Spirometric profile of narghile smokers

Rev Mal Respir. 2011 Sep;28(7):e39-51. doi: 10.1016/j.rmr.2008.10.001. Epub 2011 Jul 26.


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.

MeSH terms

  • Adult
  • Aging
  • Airway Obstruction / etiology
  • Airway Obstruction / physiopathology*
  • Body Mass Index
  • Cross-Sectional Studies
  • Equipment Design
  • Humans
  • Lung / pathology
  • Lung / physiopathology
  • Lung Volume Measurements
  • Male
  • Middle Aged
  • Nebulizers and Vaporizers*
  • Respiratory Function Tests
  • Smoke / analysis
  • Smoking / adverse effects
  • Smoking / physiopathology*
  • Smoking / trends
  • Spirometry*
  • Surveys and Questionnaires
  • Tobacco / chemistry
  • Tunisia
  • Young Adult


  • Smoke