TY - JOUR T1 - Waterpipe smoking and dependence are associated with chronic obstructive pulmonary disease: A case control study JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - 4695 AU - Georges Khayat AU - Pascale Salameh AU - Mirna Waked AU - Michele Dramaix Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/4695.abstract N2 - Waterpipe (WP) smoking is gaining in popularity in the Lebanese population. Although WP smokers are potentially exposed to the same noxious substances found in cigarettes, popular belief considers WP smoking harmless. Our objective was to evaluate the association between WP smoking, dependence and COPD.We conducted a case-control study in two tertiary care hospitals. Cases were included if diagnosed as COPD by a chest physician and confirmed by a post-bronchodilator spirometry (FEV1/FVC<0.7); controls were included if free of any respiratory disease or symptom. After an oral informed consent, a standardized questionnaire was administered and spirometry results were collected by trained technicians.211 COPD cases and 554 healthy controls were enrolled. In previous smokers, any type of smoking was associated with COPD: OR=28.3 (p<0.001) for cigarette smoking, OR=12.2 (p<0.001) for waterpipe smoking, and OR=41.9 (p<0.001) for mixed smoking. Lower odds ratios were found in current smokers: OR =19.6 (p<0.001) for cigarette smoking, OR=1.8 (p=0.299) for waterpipe smoking and OR=9.5 (p<0.001) for mixed smoking. However, assessing WP dependence by the validated LWDS-11 scale in current WP smokers, found an OR=15.0 (p=0.001) for the association between WP dependence and COPD. These results were confirmed by stratified and multivariate analysis, after adjustment for cigarette smoking and other potential confounding variables.This is the first study that looked at the relation between COPD and WP smoking, and that showed a high risk of COPD in ex-smokers of WP. In current smokers of WP, dependent individuals have an increasing risk of COPD, as much as cigarette smokers. ER -