CHEST
Original ResearchChinese Water-Pipe Smoking and the Risk of COPD
Section snippets
Individuals and Study Design
This multicenter, population-based, cross-sectional study (October 15, 2011 to January 12, 2013) enrolled 1,238 individuals from 10 towns (Dahe, Dongshan, Housuo, Fuchun, Zhongan, Yingshang, Zhuyuan, Laochang, Shibalianshan, and Huangnihe) covering a wide geographic area in Fuyuan County, Yunnan Province, China, and representing a total population of > 780,000.
We targeted all residents ≥ 40 years of age14 and used a random-digit phone sampling at 12 local hospitals and clinics (see e-Appendix 1
Individual Characteristics
A total of 1,238 individuals were included in the analysis (Fig 2); baseline characteristics are presented in Table 1. Smokers and passive smokers were similar in individual demographics including age, height, weight, and hypertension, whereas the NS group tended to consume less alcohol compared with the CWS and CS groups.
Pulmonary Impairment
The mean smoking duration (years) was similar in the CWS and CS groups (28 ± 11.2 vs 28.5 ± 13.5) (Table 1). The CWS group subconsciously increased the daily frequency of
Discussion
We provide robust results that large-volume Chinese water-pipe use and exposure are associated with the elevated prevalence of COPD, which has been identified by epidemiologic, physiologic, radiologic, and toxicologic findings for the first time. One thousand two hundred and thirty-eight individuals, 40 years of age or older, were enrolled from 10 towns. In our study, potential risk factors for COPD included the following: CWS (OR, 10.61; 95% Cl, 6.89-16.34), CWPS (OR, 5.50; 95% Cl, 3.61-8.38),
Conclusions
In conclusion, the Chinese water pipe has mistakenly been deemed as less harmful. Our study has provided evidence confirming this misconception. Exposure to active and passive Chinese water-pipe smoke may be a significant risk factor for developing COPD. The damage from Chinese water-pipe use and exposure is worse than that from cigarettes. Our results highlight that smoking cessation in Chinese water-pipe users is as important as the smoking cessation of other tobacco products in the
Acknowledgments
Author contributions: C. B. takes responsibility for the content of the manuscript, including data and analysis. J. S. contributed to the conduct of the study; J. S., P. Y., Yuqi Wang, X. Q., J. F., Yi Wang, G. G., G. L., K. M., B. L., C. L., X. Wang, Y. S., and C. B. contributed to the completion of the work and development of the manuscript; J. S. contributed to the drafting of the manuscript; P. Y. contributed to the design of the work and revision of the manuscript; Yuqi Wang, X. Q., J. F.,
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This study was presented as an oral presentation at CHEST 2012, October 20-25, 2012, Atlanta, GA.
FUNDING/SUPPORT: This work was supported primarily by the National Key Scientific and Technology Support Program: Collaborative Innovation of Clinical Research for Chronic Obstructive Pulmonary Disease and Lung Cancer [2013BAI09B09]. Dr She was supported by the National Natural Science Foundation for Young Scholars of China [81200051]; the Research Fund for the Doctoral Program of Higher Education of China [20110071120060]; the Science Foundation for Young Scholars in Zhongshan Hospital [2012ZSQN04]; and the Scientific Project for Fudan University [20520133474].
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