Effect of narghile and cigarette smoking on newborn birthweight

Objective To assess the effect of narghile smoking on the weight of newborns. Design Historical retrospective cohort. Setting Six major hospitals in Greater Beirut, Lebanon. Population Consecutive singleton newborns delivered from August 2000 to August 2003. Methods Obstetric and nursery charts were reviewed to obtain information about maternal and neonatal variables. Information concerning initiation of smoking, dose of smoking, smoking habits during pregnancy, and socio-demographic characteristics was collected through interviews with mothers. Main outcome measures Low birthweight and newborn birthweight. Results Exclusive narghile smokers constituted 4.4% (378/8592) of women. Multiparas were significantly more likely to smoke cigarettes and narghile. Mothers smoking narghile more than once per day were at 2.4 increased odds of having low birthweight infants compared with nonsmoking mothers (OR 2.4; 95% CI 1.2-5.0) after adjusting for confounding variables. No difference was noted between women smoking narghile in the first trimester and those initiating smoking in subsequent trimesters regarding low birthweight. Conclusions Narghile smoking more than once per day increases the odds of low birthweight by a 2.4-fold compared with nonsmokers, although to a lesser extent than cigarette smoking.