Waterpipe smoking among women tied to GERD
There appears to be an association between waterpipe tobacco smoking and gastro-oesophageal reflux disease (GERD), which is a known risk factor for oesophageal adenocarcinoma, a study has shown.
Researchers analysed baseline lifestyle data (eg, duration and frequency of tobacco use) of 9,264 individuals aged between 40 and 75 years who participated in the Pars Cohort Study conducted in southern Iran.
Of the patients, 25.4 percent had severe GERD that interfered with routine activities, 25.1 percent had frequent GERD (at least once a week) and 11.2 percent had both severe and frequent GERD, all of which were more common among women (p<0.001).
Multivariable logistic regression analysis found that among individuals not taking medication for their reflux symptoms, waterpipe smoking was associated with severe GERD (odds ratio [OR], 1.18; 95 percent CI, 1.04 to 1.35), frequent GERD (OR, 1.16; 1.02 to 1.32) and severe and frequent GERD (OR, 1.30; 1.08 to 1.56). The magnitude of the reported associations increased with duration of waterpipe use, intensity and cumulative waterpipe-years. The OR for severe and frequent GERD was 1.44 (1.12 to 1.86) in those who had smoked more than 48 waterpipe-years.
An effect modification by sex was observed, and all the associations were only seen among women.
In the cohort, waterpipe smoking was reported in 45.6 percent of women and 28.3 percent of men. GERD was defined based on questions evaluating heartburn and regurgitation in the past 12 months, frequency and severity.
Researchers pointed out that the association between smoking and GERD symptoms may involve several mechanisms. First is that smoking can reduce the pressure of the lower oesophageal sphincter, thus allowing the gastric contents into the oesophagus. The other entails the effects of tobacco on diminishing the salivary bicarbonate secretion, which plays an important role in gastric acid neutralization.
Given the growing prevalence of waterpipe smoking in many populations, the present data can inform public health and policy making, researchers said.