Dataset Information

Unveiling an Association between Waterpipe Smoking and Bladder Cancer Risk: A Multicenter Case-Control Study in Iran.

ABSTRACT:

Background

Limited data exist for the association between bladder cancers and waterpipe smoking, an emerging global public health concern.

Methods

We used the IROPICAN database in Iran and used multivariable logistic regression, adjusting for cigarette smoking, opium use, and other confounding factors. In addition, we studied the association between exclusive waterpipe smoking and bladder cancer.

Results

We analyzed 717 cases and 3,477 controls and a subset of 215 patients and 2,145 controls who did not use opium or cigarettes. Although the OR adjusted for opium, cigarettes, and other tobacco products was 0.92 [95% confidence interval (CI), 0.69-1.20], we observed a statistically significant elevated risk in exclusive waterpipe smokers (OR = 1.78; 95% CI, 1.16-2.72) compared with non-users of opium or any tobacco. Associations were strongest for smoking more than two heads/day (OR = 2.25; 95% CI, 1.21-4.18) and for initiating waterpipe smoking at an age less than 20 (OR = 2.73; 95% CI, 1.11-6.72). The OR for urothelial bladder cancer was higher in ex-smokers (OR = 2.35; 95% CI, 1.24-4.42) than in current smokers (OR = 1.52; 95% CI, 0.72-3.15). All observed associations were consistently higher for urothelial histology.

Conclusions

Waterpipe smoking may be associated with an increased risk of bladder cancer, notably among individuals who are not exposed to cigarette smoking and opium.

Impact

The study provides compelling evidence that waterpipe smoking is a confirmed human carcinogen, demanding action from policymakers. See related In the Spotlight, p. 461.

SUBMITTER: Hadji M

PROVIDER: S-EPMC10988205 | biostudies-literature | 2024 Apr

REPOSITORIES: biostudies-literature

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Publications

Unveiling an Association between Waterpipe Smoking and Bladder Cancer Risk: A Multicenter Case-Control Study in Iran.

Hadji Maryam M Rashidian Hamideh H Marzban Maryam M Rezaianzadeh Abbas A Ansari-Moghaddam Alireza A Bakhshi Mahdieh M Nejatizadeh Azim A Seyyedsalehi Monireh Sadat MS Naghibzadeh-Tahami Ahmad A Haghdoost AliAkbar A Mohebbi Elham E Freedman Neal D ND Malekzadeh Reza R Etemadi Arash A Kamangar Farin F Weiderpass Elisabete E Pukkala Eero E Boffetta Paolo P Zendehdel Kazem K

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20240401 4

<h4>Background</h4>Limited data exist for the association between bladder cancers and waterpipe smoking, an emerging global public health concern.<h4>Methods</h4>We used the IROPICAN database in Iran and used multivariable logistic regression, adjusting for cigarette smoking, opium use, and other confounding factors. In addition, we studied the association between exclusive waterpipe smoking and bladder cancer.<h4>Results</h4>We analyzed 717 cases and 3,477 controls and a subset of 215 patients ...[more]

PMID: 38180357

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Project description:BackgroundWaterpipe and cigarette smoking dependence are becoming increasingly prevalent forms of addiction globally. This study examined whether cumulative cigarette smoking and cumulative waterpipe smoking are associated with higher dependence on both cigarettes and waterpipe.MethodsThis cross-sectional study conducted between February and April 2020, enrolled 363 participants drawn from all Lebanese districts. The mean age was 29.51 years, 64.8% were females, and 124 (34.2%) exclusive cigarette smokers, 189 (52.1%) exclusive waterpipe smokers, and 50 (13.8%) dual smokers (waterpipe and cigarette). We used the Hooked on Nicotine Checklist (HONC) as an indicator of decreased autonomy towards nicotine, in addition to the Lebanon Waterpipe Dependence Scale-11 (LWDS11) and the Lebanese Cigarette Dependence scale (LCD). A stepwise linear regression was performed taking the HONC scores due to cigarette and waterpipe smoking, LCD and LWDS-11 scores as dependent variables.ResultsThe results showed that in the total sample, higher cumulative cigarette smoking (B = 0.005 with a confidence interval of 0.004, 0.006) was significantly associated with higher HONC cigarette scores, whereas higher cumulative waterpipe smoking (B = -0.006 with a confidence interval of - 0.009, - 0.002) was significantly associated with lower HONC cigarette scores. Moreover, higher cumulative waterpipe smoking (B = 0.012 with a confidence interval of 0.009,0.015) was significantly associated with higher HONC waterpipe scores. The results showed that, in both sexes, higher cumulative cigarette smoking was associated with higher HONC cigarette scores and lower HONC waterpipe scores. Furthermore, higher cumulative waterpipe smoking was significantly associated with higher HONC waterpipe scores in both sexes.ConclusionOur study supports the fact that heavy nicotine consumption, related to both the increased frequency and smoking duration, can increase the risk of dependence. It raises the need for strategic plans to minimize and discourage the use of nicotine products in Lebanese community settings.

Project description:BackgroundIn recent years waterpipe smoking has become a popular practice amongst young adults in eastern Mediterranean countries, including Iran. The aim of this study was to assess waterpipe smoking perceptions and practices among first-year health sciences university students in Iran and to identify factors associated with the initiation and maintenance of waterpipe use in this population.ResultsOut of 371 first-year health sciences students surveyed, 358 eight students completed a self-administered questionnaire in the classrooms describing their use and perceptions towards waterpipe smoking. Two hundred and ninety six responders met study inclusion criteria. Waterpipe smoking was common among first-year health sciences university students, with 51% of students indicating they were current waterpipe smokers. Women were smoking waterpipes almost as frequently as men (48% versus 52%, respectively). The majority of waterpipe smokers (75.5%) indicated that the fun and social aspect of waterpipe use was the main motivating factor for them to continue smoking. Of waterpipe smokers, 55.3% were occasional smokers, using waterpipes once a month or less, while 44.7% were frequent smokers, using waterpipes more than once a month. A large number of frequent waterpipe smokers perceived that waterpipe smoking was a healthier way to use tobacco (40.6%) while only 20.6% thought it was addictive. Compared to occasional smokers, significantly more frequent smokers reported waterpipe smoking was relaxing (62.5% vs. 26.2%, p = 0.002), energizing (48.5% vs. 11.4%, p = 0.001), a part of their culture (58.8% vs. 34.1%, p = 0.04), and the healthiest way to use tobacco (40.6% vs. 11.1%, p = 0.005).ConclusionsSocial and recreational use of waterpipes is widespread among first-year health sciences university students in Iran. Women and men were almost equally likely to be current waterpipe users. Public health initiatives to combat the increasing use of waterpipes among university students in Iran must consider the equal gender distribution and its perception by many waterpipe smokers as being a healthier and non-addictive way to use tobacco.

Dataset Information

Unveiling an Association between Waterpipe Smoking and Bladder Cancer Risk: A Multicenter Case-Control Study in Iran.

Background

Methods

Results

Conclusions

Impact

Publications

Unveiling an Association between Waterpipe Smoking and Bladder Cancer Risk: A Multicenter Case-Control Study in Iran.

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