{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:04:41Z","timestamp":1773007481965,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012155","name":"National Institute for Medical Research Development","doi-asserted-by":"publisher","award":["940045"],"award-info":[{"award-number":["940045"]}],"id":[{"id":"10.13039\/501100012155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Although the prevalence of waterpipe smoking is increasing worldwide, evidence on its health hazards, including cancer, is limited. We examined the association between waterpipe smoking and head and neck squamous cell carcinoma (HNSCC) and its subsites. We analyzed data of 918 cases and 3477 controls from the IROPICAN study. Multiple logistic regression models estimated the odds ratios (OR) and 95% confidence intervals (CI). We additionally excluded cigarette smokers, opium users, and nass users to study the association between exclusive waterpipe smoking and HNSCC. The crude OR for ever waterpipe smoking was 1.0 (95% CI: 0.8, 1.3), which decreased to 0.8 (95% CI: 0.6, 1.1) after adjusting for confounding variables. However, we observed statistically non\u2010significant elevated odds of HNSCC (OR: 1.3, 95% CI: 0.9, 1.9), while a significant excess odds of laryngeal cancer (OR: 2.5, 95% CI: 1.0, 5.7) in exclusive waterpipe smokers compared to never tobacco users. Additionally, an especially high OR was observed for laryngeal cancer in exclusive waterpipe smokers with more than 20\u2009years of use (OR: 4.9, 95% CI: 1.7, 14.7). Initiating exclusive waterpipe smoking before the age of 20 was also significantly associated with increased odds of HNSCC (OR: 2.9, 95% CI: 1.3, 6.7) and laryngeal cancer (OR: 9.0, 95% CI: 2.1, 38.2). In conclusion, although no association was found between waterpipe smoking and HNSCC, exclusive waterpipe smoking, particularly at high doses and long duration, seems to lead to an increased risk of HNSCC, especially laryngeal cancer. Larger studies with sufficient power are warranted.<\/jats:p>","DOI":"10.1002\/ijc.70258","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T08:16:51Z","timestamp":1766737011000},"page":"2309-2316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between waterpipe smoking and head and neck squamous cell carcinoma: A multicenter case\u2013control study in Iran"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5486-7513","authenticated-orcid":false,"given":"Maryam","family":"Hadji","sequence":"first","affiliation":[{"name":"A.I. Virtanen Institute for Molecular Sciences University of Eastern Finland  Kuopio Finland"},{"name":"Health Sciences Unit, Faculty of Social Sciences Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2155-1683","authenticated-orcid":false,"given":"Hamideh","family":"Rashidian","sequence":"additional","affiliation":[{"name":"Cancer Research Center, Cancer Institute Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Marzban","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Public Health Bushehr University of Medical Science  Bushehr Iran"},{"name":"Clinical Research Development Center, The Persian Gulf Martyrs Bushehr University of Medical Science  Bushehr 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Sciences University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Naghibzadeh\u2010Tahami","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center, Institute for Futures Studies in Health Kerman University of Medical Sciences  Kerman Iran"},{"name":"Regional Knowledge HUB for HIV\/AIDS Surveillance, Research Centre for Modelling in Health, Institute for Future Studies in Health Kerman University of Medical Sciences  Kerman Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali Akbar","family":"Haghdoost","sequence":"additional","affiliation":[{"name":"Regional Knowledge HUB for HIV\/AIDS Surveillance, Research Centre for Modelling in Health, Institute for Future Studies in Health Kerman University of Medical Sciences  Kerman Iran"},{"name":"Department of Biostatistics and Epidemiology Kerman University of Medical Sciences  Kerman 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Genetics National Cancer Institute  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farin","family":"Kamangar","sequence":"additional","affiliation":[{"name":"Department of Biology, School of Computer, Mathematical and Natural Sciences Morgan State University  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9536-6440","authenticated-orcid":false,"given":"Eero","family":"Pukkala","sequence":"additional","affiliation":[{"name":"Health Sciences Unit, Faculty of Social Sciences Tampere University  Tampere Finland"},{"name":"Finnish Cancer Registry Institute for Statistical and Epidemiological Cancer Research  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3811-2791","authenticated-orcid":false,"given":"Paolo","family":"Boffetta","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical 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