水烟烟草吸烟和癌症死亡的风险

在全球范围内，使用非甲状腺素产品，包括水烟烟草（WTP），趋势越来越多。 While cigarette smoking is a well-established risk factor for numerous cancers, little is known about the association between WTP smoking and cancer mortality.To assess the association between WTP smoking and risk of cancer mortality in Vietnam.This cohort study was based on data from the Hanoi Prospective Cohort Study, an ongoing study with a median (range) follow-up of 11.0 (0.1-11.6) years for participants aged 15 years or older in Northern越南从2007年到2019年。从2023年6月1日至9月1日分析了数据。吸烟和WTP吸烟状态。遍及现场特定的癌症死亡率。 COX比例回归模型用于计算危险比（HR）和95％CI，仅WTP吸烟，单独吸烟，双WTP和吸烟双重吸烟与癌症死亡的风险以及39401研究参与者中的554例癌症死亡的风险（平均年龄[SD]年龄在40.4.4 [18. 18.8]中， [52.3％]）。在多变量模型中，与永不吸烟者相比，吸烟者的癌症死亡风险显着增加（HR，1.87; 95％CI，1.48-2.35）。与从未吸烟者相比，独家WTP吸烟者的癌症死亡率风险最高（HR，2.66; 95％CI，2.07-3.43）。 WTP和香烟双吸烟者（HR，2.06; 95％CI，1.53-2.76）的癌症死亡率高于专属吸烟者（HR，1.86; 95％CI，1.41-2.45）。由于大多数吸烟者（95.6％[9312的8897]）是男性，因此在男性参与者中，这些模式更为明显。 Compared with never smokers, exclusive WTP smoking among males was associated with an elevated risk of death from liver cancer (HR, 3.92; 95% CI, 2.25-6.85), lung cancer (HR, 3.49; 95% CI, 2.08-5.88), nasopharyngeal carcinoma (HR, 2.79; 95% CI, 1.27-6.12), and stomach cancer （HR，4.11; 95％CI，2.04-8.27）。对于独家WTP吸烟者，在每天吸烟11至15次疗程的人中，癌症死亡率的风险最高（HR，3.42; 95％CI，2.03-5.75），在26至30岁时开始吸烟（HR，4.01; 95％CI； 95％CI，2.63-6.11），吸烟9至20年，HR，HR，4.05％和95％和75％和75％和7％和7％，和75％和7％，和75％和7％，;每年吸烟61至160个会议（HR，3.68; 95％CI，2.38-5.71）。对于男性而言，与那些在1年内戒烟超过10年的人患癌症死亡的风险较低（HR，0.27; 95％CI，0.11-0.66; p的趋势; p的趋势<.001 p <.001）。在越南的这一同类研究中，越南，与wtp吸烟或与吸烟的癌症相关，与Lunger癌症相关，与Lunger癌症相关。鼻咽癌和胃癌。在越南和中低收入国家中，有必要为控制WTP吸烟的量身定制计划，其吸烟和适度的资源流行率很高，以解决与吸烟有关的问题。

There has been an increasing trend of using noncigarette products, including waterpipe tobacco (WTP), worldwide. While cigarette smoking is a well-established risk factor for numerous cancers, little is known about the association between WTP smoking and cancer mortality.To assess the association between WTP smoking and risk of cancer mortality in Vietnam.This cohort study was based on data from the Hanoi Prospective Cohort Study, an ongoing study with a median (range) follow-up of 11.0 (0.1-11.6) years for participants aged 15 years or older in Northern Vietnam from 2007 through 2019. Data were analyzed from June 1 to September 1, 2023.Tobacco smoking and WTP smoking statuses.Overall and site-specific cancer mortality. Cox proportional regression models were used to calculate the hazard ratio (HR) and 95% CIs for the associations between WTP smoking alone, cigarette smoking alone, and dual WTP and cigarette smoking and the risk of cancer death.A total of 554 cancer deaths were identified among the 39 401 study participants (mean [SD] age, 40.4 [18.8] years; 20 616 females [52.3%]). In multivariable models, compared with never smokers, ever smokers had a significantly increased risk of cancer mortality (HR, 1.87; 95% CI, 1.48-2.35). Exclusive WTP smokers had the highest risk of cancer mortality compared with never smokers (HR, 2.66; 95% CI, 2.07-3.43). Risk of cancer mortality was higher for dual smokers of WTP and cigarettes (HR, 2.06; 95% CI, 1.53-2.76) than for exclusive cigarette smokers (HR, 1.86; 95% CI, 1.41-2.45). As most smokers (95.6% [8897 of 9312]) were male, these patterns were more apparent in male participants. Compared with never smokers, exclusive WTP smoking among males was associated with an elevated risk of death from liver cancer (HR, 3.92; 95% CI, 2.25-6.85), lung cancer (HR, 3.49; 95% CI, 2.08-5.88), nasopharyngeal carcinoma (HR, 2.79; 95% CI, 1.27-6.12), and stomach cancer (HR, 4.11; 95% CI, 2.04-8.27). For exclusive WTP smokers, the risk of cancer mortality was highest among those who smoked 11 to 15 sessions per day (HR, 3.42; 95% CI, 2.03-5.75), started smoking at age 26 to 30 years (HR, 4.01; 95% CI, 2.63-6.11), smoked for 9 to 20 years (HR, 4.04; 95% CI, 2.16-7.56), and smoked 61 to 160 sessions annually (HR, 3.68; 95% CI, 2.38-5.71). For males, the risk of cancer death was lower for those who had quit smoking for more than 10 years, compared with those who quit smoking within 1 year (HR, 0.27; 95% CI, 0.11-0.66; P for trend < .001).In this cohort study in Vietnam, WTP smoking alone or in combination with cigarette smoking was associated with an increased risk of cancer death due to liver cancer, lung cancer, nasopharyngeal carcinoma, and stomach cancer. A tailored program to control WTP smoking is warranted in Vietnam and low- and middle-income countries with a high prevalence of smoking and modest resources to address smoking-related issues.