Table 3

Long-term effect of waterpipe smoking on pulmonary function

Study	Population	WP quantity	Tobacco type	Included only healthy participants?	Comparison	Diff in FEV₁%pred*	Diff in FVC %pred*	Diff in FEV₁/FVC %*	Diff in FEF25–75%pred*
Boskabady 201261	371 men, 301 women, average ages in 30s and 40s	Average (Avg) 1.17 (±0.53) WP smoked per week	Unspecified	Yes	WP vs non-smokers	−14.6	−21.9	NE	−13.8
Boskabady 201261	371 men, 301 women, average ages in 30s and 40s	Average (Avg) 1.17 (±0.53) WP smoked per week	Unspecified	Yes	WP vs cigarette (normal inhalation)	−3.83 (NS)	−7.03	NE	−13.0
Ben Saad 201363	142 men age 35–60 years	Avg 36 (±22) WP-years	Tabamel (sweetened tobacco)	Yes	WP vs cigarette	+24.0	+14.0	+13.0	NE
Ben Saad 201162	110 men, age 20–60 years	Median 14 WP-years 14	Unspecified	Yes	WP vs reference values	†	†	†	†
Mutairi 200664	139 men, 13 women, age 24–65 years	unspecified	Moassal,	Yes	WP vs cigarette	−1.1 (NS)	NE	+0.5‡ (NS)	NE
Mutairi 200664	139 men, 13 women, age 24–65 years	unspecified	Moassal,	Yes	WP vs non-smokers	−12.2 (NS)	NE	−2.5‡ (NS)	NE
Aydin 200465	25 persons average age 49.2 (±12.2) years	Avg 23.7 (±8.3) years smoking 1–2 times/day	Unspecified	Yes	WP vs passive cigarette smokers	−2.5 (NS)	+0.9 (NS)	−5.6‡	−7.2 (NS)
Kiter 200066	397 men, age 18–85 years	Average 37 (±42) Jurak-years	Jurak (tobacco-fruit mixture)	No	WP vs non-smokers	−6.5	−5.86 (NS)	−3.02‡	−8.63
Kiter 200066	397 men, age 18–85 years	Average 37 (±42) Jurak-years	Jurak (tobacco-fruit mixture)	No	WP vs cigarette	+3.01	−0.5 (NS)	+4.49‡	+5.08
Mohammad 201367	788 women, age 44+ years	Unspecified	Unspecified	No	WP vs cigarette	+5.3 (NS)	NE	+0.1 (NS)	NE
Mohammad 201367	788 women, age 44+ years	Unspecified	Unspecified	No	WP vs non-smokers	+5.3 (NS)	NE	+0.1 (NS)	NE
She 201469	1238, mostly men, age 40+ years	Average 28 (±11.2) years of 17.9 (±8.9) g tobacco/day	Chinese WP tobacco	Yes	WP vs non-smokers	−9.4	+6.1	−12.1	NE
					WP vs cigarette	−4.0	+7.1	−8.0	NE
					WP passive vs never-passive	−9.0	−6.6	−4.5	NE
					WP passive vs cigarette-passive	−6.9	−5.5	−3.0	NE
Al-Fayez 198870	441 men, 154 women smokers, 878 total participants, men 20–59 years, women 17–59 years	Not reported	Jurak (tobacco-fruit mixture)	Yes	WP smokers vs non-smokers
					Males	−0.54 L	−0.43 L	−4.6	NE
					Females	−0.41 L	−0.19 L	−11.42	NE
Boskabady 201471	§	§	§	§	§	§	§	§	§
Layoun 201421	87 men, 45 women, avg age 33.4 (±13.29) years, exclusive WP smokers	Avg 11.12 (±17.27) WP/week	Moassal	No	WP vs non-smokers	−4.4 (NS)	−9.1	+5.56	NE
Layoun 201421		Avg 11.12 (±17.27) WP/week	Moassal	No	WP vs cigarette	+1.63 (NS)	−2.28 (NS)	+4.28	NE

*All pulmonary function values are differences (WP value—comparison group value). The units are % predicted, except FEV₁/FVC, which is a % ratio, or otherwise specified.
†FEV₁ and FEF25-75 decreased compared to reference values; no comparison group was included. FVC and FEV₁/FVC were non-significant in this comparison.
‡Per cent predicted value.
§Same as 2012 data.
% pred, percent predicted; % pred, per cent predicted comparison group; Diff, difference; FEF25-75, forced expiratory flow between 25% and 75% (middle half) of the FVC; FEV₁, forced expiratory volume in 1 s; FEV₁/FVC, Ratio of FEV₁/FVC; FVC, forced vital capacity; NE, not evaluated; NS, no significant difference with comparison group; unsp, unspecified; unsp, unspecified.