Water-pipe smoking and serum testosterone levels in adult males in Qatar
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College of Medicine, Qatar University, Doha, Qatar
Biomedical Research Centre, Qatar University, Doha, Qatar
Ala-Eddin Al Moustafa   

College of Medicine, Qatar University, 2713 Doha, Qatar
Publish date: 2019-03-13
Tob. Induc. Dis. 2019;17(March):19
Water-pipe (WP) smoking is the most common method of tobacco consumption in the Middle-East and is rapidly spreading on a global scale. Although, water-pipe smoking is linked to various diseases, such as emphysema and various types of cancers, its effect on testosterone levels has yet to be investigated. This study explores the effect of water-pipe smoking on serum testosterone levels in males in Qatar.

In this cross-sectional sample within a cohort study, we retrieved data for a total of 1000 male volunteers from the Qatar BioBank (QBB) project. A selfreported questionnaire was used to determine the water-pipe smoking status of participants. Moreover, participants were stratified based on the frequency of smoking. Total testosterone and sex hormone binding globulin (SHBG) were measured clinically, whereas free testosterone and bioavailable testosterone were calculated using Vermeulen’s equation. Hormone values of 541 males (277 waterpipe smokers and 264 non-smokers) were compared using multiple regression analysis based on water-pipe smoking status after adjusting for confounding factors.

No statistically significant difference was observed between WP smokers and non-water-pipe smokers in the likelihood of having lower or higher total testosterone, after adjustment for confounding factors. Similar results were found in free testosterone, bioavailable testosterone, and sex hormone binding globulin (all p>0.05). When compared with the reference group, both light and heavy water-pipe smokers had a similar likelihood of circulating low total testosterone levels (OR=0.83, 95% CI: 0.46–1.49; and OR=0.80, 95% CI: 0.43– 1.49; respectively).

Our results reveal, for the first time, that there is no significant change in total testosterone, free testosterone, bioavailable testosterone and sex hormone binding globulin in waterpipe smokers compared to non-water-pipe smokers. Therefore, we believe that further studies are needed to confirm the effect of water-pipe smoking on testosterone in different populations.

We would like to thank the Public Health Department of the College of Medicine, Qatar University for their support. We thank QBB for their support in providing us with the data.
Authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
This work was supported by the College of Medicine of Qatar University and grant QUST-2-CMED-2018-1 from Qatar University.
Not commissioned; externally peer reviewed.
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