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Tobacco Cessation and Prevention |

Chinese Waterpipe Smoking: A New Risk Factor for Lung Cancer and COPD?

Jun She*, MD; Ping Yang, MD; Chunxue Bai, MD
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Zhongshan Hospital, Fudan University, Shanghai, China


Chest. 2012;142(4_MeetingAbstracts):1079A. doi:10.1378/chest.1375270
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Abstract

SESSION TYPE: Tobacco Cessation and Prevention

PRESENTED ON: Tuesday, October 23, 2012 at 04:30 PM - 05:45 PM

PURPOSE: Chinese waterpipe(CW) smoking, which is different from Arabic waterpipe, has been known as rendering no harm under the assumption that no charcoal was used and tobacco smoke could be passed through water. However, the mortality and morbidity of lung cancer were higher than Chinese nationwide rates by 3-fold; and the incidence rate of chronic obstructive pulmonary disease(COPD) was also high in many areas of CW smoking. We postulate that CW smoking might be a new and independent risk factor for lung cancer and COPD in China.

METHODS: A cohort of 1296 subjects, aged >40 years, was included in this study. 227 are CW smokers and 212 are their passive smoke spouse. Cigarette smokers(212) and their passive smoke spouse(225), non smokers(204) and their spouse(216) as the reference groups. All subjects were measured on carbon monoxide(CO) levels, spirometry and chest X-ray; nicotine, tar, tumor biomarkers were tested by blood. We also collected the water of CW to detect the toxic residues.

RESULTS: The mean CO levels of CW smokers(48ppm) were significantly increased compared to cigarette smokers(23ppm) and non smokers(5ppm). Moreover, CW passive smoke spouse were also higher(31ppm) than other two reference groups. The percentage of abnormal lung function in CW smokers and their passive smoke spouse were 82.7% and 66.5%, while lower percentages were observed in cigarette smokers and their passive smoke spouse or in non-smokers and their spouse(62.5%, 55.6%, 33.3%, 33.3%, respectively). Carcino-embryonic antigen(CEA) was increased in CW smokers and their passive smoke spouse compared to other groups. Finally, many toxic and carcinogenic substances, eg: lead, benzene, endotoxin and polycyclic aromatic hydrocarbons were detected in the water of CW.

CONCLUSIONS: CW smoking may impose greater risk for lung cancer and COPD than cigarette smoking. More importantly, CW smoking not only damage CW smoker themselves, but also harm their passive smoke spouse.

CLINICAL IMPLICATIONS: Smoking cessation in CW users is as important as in other tobacco products in preventive intervention of lung cancer and COPD.

DISCLOSURE: The following authors have nothing to disclose: Jun She, Ping Yang, Chunxue Bai

No Product/Research Disclosure Information

Zhongshan Hospital, Fudan University, Shanghai, China

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