Waterpipe effects on pulmonary function and cardiovascular indices: a comparison to cigarette smoking in real life situation

Introduction: Smoking is known to have physiological effects on biological systems. The purpose of this study is to evaluate acute and chronic effects on pulmonary functions and cardiovascular indices of waterpipe (WP) smoking in real life circumstances.Methods: Three groups were included in the study: non-smokers (N = 42), WP smokers (N = 42) and cigarette smokers (N = 48). A questionnaire was completed for each participant, in addition to pulmonary function [forced expiratory volume at 1 s (FEV1), 6 s (FEV6), percentage of FEV1/FEV6], and cardiovascular [diastolic blood pressure (DBP), systolic blood pressure (SBP) and heart rate (HR)] measures, taken before and after smoking.Results: Mean values of FEV1, FEV6, FEV1/FEV6, DBP and SBP in WP and cigarette smokers were very close. However, WP smoking significantly increased HR compared to cigarette smokers (p = 0.007); duration of smoking, age at first WP and quantity of smoking affected pulmonary function and cardiovascular values. In the subgroup of WP smokers, DBP was acutely increased by a larger WP size (p = 0.011), while the FEV6 was acutely increased by a smaller WP size (p = 0.045).Conclusion: WP smoking affected the cardiovascular system more than cigarette smoking, while it had similar effects on pulmonary function.