Waterpipe smoking and dependence are associated with chronic bronchitis: a case–control study in Lebanon

Waterpipe smoking and its association with chronic bronchitis has not been assessed in Lebanon. This case–control study in Beirut in 2009/2010 evaluated this relationship: 274 cases of chronic bronchitis and 559 controls without the condition aged ≥ 40 years were enrolled. Data were collected by questionnaire on: sociodemographic characteristics, respiratory symptoms, smoking (waterpipe and cigarette) and nicotine dependence. ANOVA, Student, Kruskal–Wallis, chi-squared and Fisher exact tests were used when applicable and logistic regression analysis was carried out. Previous waterpipe smoking (OR = 6.4), previous mixed smoking (OR = 38.03) and current mixed smoking (OR = 7.68) were significantly associated with chronic bronchitis (P 0.001 for all) but current exclusive waterpipe smoking was not (OR = 1.87, 95% CI: 0.74–4.72). Current waterpipe dependence was significantly associated with chronic bronchitis (OR = 3.74, P 0.001). After adjustment for covariates/confounders, ever waterpipe smoking 20 WP-years (P 0.001) was significantly associated with chronic bronchitis.