Evaluation of the risk of lung cancer due to hookah smoking: a meta-analysis study

Background: Hookah smoking has been growing among people because consumers believe that smoking in the form of hookahs has lesser health effects than cigarettes. However, recent reports showed that water pipe smoking (WSP) increased heart rate, blood pressure, impaired pulmonary function and carbon monoxide intoxication. Chronic bronchitis, emphysema and coronary artery disease are serious problems of long-term use of this kind of smoking. Lung, gastric and esophageal cancers are associated with WPS, as well as periodontal disease, and obstetrical complications. Hence purpose of this study was to survey the relationship between lung cancer and tobacco consumption in the form of hookah through meta-analysis. Methods: In this meta-analysis study we conducted an electronically search in databases PubMed, MEDLINE and EMBASE to find relevant articles regarding the adverse effects of hookah smoking, using the terms ‘water pipe’ and its synonyms (hookah, shisha, goza, narghileh, arghileh and hubble-bubble) in various spellings in Iran University of Medical Sciences (IUMS), Tehran, Iran from January to May 2017. All articles including Cohort and case-control studies published between 1980 and 2017 and conducted in the world were included without restriction regarding publication language. The cross-sectional studies, case reports, conference abstracts, reviews and studies not conducted on humans were excluded. The article selection process and data extraction were performed by two independent investigators. The articles were evaluated using odds ratios, heterogeneity and distribution models. Results: In this study, 120 articles related to the effect of hookah smoke on health were found. Of these articles, there were 9 articles related to the effect of hookah smoke on lung cancer. The results showed that hookah smoking could increases the risk of lung cancer with a chance ratio of 3.72 and a confidence interval of 4.85-2.60. Heterogeneity and distribution were not observed among selected articles. Conclusion: There is accumulating evidence about the association of water pipe tobacco smoking with of lung cancer, which increases the risk of lung cancer due to water pipe tobacco smoking consumption.