A COMPARATIVE STUDY OF PLASMA FIBRINOGEN AMONG HOOKAH SMOKERS, CIGARETTE SMOKERS AND NON-SMOKERS

Abstract

Background- Although over the last decade smoking rates have decreased, hookahs seem to have proved increasingly popular in some eastern countries. It has been demonstrated that smoking increases the plasma fibrinogen level, which is an independent risk factor for cardiovascular disease. Our objective was to investigate the extent to which hookah smokers in comparison with cigarette smokers and non-smokers have their fibrinogen level increased.<br />Methods- In this comparative analytic study, 450 men aged 20-75 years old were emolled (150 hookah smokers, 150 cigarette smokers and 150 non-smokers). Two ml blood samples were taken, and fibrinogen was measured by the Clauss method. Data were analyzed by SPSS11 statistical package; X², ANOVA and (-tests were used for analysis.<br />Results- The difference in the mean fibrinogen level among the three groups was statistically significant by one-way ANOVA test (P<0.001).Mean difference was 53.21 for hookah smokers compared with non-smokers (t=8.2, P<0.01). It was 39.47 when hookah smokers were compared with cigarette smokers (t=7.24, P<0.01). In subjects aged less than 55 years, the proportion of people with fibrinogen level included in higher tertile to lower tertile was 2 for hookah smokers, 0.16 for cigarette smokers and 0.19 for nonsmokers.<br />In subjects aged 55 or more, this proportion was calculated to be 13 for hookah smokers, 3.5 for cigarette smokers and 0.33 for non-smokers; the difference was statistically significant. The difference for being included in low tertile or not was significant for both the hookah smokers and cigarette smokers when compared separately with non-smokers. It was found that higher tertile to lower tertile proportion was 24 in those who smoked hookahs more than three times a day and in those who had smoked hookahs for 10 years or more (P<0.001). In those who had smoked hookahs for less than 10 years or less than 3 times a day, the proportion was 1.47 compared to nonsmokers at 0.19.<br />Conclusion- Hookah smokers (especially, those smoking for more than 10 years) suffer a dramatic increase in their plasma fibrinogen in comparison with cigarette smokers and non-smokers