Pulmonary Abnormalities in Young, Light-Use Waterpipe (Hookah) Smokers

• DOI: 10.1164/rccm.201512-2470oc
• Publication Date: 2016-03-23T16:41:20Z
• Authors: Yael Strulovici-B...; Renat Shaykhiev; Jacqueline Salit; Ruba S. Deeb; Anja Krause; Robert J. Kaner; Thomas L. Vincent; Francisco Agosto-...; Guoqing Wang; Charleen Hollmann; Vignesh Shanmugam; Ahmad M. Almulla; Hisham Sattar; Mai Mahmoud; Jason G. Mezey; Steven S. Gross; Michelle R. Staudt; Matthew S. Walters; Ronald G. Crystal
• Keywords: Adult; Male; Carbon Monoxide; Nicotine; Smoking; Sputum; Epithelial Cells; Tobacco Use Disorder; Thorax; 3. Good health; Pulmonary Alveoli; 03 medical and health sciences; 0302 clinical medicine; Carboxyhemoglobin; Cough; Cell-Derived Microparticles; Case-Control Studies; Forced Expiratory Volume; Humans; Pulmonary Diffusing Capacity; Female; Cotinine; Lung

Waterpipes, also called hookahs, are currently used by millions of people worldwide. Despite the increasing use of waterpipe smoking, there is limited data on the health effects of waterpipe smoking and there are no federal regulations regarding its use.To assess the effects of waterpipe smoking on the human lung using clinical and biological parameters in young, light-use waterpipe smokers.We assessed young, light-use, waterpipe-only smokers in comparison with lifelong nonsmokers using clinical parameters of cough and sputum scores, lung function, and chest high-resolution computed tomography as well as biological parameters of lung epithelial lining fluid metabolome, small airway epithelial (SAE) cell differential and transcriptome, alveolar macrophage transcriptome, and plasma apoptotic endothelial cell microparticles.Compared with nonsmokers, waterpipe smokers had more cough and sputum as well as a lower lung diffusing capacity, abnormal epithelial lining fluid metabolome profile, increased proportions of SAE secretory and intermediate cells, reduced proportions of SAE ciliated and basal cells, markedly abnormal SAE and alveolar macrophage transcriptomes, and elevated levels of apoptotic endothelial cell microparticles.Young, light-use, waterpipe-only smokers have a variety of abnormalities in multiple lung-related biological and clinical parameters, suggesting that even limited waterpipe use has broad consequences on human lung biology and health. We suggest that large epidemiological studies should be initiated to investigate the harmful effects of waterpipe smoking.