Waterpipe smoking and dependence are associated with chronic bronchitis: a case-control study in Lebanon

Abstract

Waterpipe smoking and its association with chronic bronchitis has not been assessed in Lebanon. This case-control study in Beirut in 2009/2010 evaluated this relationship: 274 cases of chronic bronchitis and 559 controls without the condition aged >/=40 years were enrolled. Data were collected by questionnaire on: sociodemographic characteristics, respiratory symptoms, smoking [‎waterpipe and cigarette]‎ and nicotine dependence. ANOVA, Student, Kruskal-Wallis, chi-squared and Fisher exact tests were used when applicable and logistic regression analysis was carried out. Previous waterpipe smoking [‎OR = 6.4]‎, previous mixed smoking [‎OR = 38.03]‎ and current mixed smoking [‎OR = 7.68]‎ were significantly associated with chronic bronchitis [‎P < 0.001 for all]‎ but current exclusive waterpipe smoking was not [‎OR = 1.87, 95% CI: 0.74-4.72]‎. Current waterpipe dependence was significantly associated with chronic bronchitis [‎OR = 3.74, P < 0.001]‎. After adjustment for covariates/confounders, ever waterpipe smoking > 20 WP-years [‎P < 0.001]‎ was significantly associated with chronic bronchitis