National and Regional Fraction of Cancer Incidence and Death Attributable to Current Tobacco and Water-Pipe Smoking in the Eastern Mediterranean Countries in 2020.

This article focuses on estimating the Population Attributable Fraction (PAF) of cancers due to tobacco use, including cigarette and water-pipe smoking, in the Eastern Mediterranean Region (EMRO) in 2020. Using data from national surveys, GLOBOCAN 2020, and published relative risks, the study found that 14.6% of adult cancer cases and 17.9% of cancer deaths in EMRO were attributable to tobacco smoking, with higher proportions in men than women. Water-pipe smoking accounted for 1.0% of incident cancers and 1.3% of cancer deaths, highlighting its emerging role in cancer burden, especially given its cultural prevalence and under-recognition of risks in the region. The study emphasizes variability across EMRO countries and calls for improved surveillance, further research on water-pipe carcinogenicity, and strengthened tobacco control policies targeting both cigarette and water-pipe use, particularly among women and youth.