Micronucleus assay in waterpipe tobacco and cigarette smokers: A comparative study

Aim: Waterpipe tobacco smoking (WTS) has become a global epidemic, especially among youth. WTS has not been studied like cigarette smoking. There is a dire need to study and document health effects of waterpipe smoking in general and specifically on the oral cavity. Materials and methods: A total sample size of 400 was studied. One hundred exclusive shisha smokers, 100 exclusive cigarette smokers, 100 subjects smoking both cigarette and shisha and 100 non-smokers. We recorded and associated socio-demographical data pertaining to WTS and cigarette smoking in UAE and examining their toxic effects on the oral mucosa at a cytogenetic level by studying the micronuclei (MN) stained by Feulgen and Acridine Orange (DNA specific stains). Results: A significant association was observed between age distribution and groups. Majority of subjects were males. Arabic nationalities were consuming a higher percentage of Waterpipe and Cigarette separately, and Indian nationality was consuming a higher percentage of waterpipe and cigarette together. Comparison of Micronuclei in Feulgen and Micronuclei in Acridine Orange group between four groups was significant. Mean micronuclei in feulgen was highest for Waterpipe and Cigarette group followed by shisha group and least for Control group. Similarly, Mean micronuclei in acridine orange was highest for waterpipe and cigarette group followed by shisha group and least for control group. Conclusion: Further epidemiological studies should be undertaken to determine whether WTS is associated with the incidence of lung cancer/oral cancerous lesions. Clinical significance: The findings of this study could be used to spread awareness that waterpipe smoking, like cigarette smoking, has the potential to cause genotoxic effects and could eventually lead to carcinogenicity based on duration and frequency.