Quit the Hookah! Lung Damage, Inflammation Is Reversible with Smoking Cessation

Rockville, Md. (March 23, 2021)—New research finds that quitting smoking is an effective way to resolve impaired lung function and airway inflammation associated with waterpipe smoking. The study is published ahead of print in the American Journal of Physiology-Lung Cellular and Molecular Physiology.

“Our data provided biological plausibility for the beneficial impact of [smoking cessation] on lung physiology.”

Waterpipe smoking is a method of tobacco combustion that uses a single or multi-stemmed pipe—also called a hookah—to smoke tobacco that has first passed through water. This form of smoking is common in Eastern Mediterranean regions but is becoming increasingly popular among young people in Europe and North America. Studies have found a strong association between waterpipe smoking and chronic obstructive pulmonary disease (COPD)—and that quitting smoking (smoking cessation) can prevent the progression of COPD. Research has also shown that waterpipe smoking increases airway inflammation and cellular damage (oxidative stress) in the lungs. However, less is known about the positive effects of quitting hookah smoking on these factors.

In a new study, researchers studied mice that were exposed to daily periods of waterpipe smoke for either three or six months (“smoke-exposed”) or for three months followed by room air for another three months (“smoking cessation”). The smoke-exposed and smoking cessation groups were compared with a control group that breathed only room air for six months. The trial period was the rough equivalent of a person who smoked for 12 years, followed by 12 years without smoking.

The researchers found fewer inflammatory cells and less cell death in the lungs of the smoking cessation group than in either of the smoke-exposed groups. The animals that “quit smoking” also had a reversal of protein levels that, when high, trigger inflammation and oxidative stress. In addition, urine cotinine levels dropped in the smoking cessation group after three months without waterpipe smoke exposure. Cotinine is a metabolite of nicotine and is used as a marker for smoking status.

“Our data provided biological plausibility for the beneficial impact of [smoking cessation] on lung physiology. Further studies using long periods of [smoking cessation] … are warranted,” the research team wrote.

Read the full article, “Effect of smoking cessation on chronic waterpipe smoke inhalation-induced airway hyperresponsiveness, inflammation and oxidative stress,” published ahead of print in the American Journal of Physiology-Lung Cellular and Molecular Physiology..

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