Abstract：
OBJECTIVE: This study investigated the association between lung cancer and waterpipe smoking, which is an emerging global public health concern.
METHODS: Multicentre case-control study.
METHODS: This study included 627 cases and 3477 controls from the Iranian Study of Opium and Cancer (IROPICAN) study, which was conducted between 2017 and 2020. One frequency-matched control for each lung cancer patient was selected by age, gender and residential place; however, this study used controls of four cancer types in the analyses. The multivariable logistic regression model estimated the odds ratio (OR) and 95% confidence intervals (CIs). Additional analyses were performed among 181 lung cancer cases and 2141 controls who were not cigarette smokers or opium or nass/pipe users.
RESULTS: The odds of lung cancer were higher among waterpipe smokers than never-smokers (OR = 1.3, 95% CI: 1.0-1.7). Results showed a higher OR of lung cancer for those who smoked the waterpipe daily (OR = 2.1, 95% CI: 1.4-3.0), smoked more than two heads per day (OR = 2.7, 95% CI: 1.8-4.0), had smoked for >20 years (OR = 1.9, 95% CI: 1.3-2.7), smoked more than 20 head-years (OR = 2.8, 95% CI: 1.9-4.1) and initiated smoking before the age of 30 years (OR = 1.7, 95% CI: 1.1-2.5). The association was only statistically significant for squamous cell carcinomas (OR = 1.8, 95% CI 1.2-2.7). Furthermore, this study observed a higher OR of lung cancer among exclusive waterpipe smokers (OR = 2.3, 95% CI: 1.6, 3.5).
CONCLUSIONS: Waterpipe smoking was associated with an increased risk of lung cancer. The association was stronger with higher frequency, duration and intensity of exposure to waterpipe smoking. The association increases in exclusive waterpipe smokers, which is likely due to controlling for residual confounding by cigarette smoking and opium consumption, and higher exposure levels in this subpopulation.
METHODS: Multicentre case-control study.
METHODS: This study included 627 cases and 3477 controls from the Iranian Study of Opium and Cancer (IROPICAN) study, which was conducted between 2017 and 2020. One frequency-matched control for each lung cancer patient was selected by age, gender and residential place; however, this study used controls of four cancer types in the analyses. The multivariable logistic regression model estimated the odds ratio (OR) and 95% confidence intervals (CIs). Additional analyses were performed among 181 lung cancer cases and 2141 controls who were not cigarette smokers or opium or nass/pipe users.
RESULTS: The odds of lung cancer were higher among waterpipe smokers than never-smokers (OR = 1.3, 95% CI: 1.0-1.7). Results showed a higher OR of lung cancer for those who smoked the waterpipe daily (OR = 2.1, 95% CI: 1.4-3.0), smoked more than two heads per day (OR = 2.7, 95% CI: 1.8-4.0), had smoked for >20 years (OR = 1.9, 95% CI: 1.3-2.7), smoked more than 20 head-years (OR = 2.8, 95% CI: 1.9-4.1) and initiated smoking before the age of 30 years (OR = 1.7, 95% CI: 1.1-2.5). The association was only statistically significant for squamous cell carcinomas (OR = 1.8, 95% CI 1.2-2.7). Furthermore, this study observed a higher OR of lung cancer among exclusive waterpipe smokers (OR = 2.3, 95% CI: 1.6, 3.5).
CONCLUSIONS: Waterpipe smoking was associated with an increased risk of lung cancer. The association was stronger with higher frequency, duration and intensity of exposure to waterpipe smoking. The association increases in exclusive waterpipe smokers, which is likely due to controlling for residual confounding by cigarette smoking and opium consumption, and higher exposure levels in this subpopulation.
摘要：
目的：这项研究调查了肺癌与水烟之间的关系，这是一个新兴的全球公共卫生问题。
方法：多中心病例对照研究。
方法：这项研究包括来自伊朗鸦片和癌症研究（IROPICAN）研究的627例病例和3477例对照，这是在2017年至2020年之间进行的。每个肺癌患者按年龄选择一个频率匹配的对照，性别和居住地；然而，这项研究在分析中使用了四种癌症类型的对照.多变量逻辑回归模型估计了比值比（OR）和95％置信区间（CI）。对181例肺癌病例和2141例非吸烟者或鸦片或烟斗使用者的对照进行了其他分析。
结果：吸烟者患肺癌的几率高于不吸烟者（OR=1.3，95%CI：1.0-1.7）。结果显示，每天吸烟的人肺癌的OR较高（OR=2.1，95％CI：1.4-3.0），每天吸烟超过两个头（OR=2.7，95%CI：1.8-4.0），吸烟时间>20年(OR=1.9，95%CI：1.3-2.7)，吸烟超过20年头(OR=2.8,95%CI:1.9-4.1),并在30岁前开始吸烟(OR=1.7,95%CI:1.1-2.5).鳞状细胞癌的相关性仅具有统计学意义（OR=1.8，95％CI1.2-2.7）。此外，这项研究观察到,在完全使用水烟的吸烟者中,肺癌的OR较高(OR=2.3,95%CI:1.6,3.5).
结论：吸烟与肺癌风险增加相关。这种关联更强，频率更高，暴露于水烟的持续时间和强度。专属水烟吸烟者的协会增加，这可能是由于吸烟和鸦片消费控制了残留的混杂因素，和更高的暴露水平在这个亚群。
方法：多中心病例对照研究。
方法：这项研究包括来自伊朗鸦片和癌症研究（IROPICAN）研究的627例病例和3477例对照，这是在2017年至2020年之间进行的。每个肺癌患者按年龄选择一个频率匹配的对照，性别和居住地；然而，这项研究在分析中使用了四种癌症类型的对照.多变量逻辑回归模型估计了比值比（OR）和95％置信区间（CI）。对181例肺癌病例和2141例非吸烟者或鸦片或烟斗使用者的对照进行了其他分析。
结果：吸烟者患肺癌的几率高于不吸烟者（OR=1.3，95%CI：1.0-1.7）。结果显示，每天吸烟的人肺癌的OR较高（OR=2.1，95％CI：1.4-3.0），每天吸烟超过两个头（OR=2.7，95%CI：1.8-4.0），吸烟时间>20年(OR=1.9，95%CI：1.3-2.7)，吸烟超过20年头(OR=2.8,95%CI:1.9-4.1),并在30岁前开始吸烟(OR=1.7,95%CI:1.1-2.5).鳞状细胞癌的相关性仅具有统计学意义（OR=1.8，95％CI1.2-2.7）。此外，这项研究观察到,在完全使用水烟的吸烟者中,肺癌的OR较高(OR=2.3,95%CI:1.6,3.5).
结论：吸烟与肺癌风险增加相关。这种关联更强，频率更高，暴露于水烟的持续时间和强度。专属水烟吸烟者的协会增加，这可能是由于吸烟和鸦片消费控制了残留的混杂因素，和更高的暴露水平在这个亚群。
