ArticleTobacco control2017
Hazards of cigarettes, smokeless tobacco and waterpipe in a Middle Eastern Population: a Cohort Study of 50 000 individuals from Iran.
Article in Tobacco control, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 5 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- The waterpipe smoking and human health: a systematic review and meta-analysis of 191 observational studies.Systematic reviews · 2025Pooled it
- Prevalence of tobacco use among cancer patients in Iran: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- The health impact of smokeless tobacco products: a systematic review.Harm reduction journal · 2021Pooled it
- Risk of Coronary Heart Disease Among Smokeless Tobacco Users: Results of Systematic Review and Meta-Analysis of Global Data.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2019Pooled it
- A systematic review on association between smokeless tobacco & cardiovascular diseases.The Indian journal of medical research · 2018Pooled it
- Dietary Intake of Animal and Plant Proteins and Risk of Gastrointestinal Cancer Mortality: Results from the Golestan Cohort Study.The Journal of nutrition · 2025Article
- Trends in urinary tract cancer incidence in Golestan province, Iran: a 16-year population-based study.BMC cancer · 2025Article
- Impact of smoking and opium cessation on gastrointestinal cancer risk: A 15-year longitudinal study in Golestan Cohort.Scientific reports · 2025Article
- Article
- Modifiable risk factors for cancer in the middle East and North Africa: a scoping review.BMC public health · 2024Article
- The Cancer Incidence Pattern in Isfahan Province: An Industrial Region in the Central Part of Iran.Journal of cancer epidemiology · 2024Article
- Article
- Prevalence and Incidence of Metabolic Syndrome and Its Components Among Waterpipe Users.International journal of public health · 2024Article
- Smoke exposure associated with higher urinary benzene biomarker muconic acid (MUCA) in Golestan Cohort Study participants.Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals · 2023Article
- Psychometric properties of Fagerström Tolerance Questionnaire among Turkmen Nass (Naswar) users.Addiction science & clinical practice · 2023Article
- Epidemiology and prevalence of tobacco use in Tehran; a report from the recruitment phase of Tehran cohort study.BMC public health · 2023Article
- Chest Pain in a Young Male with Carbon Monoxide Poisoning and Substance Abuse: A Case Report and Literature Review.ARYA atherosclerosis · 2023Article
- Cigarette Smoking and Opium Use in Relation to the Oral Microbiota in Iran.Microbiology spectrum · 2021Article
- Associations between Biomarkers of Exposure and Lung Cancer Risk among Exclusive Cigarette Smokers in the Golestan Cohort Study.International journal of environmental research and public health · 2021Article
- Dietary quality using four dietary indices and lung cancer risk: the Golestan Cohort Study (GCS).Cancer causes & control : CCC · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundThere is limited information about the hazards of cigarettes, smokeless tobacco and waterpipe in the Middle East. The aim of this study was to determine the association between different types of tobacco use and earlier death in the Golestan Cohort Study.
methodsThe Study includes 50 045 adults (aged 40-75 years) from north eastern Iran. The baseline questionnaire (2004-2008) assessed information about use of cigarettes, chewing tobacco (nass) and waterpipe. To assess the use of each type of tobacco compared with never tobacco users, we used Cox regression models adjusted for age, socioeconomic status, area of residence, education and other tobacco used, and stratified by sex, ethnicity and opium use.
results17% of participants reported a history of cigarette smoking, 7.5% chewing tobacco (nass) and 1.1% smoking waterpipe, and these figures declined in the later birth cohorts. During a median follow-up of 8 years, 4524 deaths occurred (mean age 64.8+9.9 years). Current (HR=1.44; 95% CI 1.28 to 1.61) and former (HR=1.35; 95% CI 1.16 to 1.56) cigarette smokers had higher overall mortality relative to never tobacco users. The highest cigarette-associated risk was for cancer death among current heavy smokers (HR=2.32; 95% CI 1.66 to 3.24). Current nass chewing was associated with overall mortality (HR=1.16; 95% CI 1.01 to 1.34), and there was a 61% higher risk of cancer death in people chewing nass more than five times a day. We observed an association between the cumulative lifetime waterpipe use (waterpipe-years≥28) and both overall (HR=1.66; 95% CI 1.11 to 2.47), and cancer mortality (HR=2.82; 95% CI 1.30 to 6.11).
conclusionsRegular use of cigarettes, smokeless tobacco and waterpipe were associated with the risk of earlier death (particularly from cancer) in our cohort.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.