Homoud Mazen M, Qoutah Rowaida, Krishna Gokul, Harbli Noran, Saaty Layan, Obaidan Afrah, Alkhathami Abdulrahman, Jamil Noran, Alkayyat Tala M, Alsughayyir Maryam, Gubari Nada, Alkhathami Saleh, Alqarni Ali, Alqurashi Omar, Assiri Khalid, Alwadeai Khalid Saeed, Abdulrahman Wafaa, Alahmadi Husam, Alahmari Ayedh
Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Respiratory Therapy, Batterjee Medical College, Jeddah, Saudi Arabia.
Tob Induc Dis. 2025 May 10;23. doi: 10.18332/tid/202350. eCollection 2025.
Globally, over 1 billion people smoke, resulting in approximately 8 million deaths each year. Although the health risks associated with traditional cigarettes are extensively documented, there is an increasing need to evaluate the long-term effects of alternative tobacco products, particularly shisha, and e-cigarettes. This study seeks to compare the respiratory, hematological, and inflammatory profiles of long-term users of cigarettes, shisha, and e-cigarettes in Saudi Arabia.
A cross-sectional, observational study was conducted at the Respiratory Therapy laboratories of Batterjee Medical College (BMC), Jeddah, Saudi Arabia, between February 2022 and August 2023. It involved four groups: cigarette smokers, shisha smokers, e-cigarette users, and non-smokers. Pulmonary function tests (PFTs) measured FEV, FVC, and other lung function parameters. Hematological profiles, including WBC, neutrophils, lymphocytes, monocytes, and C-reactive protein (CRP) levels, were assessed.
Cigarette and shisha users demonstrated significantly reduced FEV (cigarettes: 3.11 ± 0.54 L/s, shisha: 3.26 ± 0.71 L/s; p≤0.0001), FEV (% predicted: 81.63 ± 12.11 for cigarettes, 88.09 ± 12.92 for shisha; p≤0.0001), and FVC (3.87 ± 0.68 L for cigarettes, 3.95 ± 0.880 L for shisha; p=0.004), compared to non-smokers and e-cigarette users. Cigarette smokers exhibited significantly elevated WBC (7.92 ± 2.84 ×10/L; p≤0.001), neutrophil (4.03 ± 2.29 ×10/L), lymphocyte (2.95 ± 0.95 ×10/L), and monocyte counts (0.67 ± 0.21 ×10/L) compared to non-smokers, shisha, and e-cigarette users (p≤0.0001). Cigarette smokers and shisha smokers presented different lung function results but similar inflammatory profiles. However, e-cigarette users demonstrated comparatively higher lung function and lower inflammatory markers compared to both cigarette and shisha users.
Compared to non-smokers, long-term cigarette and shisha smoking is associated with airway obstructive changes and increased inflammatory responses. Although e-cigarette users demonstrated lower inflammatory markers and less deviation from normal PFT, some exhibited borderline values with airway obstruction. Further research is needed to clarify the long-term health consequences of e-cigarette use.
在全球范围内，超过10亿人吸烟，每年导致约800万人死亡。尽管与传统香烟相关的健康风险已有大量记录，但越来越有必要评估替代烟草产品，特别是水烟和电子烟的长期影响。本研究旨在比较沙特阿拉伯长期使用香烟、水烟和电子烟者的呼吸、血液学和炎症指标。
2022年2月至2023年8月，在沙特阿拉伯吉达市巴特吉医学院（BMC）的呼吸治疗实验室进行了一项横断面观察性研究。研究包括四组：吸烟者、水烟吸烟者、电子烟使用者和非吸烟者。通过肺功能测试（PFT）测量第一秒用力呼气容积（FEV）、用力肺活量（FVC）和其他肺功能参数。评估血液学指标，包括白细胞（WBC）、中性粒细胞、淋巴细胞、单核细胞和C反应蛋白（CRP）水平。
与非吸烟者和电子烟使用者相比，香烟和水烟使用者的FEV（香烟：3.11±0.54L/s，水烟：3.26±0.71L/s；p≤0.0001）、FEV（预测值百分比：香烟为81.63±12.11，水烟为88.09±12.92；p≤0.0001）和FVC（香烟为3.87±0.68L，水烟为3.95±0.880L；p=0.004）显著降低。与非吸烟者、水烟使用者和电子烟使用者相比，吸烟者的白细胞（7.92±2.84×10⁹/L；p≤0.001）、中性粒细胞（4.03±2.29×10⁹/L）、淋巴细胞（2.95±0.95×10⁹/L）和单核细胞计数（0.67±0.21×10⁹/L）显著升高（p≤0.0001）。吸烟者和水烟吸烟者的肺功能结果不同，但炎症指标相似。然而，与香烟和水烟使用者相比，电子烟使用者的肺功能相对较高，炎症标志物较低。
与非吸烟者相比，长期吸烟和吸水烟与气道阻塞性改变和炎症反应增加有关。尽管电子烟使用者的炎症标志物较低，肺功能测试与正常水平的偏差较小，但一些人仍表现出气道阻塞的临界值。需要进一步研究以阐明使用电子烟的长期健康后果。
