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      The prevalence of waterpipe tobacco smoking among the general and specific populations: a systematic review

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          Abstract

          Background

          The objective of this study was to systematically review the medical literature for the prevalence of waterpipe tobacco use among the general and specific populations.

          Methods

          We electronically searched MEDLINE, EMBASE, and the ISI the Web of Science. We selected studies using a two-stage duplicate and independent screening process. We included cohort studies and cross sectional studies assessing the prevalence of use of waterpipe in either the general population or a specific population of interest. Two reviewers used a standardized and pilot tested form to collect data from each eligible study using a duplicate and independent screening process. We stratified the data analysis by country and by age group. The study was not restricted to a specific context.

          Results

          Of a total of 38 studies, only 4 were national surveys; the rest assessed specific populations. The highest prevalence of current waterpipe smoking was among school students across countries: the United States, especially among Arab Americans (12%-15%) the Arabic Gulf region (9%-16%), Estonia (21%), and Lebanon (25%). Similarly, the prevalence of current waterpipe smoking among university students was high in the Arabic Gulf region (6%), the United Kingdom (8%), the United States (10%), Syria (15%), Lebanon (28%), and Pakistan (33%). The prevalence of current waterpipe smoking among adults was the following: Pakistan (6%), Arabic Gulf region (4%-12%), Australia (11% in Arab speaking adults), Syria (9%-12%), and Lebanon (15%). Group waterpipe smoking was high in Lebanon (5%), and Egypt (11%-15%). In Lebanon, 5%-6% pregnant women reported smoking waterpipe during pregnancy. The studies were all cross-sectional and varied by how they reported waterpipe smoking.

          Conclusion

          While very few national surveys have been conducted, the prevalence of waterpipe smoking appears to be alarmingly high among school students and university students in Middle Eastern countries and among groups of Middle Eastern descent in Western countries.

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          Most cited references54

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          Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic.

          T Eissenberg, Rabab Ward, W Maziak … (2004)
          The global tobacco epidemic may kill 10 million people annually in the next 20-30 years, with 70% of these deaths occurring in developing countries. Current research, treatment, and policy efforts focus on cigarettes, while many people in developing regions (Asia, Indian subcontinent, Eastern Mediterranean) smoke tobacco using waterpipes. Waterpipes are increasing in popularity, and more must be learned about them so that we can understand their effects on public health, curtail their spread, and help their users quit. To conduct a comprehensive review regarding global waterpipe use, in order to identify current knowledge, guide scientific research, and promote public policy. A Medline search using as keywords "waterpipe", "narghile", "arghile", "shisha", "hookah", "goza", "hubble bubble" and variant spellings (for example, "hooka"; "hukka") was conducted. Resources compiled recently by members of GLOBALink were used. Every identified published study related to waterpipe use was included. Research regarding waterpipe epidemiology and health effects is limited; no published studies address treatment efforts. Waterpipe use is increasing globally, particularly in the Eastern Mediterranean Region, where perceptions regarding health effects and traditional values may facilitate use among women and children. Waterpipe smoke contains harmful constituents and there is preliminary evidence linking waterpipe smoking to a variety of life threatening conditions, including pulmonary disease, coronary heart disease, and pregnancy related complications. More scientific documentation and careful analysis is required before the spread of waterpipe use and its health effects can be understood, and empirically guided treatment and public policy strategies can be implemented.
          Article 0 comments Cited 141 times – based on 0 reviews     Review now
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            Effects of water-pipe smoking on lung function: a systematic review and meta-analysis.

            Philippe Abou Jaoude, Roland Honeine, Jihad Irani … (2011)
            Although common in many Middle Eastern countries, water-pipe tobacco smoking, commonly known as water-pipe smoking (WPS), is increasingly popular in Western cultures. The primary objective of this study was to systematically review the effects of WPS on lung function. The secondary objective was to compare the effects of WPS and cigarette smoking on lung function. We conducted a systematic review using the approach of the Cochrane Collaboration to search for, select, and abstract studies. We conducted two separate meta-analyses comparing water-pipe smokers with nonsmokers, and water-pipe smokers with cigarette smokers for each of three spirometric measurements (FEV₁, FVC, and FEV₁/ FVC). We used the standardized mean difference (SMD) to pool the results. Six cross-sectional studies were eligible for this review. Compared with no smoking, WPS was associated with a statistically significant reduction in FEV₁ (SMD = -0.43; 95% CI, -0.58 to -0.29; equivalent to a 4.04% lower FEV₁%), a trend toward lower FVC (SMD = -0.15; 95% CI, -0.34 to 0.04; equivalent to a 1.38% reduction in FVC%), and lower FEV₁/ FVC (SMD = -0.46; 95% CI, -0.93 to 0.01; equivalent to a 3.08% lower FEV₁/ FVC). Comparing WPS with cigarette smoking, there was no statistically significant difference in FEV₁, FVC, and FEV₁/ FVC. The six studies suffered from methodologic limitations. WPS negatively affects lung function and may be as harmful as cigarette smoking. WPS, therefore, is likely to be a cause of COPD.
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              Waterpipe tobacco smoking: an emerging health crisis in the United States.

              Caroline J. Cobb, Kenneth D Ward, Wasim Maziak … (2015)
              To examine the prevalence and potential health risks of waterpipe tobacco smoking. A literature review was performed to compile information relating to waterpipe tobacco smoking. Waterpipe tobacco smoking is increasing in prevalence worldwide; in the United States, 10-20% of some young adult populations are current waterpipe users. Depending on the toxicant measured, a single waterpipe session produces the equivalent of at least 1 and as many as 50 cigarettes. Misconceptions about waterpipe smoke content may lead users to underestimate health risks. Inclusion of waterpipe tobacco smoking in tobacco control activities may help reduce its spread.
              Article 0 comments Cited 60 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central
                ISSN (Electronic): 1471-2458
                Publication date Collection: 2011
                Publication date (Electronic): 19 April 2011
                Volume: 11
                Page: 244
                Affiliations
                [1 ]Department of Medicine, State University of New York at Buffalo, NY, USA
                [2 ]Department of Family Medicine, State University of New York at Buffalo, NY, USA
                [3 ]Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton Canada
                [4 ]Department of Social and Preventive Medicine, State University of New York at Buffalo, NY, USA
                [5 ]Department of Pediatrics, Wayne State University, Detroit, MI, USA
                [6 ]Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
                Article
                Publisher ID: 1471-2458-11-244
                DOI: 10.1186/1471-2458-11-244
                PMC ID: 3100253
                PubMed ID: 21504559
                SO-VID: be09ec39-becf-43c6-ac77-d5cc1d95fd90
                Copyright © Copyright ©2011 Akl et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 11 August 2010
                Date accepted : 19 April 2011
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Public health
                Data availability:
                ScienceOpen disciplines: Public health

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