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Cancer risk in waterpipe smokers: a meta-analysis

Author

Listed:
  • Ravinder Mamtani

    (Weill Cornell Medicine-Qatar)

  • Sohaila Cheema

    (Weill Cornell Medicine-Qatar)

  • Javaid Sheikh

    (Weill Cornell Medicine-Qatar)

  • Ahmad Al Mulla

    (Hamad Medical Corporation)

  • Albert Lowenfels

    (New York Medical College)

  • Patrick Maisonneuve

    (European Institute of Oncology)

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.

Suggested Citation

  • Ravinder Mamtani & Sohaila Cheema & Javaid Sheikh & Ahmad Al Mulla & Albert Lowenfels & Patrick Maisonneuve, 2017. "Cancer risk in waterpipe smokers: a meta-analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(1), pages 73-83, January.
  • Handle: RePEc:spr:ijphth:v:62:y:2017:i:1:d:10.1007_s00038-016-0856-2
    DOI: 10.1007/s00038-016-0856-2
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    Cited by:

    1. Rima Nakkash & Tamara Lotfi & Dima Bteddini & Pascale Haddad & Hala Najm & Lina Jbara & Hala Alaouie & Lama Al Aridi & Ahmad Al Mulla & Ziyad Mahfoud & Rima A. Afifi, 2018. "A Randomized Controlled Trial of a Theory-Informed School-Based Intervention to Prevent Waterpipe Tobacco Smoking: Changes in Knowledge, Attitude, and Behaviors in 6th and 7th Graders in Lebanon," IJERPH, MDPI, vol. 15(9), pages 1-17, August.

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