Evaluation of the Effects of Hubble-Bubble(Waterpipe) Smoking on Pulmonary Function in Patients with Respiratory Symptoms Referred to Hazrat Rasoul and Haft-e-Tir Hospitals in Tehran

Waterpipe smoking is increasingly becoming a worldwide phenomenon with populations in the Eastern Mediterranean region like Iran. However, most recent researches have put their focus on cigarette rather than waterpipe smoking. Although research on the health effects of waterpipe is still scarce, preliminary evidence links waterpipe use to respiratory, cardiovascular and cancer diseases. Therefore, this study was carried out to evaluate the effects of hubble-bubble(waterpipe) smoking on pulmonary function. Patients & The present cross-sectional study was performed as census procedure. All 1014 individuals with respiratory symptoms who referred to Hazrat Rasoul and Haft-e-Tir Hospitals in Tehran, from October 2003 to October 2004, were enrolled in the study. Spirometric indices, demographic data, history of cigarette and waterpipe smoking were recorded. Data was later analyzed via SPSS V.11.5 software using statistical tests such as Chi2, t-test, one-way ANOVA and correlation and Pvalue<0.05 was considered significant. Out of 1014 individuals evaluated in this study, there were 691(68.1%) men and 323(31.9%) women with the mean age of 51.20(SD=17.74) years. 94(9.3%) individuals had the history of waterpipe smoking, whereas the other 920(90.7%) had never smoked hubble-bubble. The mean of spirometric indices such as FEV1 and FEF25-75 were 72.24%(SD=24.64) and 67.93%(SD=34.84), respectively. There was not any significant association between waterpipe smoking & FEV1(P=0.213), and duration of waterpipe smoking & FEV1(P=0.975). Also, no significant relationship was seen between waterpipe smoking and FEF25-75(P=0.185). However, both cigarette smoking and its duration had significant effect on FEV1 and FEF25-75. Studies on the health effects of this smoking method(hubble-bubble) are scanty and often suffer from poor control of other confounding factors such as cigarette smoking. While, previous studies suggested that hubble-bubble smoking could affect respiratory function, blood pressure, and heart rate, this study did not show any significant association between waterpipe smoking and some spirometric indices(FEV1 and FEF25-75). The effect of tobacco in this kind of usage(waterpipe) probably becomes ineffective because of other effects such as mucolytic effect of this type of smoking.