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Meta-Analysis
. 2024 Jan;14(1):e3357.
doi: 10.1002/brb3.3357.

Water pipe smoking and stroke: A systematic review and meta-analysis

Mehrdad Bagherpour-Kalo  1 , Michael E Jones  2 , Parvaneh Darabi  3 , Mostafa Hosseini  1
Affiliations
Meta-Analysis

Water pipe smoking and stroke: A systematic review and meta-analysis

Mehrdad Bagherpour-Kalo et al. Brain Behav. 2024 Jan.

Abstract

Objective: Despite the damaging effects of water pipe on physical health, there is little information about the potential harmful effects of this tobacco on stroke. This study aims to investigate the relationship between water pipe smoking and stroke.

Method: A systematic review was conducted including Ovid SP, Embase, Pubmed, Web of Science, Scopus, and Google Scholar databases with focus on cohort, case-control, and cross-sectional studies. We reviewed all studies reporting on water pipe smoking and stroke. The funnel plot and the Egger regression test were used to assess publication bias.

Results: In the four eligible studies, there were a total of 2759 participants that 555 patients had at least once experienced stroke. Meta-analysis revealed positive association between water pipe smoking and stroke with pooled adjusted OR 2.79 (95% CI: 1.74-3.84; I 2 = 0 , p = . 741 ${I^2}\; = \;\;0,{\mathrm{\;}}p\;\; = {\mathrm{\;\;}}.741$ ) and the funnel plot shows asymmetry publication bias.

Conclusions: We found a higher effect of water pipe smoking on stroke compared to cigarette smoking and concluded that water pipe increases the risk of stroke by 2.79. Hence, because most of the water pipe consumer society is young, especially women, policies and decisions need to be taken to control the supply of this tobacco to the market and more provide education on the health problem of water pipe smoking.

Implications: This study provides a higher effect of water pipe smoking on stroke. Physicians and researchers who intend to study in the field of stroke should better examine the effects of water pipe (including time of use, dose-response, long-term effects, and risk factors) on stroke.

Keywords: hookah; meta-analysis; stroke; systematic review; water pipe.

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Conflict of interest statement

All authors declare there are no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart for selected eligible studies included in the meta‐analysis.
FIGURE 2
FIGURE 2
Forest plot of the adjusted relationship between stroke and water pipe smoking.
FIGURE 3
FIGURE 3
Funnel plot for eligible studies include in meta‐analysis.
See this image and copyright information in PMC

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