut Res Int 20(10):7204–7213CrossRefPubMed

Feng BJ, Khyatti M, Ben-Ayoub W et al (2009) Cannabis, tobacco and domestic fumes intake are associated with nasopharyngeal carcinoma in North Africa. Br J Cancer 101(7):1207–1212CrossRefPubMedPubMedCentral

Gupta D, Boffetta P, Gaborieau V et al (2001) Risk factors of lung cancer in Chandigarh, India. Indian J Med Res 113:142–150PubMed

Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558CrossRefPubMed

Hsairi M, Achour N, Zouari B et al (1993) Etiologic factors in primary bronchial carcinoma in Tunisia. Tunis Med 71(5):265–268PubMed

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):765–772CrossRef

Jafarey NA, Zaidi SH (1976) Carcinoma of the oral cavity and oropharynx in Karachi (Pakistan). An appraisal. Trop Doct 6(2):63–67CrossRefPubMed

Jones KW, Whitlock JP Jr (1990) Functional analysis of the transcriptional promoter for the CYP1A1 gene. Mol Cell Biol 10(10):5098–5105CrossRefPubMedPubMedCentral

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

Khan NA, Teli MA, Haq Mohib-Ul et al (2011) A survey of risk factors in carcinoma esophagus in the valley of Kashmir, Northern India. J Cancer Res Ther 7(1):15–18CrossRefPubMed

Khlifi R, Olmedo P, Gil F et al (2013) Blood nickel and chromium levels in association with smoking and occupational exposure among head and neck cancer patients in Tunisia. Environ Sci Pollut Res Int 20(11):8282–8294CrossRefPubMed

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):519–524PubMed

Lubin JH, Li JY, Xuan XZ et al (1992) Risk of lung cancer among cigarette and pipe smokers in southern China. Int J Cancer 51(3):390–395CrossRefPubMed

Macaskill P, Walter SD, Irwig L (2001) A comparison of methods to detect publication bias in meta-analysis. Stat Med 20(4):641–654CrossRefPubMed

Makhyoun NA (1974) Smoking and bladder cancer in Egypt. Br J Cancer 30(6):577–581CrossRefPubMedPubMedCentral

Malik MA, Upadhyay R, Mittal RD et al (2010) Association of xenobiotic metabolizing enzymes genetic polymorphisms with esophageal cancer in Kashmir Valley and influence of environmental factors. Nutr Cancer 62(6):734–742CrossRefPubMed

Masters N, Tutt C (2015) Smoking pack years. http://www.smokingpackyears.com. Accessed Oct 2, 2015

Maziak W (2011) The global epidemic of waterpipe smoking. Addict Behav 36(1–2):1–5CrossRefPubMed

Maziak W (2012) The waterpipe: an emerging global risk for cancer. Cancer Epidemiol 37(1):1–4CrossRefPubMedPubMedCentral

Maziak W (2015) Rise of waterpipe smoking. BMJ 350:h1991CrossRefPubMed

Maziak W, Taleb ZB, Bahelah R et al (2015) The global epidemiology of waterpipe smoking. Tob Control 24(suppl 1):i3–i12CrossRefPubMed

Moon KA, Magid H, Torrey C et al (2015) Secondhand smoke in waterpipe tobacco venues in Istanbul, Moscow, and Cairo. Environ Res 142:568–574CrossRefPubMedPubMedCentral

Nakkash RT, Khalil J, Afifi RA (2011) The rise in narghile (shisha, hookah) waterpipe tobacco smoking: a qualitative study of perceptions of smokers and non smokers. BMC Public Health 11:315CrossRefPubMedPubMedCentral

Nasrollahzadeh D, Kamangar F, Aghcheli K et al (2008) Opium, tobacco, and alcohol use in relation to oesophageal squamous cell carcinoma in a high-risk area of Iran. Br J Cancer 98(11):1857–1863CrossRefPubMedPubMedCentral

Pourfarzi F, Whelan A, Kaldor J et al (2009) The role of diet and other environmental factors in the causation of gastric cancer in Iran—a population based study. Int J Cancer 125(8):1953–1960CrossRefPubMed

Qiao YL, Taylor PR, Yao SX et al (1989) Relation of radon exposure and tobacco use to lung cancer among tin miners in Yunnan Province, China. Am J Ind Med 16(5):511–521CrossRefPubMed

Quadri MF, Alharbi F, Bajonaid AM et al (2015) Oral squamous cell carcinoma and associated risk factors in Jazan, Saudi Arabia: a hospital based case control study. Asian Pac J Cancer Prev 16(10):4335–4338CrossRefPubMed

Radwan G, Hecht SS, Carmella SG et al (2013) Tobacco-specific nitrosamine exposures in smokers and nonsmokers exposed to cigarette or waterpipe tobacco smoke. Nicotine Tob Res 15(1):130–138CrossRefPubMed

Sadjadi A, Derakhshan MH, Yazdanbod A et al (2014) Neglected role of hookah and opium in gastric carcinogenesis: a cohort study on risk factors and attributable fractions. Int J Cancer 134(1):181–188CrossRefPubMed

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):595–599PubMed

Shakeri R, Malekzadeh R, Etemadi A et al (2013) Opium: an emerging risk factor for gastric adenocarcinoma. Int J Cancer 133(2):455–461CrossRefPubMed

Soliman AS, Hung CW, Tsodikov A et al (2010) Epidemiologic risk factors of hepatocellular carcinoma in a rural region of Egypt. Hepatol Int 4(4):681–690CrossRefPubMedPubMedCentral

Tee GH, Hairi NN, Nordin F et al (2015) Systematic review on international practices in controlling waterpipe tobacco smoking. Asian Pac J Cancer Prev 16(9):3659–3665CrossRefPubMed

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

van Houwelingen HC, Arends LR, Stijnen T (2002) Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med 21(4):589–624CrossRefPubMed

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

Wolpert BJ, Amr S, Ezzat S et al (2010) Estrogen exposure and bladder cancer risk in Egyptian women. Maturitas 67(4):353–357CrossRefPubMedPubMedCentral

Wu F, Chen Y, Parvez F et al (2013) A prospective study of tobacco smoking and mortality in Bangladesh. PLoS One 8(3):e58516CrossRefPubMedPubMedCentral

Title: Cancer risk in waterpipe smokers: a meta-analysis
Authors: Ravinder Mamtani
Sohaila Cheema
Javaid Sheikh
Ahmad Al Mulla
Albert Lowenfels
Patrick Maisonneuve
Publication date: 01-01-2017
Publisher: Springer International Publishing
Published in: International Journal of Public Health / Issue 1/2017
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-016-0856-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cancer risk in waterpipe smokers: a meta-analysis

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

When size matters: advantages of weighted effect coding in observational studies

Long-term trends of inequalities in mortality in 6 European countries

Acknowledgement to Reviewers 2016

Child feeding and stunting prevalence in left-behind children: a descriptive analysis of data from a central and western Chinese population

Social network and inequalities in smoking amongst school-aged adolescents in six European countries

International short-term medical missions: a systematic review of recommended practices