Environmental Science and Pollution Research

, Volume 26, Issue 30, pp 31546–31547 | Cite as

Blood lipids and pressures data of exclusive narghile smokers compared with healthy non-smokers: studies from thin to thick

  • Helmi BEN SAADEmail author
Letter to the Editor

Dear Editor,

I read with great interest the recent paper of Hallit et al. (2019) highlighting the damaging effects of narghile-use on some cardiovascular risk factors [e.g., total cholesterol (TC), low- and high- density lipoprotein cholesterol (LDL-C, HDL-C, respectively)]. Hallit et al. (2019) study is interesting because disregarding the critical effects of narghile-use on blood lipids and pressures data will surely lead to a worldwide public health problem, which physicians can undertake to prevent (Ben Saad 2009; Ben Saad 2010; Hasni et al. 2019; WHO 2015). Moreover, according to the 2015 World Health Organization advisory note on narghile-use (WHO 2015), further research related to the narghile-associated disease risk was recommended. However, three important points should be highlighted.

First, Hallit et al. (2019) omitted to identify the type of used-narghile tobacco (moassel and/or jurak and/or tombak). The lack of this important information makes between-studies comparisons...


Tobacco Hookah Biochemistry Clinical significance 


Compliance with ethical standards

Competing interests

I report personal fees from AstraZeneca, Saiph, Teriak, and Chiesi.


  1. Al Mutairi SS, Shihab-Eldeen AA, Mojiminiyi OA, Anwar AA (2006) Comparative analysis of the effects of hubble-bubble (Sheesha) and cigarette smoking on respiratory and metabolic parameters in hubble-bubble and cigarette smokers. Respirology 11:449–455CrossRefGoogle Scholar
  2. Alsoufi B (2018) Statistical versus clinical significance. J Thorac Cardiovasc Surg 155:344–345CrossRefGoogle Scholar
  3. Ben Hadj Mohamed G, Ben Saad H (2016) Handicap status of exclusive narghile smokers compared to exclusive cigarette smokers: a case control-study. Egypt J Chest Dis Tuberc 65:397–403CrossRefGoogle Scholar
  4. Ben Saad H (2009) The narghile and its effects on health. Part I: the narghile, general description and properties. Rev Pneumol Clin 65:369–375CrossRefGoogle Scholar
  5. Ben Saad H (2010) The narghile and its effects on health. Part II: the effects of the narghile on health. Rev Pneumol Clin 66:132–144CrossRefGoogle Scholar
  6. Ben Saad H, Babba M, Boukamcha R, Ghannouchi I, Latiri I, Mezghenni S, Zedini C, Rouatbi S (2014) Investigation of exclusive narghile smokers: deficiency and incapacity measured by spirometry and 6-minute walk test. Respir Care 59:1696–1709CrossRefGoogle Scholar
  7. De Oliveira E Silva ER, Foster D, McGee Harper M, Seidman CE, Smith JD, Breslow JL, Brinton EA (2000) Alcohol consumption raises HDL cholesterol levels by increasing the transport rate of apolipoproteins A-I and A-II. Circulation 102:2347–2352Google Scholar
  8. Hallit S, Hallit R, Haddad C, Youssef L, Zoghbi M, Costantine R, Kheir N, Salameh P (2019) Previous, current, and cumulative dose effect of waterpipe smoking on LDL and total cholesterol. Sci Pollut Res Int 26:8194–8201CrossRefGoogle Scholar
  9. Hasni Y, Bachrouch S, Mahjoub M, Maaroufi A, Rouatbi S, Ben Saad H (2019) Biochemical data and metabolic profiles of male exclusive narghile smokers (ENSs) compared with apparently healthy nonsmokers (AHNSs). Am J Mens Health 13:1557988319825754. CrossRefGoogle Scholar
  10. Koubaa A, Triki M, Trabelsi H, Baati H, Sahnoun Z, Hakim A (2015) The effect of a 12-week moderate intensity interval training program on the antioxidant defense capability and lipid profile in men smoking cigarettes or hookah: a cohort study. ScientificWorldJournal 2015:639369CrossRefGoogle Scholar
  11. Saffar Soflaei S, Darroudi S, Tayefi M, Nosrati Tirkani A, Moohebati M, Ebrahimi M, Esmaily H, Parizadeh SMR, Heidari-Bakavoli AR, Ferns GA, Ghayour-Mobarhan M (2018) Hookah smoking is strongly associated with diabetes mellitus, metabolic syndrome and obesity: a population-based study. Diabetol Metab Syndr 10:33CrossRefGoogle Scholar
  12. Schober P, Bossers SM, Schwarte LA (2018) Statistical significance versus clinical importance of observed effect sizes: what do p values and confidence intervals really represent? Anesth Analg 126:1068–1072CrossRefGoogle Scholar
  13. Shafique K, Mirza SS, Mughal MK, Arain ZI, Khan NA, Tareen MF, Ahmad I (2012) Water-pipe smoking and metabolic syndrome: a population-based study. PLoS One 7:e39734CrossRefGoogle Scholar
  14. Sun K, Ren M, Liu D, Wang C, Yang C, Yan L (2014) Alcohol consumption and risk of metabolic syndrome: a meta-analysis of prospective studies. Clin Nutr 33:596–602CrossRefGoogle Scholar
  15. World Health Organisation (2015) Advisory note: waterpipe tobacco smoking: 2nd edition Health effects, research needs and recommended actions for regulators. Available from: (Last visit: May 12th 2019)
  16. Yaddanapudi LN (2016) The American Statistical Association statement on P-values explained. J Anaesthesiol Clin Pharmacol 32:421–423CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Laboratory of Physiology, Faculty of Medicine of SousseUniversity of SousseSousseTunisia
  2. 2.Heart Failure (LR12SP09) Research LaboratoryFarhat HACHED HospitalSousseTunisia

Personalised recommendations