Chronic respiratory effect of narguileh smoking compared with cigarette smoking in women from the East Mediterranean region

Narguileh is a water pipe. Narguileh smoking is a traditional pattern of smoking among Eastern Mediterranean women, publicly considered as a harmless entertainment. We performed a survey aimed at tracking chronic respiratory symptoms and alteration in respiratory functions in 77 female narguileh smokers, 77 cigarette smokers, and controls. A questionnaire about respiratory symptoms, quantity, and duration of smoking was completed by each woman, and a flow-volume loop was performed with all women. Women were then categorized in subgroups according to a cumulative smoking duration of over 5 years, and cumulative quantity of 50 kilograms smoked. We obtained 8 subgroups for quantity and 10 for duration. Results showed a higher proportion of chronic bronchitis in narguileh smokers compared with cigarette smokers for both quantity and duration (p value < 0.001), as well as quasi-permanent alteration in maximum mid-expiratory flow (MMEF 25%-75%) in narguileh smokers compared with cigarette smokers (p value < 0.001). Forced expired volume in one second was more altered in cigarette smokers than in narguileh smokers (p value > 0.001). These results will help to raise health authority awareness that narguileh smoking is also dangerous for women.