COPD: Risk from Chinese WaterPipe Smoking

Chunxue Bai, MD & PhD Director, Shanghai Respiratory Research Institute Professor of Medicine, Chairman, Shanghai Leading academic discipline Chair, Chinese Alliance against Lung Cancer Vice President of Respiratory Society, Chinese Medical Association Editor-in-Chief, Translational Respiratory Medicine (Springer) Editor-in-Chief, International journal of Respiration (China) Editor-in-Chief, Perspectives of Respiratory Medicine (China)MedicalResearch.com Interview with:
Chunxue Bai, MD & PhD
Director, Shanghai Respiratory Research Institute
Professor of Medicine, Chairman, Shanghai Leading academic discipline
Chair, Chinese Alliance against Lung Cancer

MedicalResearch.com: What are the main findings of the study?

Dr. Bai: Recently, we found a dilemma phenomenon that the incidence of chronic obstructive pulmonary disease (COPD) and lung cancer has remained high in southwest China despite the 1976 National Stove Improvement Program for indoor air quality.

However, little information is known to the public about a regional endemic related to Chinese waterpipe smoking, which is different from the Arabic waterpipe. The Chinese waterpipe has been traditionally misconceived as less harmful for three reasons:

  • (1) no charcoal was used in contrast to the Arabic waterpipe,
  • (2) tobacco smoke passed through the water as opposed to cigarette smoking and
  • (3) smoking through a large volume waterpipe could “improve lung function.”

In our study, we provide robust results that the large volume Chinese waterpipe use and exposure are associated with the elevated prevalence of COPD, which have been identified by epidemiologic, physiologic, radiology, and toxicologic findings for the first time.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Bai: Noted is the five individuals in our study who were tested and confirmed as having lung cancer by computed tomography (CT) and pathology evaluations:

  • 3 CWS (lung adenocarcinoma)
  • 1 CWPS (lung adenocarcinoma) and
  • 1 CS (lung squamous cell carcinoma). It will cause our attention and strengthen the monitoring of lung cancer.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Bai: The Chinese waterpipe has been mistaken as less harmful. Our study has provided evidence confirming this misconception. Exposure to active and passive Chinese waterpipe smoke may be a significant risk factor for developing COPD. The damage from Chinese waterpipe use and exposure are worse than cigarette. Our results highlight smoking cessation in Chinese waterpipe users is as important as in other tobacco products in preventive intervention of COPD.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Bai: In addition to Chinese waterpipe use and exposure are associated with COPD; the PM2.5 from the Chinese waterpipe smoke was twice as high as from cigarette smoke. Our results also predict the prevalence of COPD will be increased by long-term exposure to high concentrations of PM2.5, which will bring a huge economic and social burden to the globe and calls for more research to be directed toward preventive measures and efforts.

Citation:

Chinese waterpipe smoking and the risk of chronic obstructive pulmonary disease
She J, Yang P, Wang Y, et al.
Published online February 20, 2014.
doi:10.1378/chest.13-1499.

Chest. 2014. doi:10.1378/chest.13-1499