ABSTRACT
INTRODUCTION: Studies of the spirometric profiles of narghile smokers are few, have some methodological limits (i.e. small sample size), and present contradictory conclusions. AIMS: (i) To determine the percentage of narghile smokers with obstructive ventilatory defect (OVD) and/or restrictive ventilatory defect (RVD) or static hyperinflation (SHI); (ii) to compare the chronological and estimated lung ages. INCLUSION CRITERIA: men aged 20 to 60 years, narghile smokers (>1 narghile-year [NY]). EXCLUSION CRITERIA: cigar or cigarette smokers and comorbidity. Narghile use quantification: NY and kg of cumulative tobacco use (1 NY=9.125 kg of cumulative tobacco use). DEFINITIONS: Large airway obstructive ventilatory defect (OVD): forced expired volume in one second (FEV(1))/forced vital capacity (FVC) less than lower limit of normal (LLN). Small airway OVD: FVC more than LLN and decrease (less than LLN) of one or more peripheral flows. RVD: total lung capacity (TLC) less than LLN. SHI: residual volume (RV) more than upper limit of normal. SPIROMETRIC MEASURES: (Vmax 22 Series/6200 Autobox, SensorMedics, Yorba Linda, California, USA with measurement of functional residual capacity by nitrogen washout). Measurements were made according to international recommendations. RESULTS: One hundred and ten narghile smokers were included (34±10 years; 1.76±0.07m; 84±14kg). Thirty-six percent of the subjects had SHI; 14% had small airway OVD; 14% had RVD, and 6% had large airway OVD. Estimated lung age was higher than chronological lung age (47±18 years vs. 34±10 years, P<0.05). CONCLUSION: Narghile use accelerates lung ageing. This study provides the health authorities with valid arguments to fight this blight on society, which increasingly involves children and pregnant women.