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Briefly, we followed the six analytical steps included in the BPRF meta-analytical approach, namely: (1) conducting a systematic review and extracting data from identified studies reporting on the association between SHS exposure and the outcomes of interest
4 Table 1 Epidemiological studies on cancer and water pipe smoking Authors, year of publication, reference no., country of study Main results Qiao et al., 1989, 8 Peoples Republic of China Case-control study: ever use of water pipe was associated with a two-fold elevation in risk for lung cancer when compared with tobacco abstainers (OR 1.9, 95%CI 0.4 4.9), and a dose-response relationship was observed with increasing categories of water pipe-years (dose times duration) Lubin et al., 1992, 9 Peoples Republic of China Case-control study: compared to non-smokers, smokers of cigarettes only (OR 2.6, 95%CI 1.16.2), smokers of water and long stem pipes only (OR 1.8, 95%CI 0.8 4.2) and mixed smokers (OR 4.1, 95%CI 2.39.2) were at increased risk for lung cancer Hsairi et al., 1993, 10 Tunisia Case-control study: regular water pipe use was associated with an increased risk of lung cancer (OR 5.7, 95%CI 0.27.6) Bedwani et al., 1997, 11 Egypt Case-control study: the ORs for urinary bladder cancer were 5.4 for 70 000 000 smokers, consum- ing 215 billion cigarettes annually
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