全球范围内使用非香烟产品（包括水烟烟草 (WTP)）的趋势日益明显。虽然吸烟是多种癌症的公认危险因素，但人们对 WTP 吸烟与癌症死亡率之间的关系知之甚少。为了评估越南 WTP 吸烟与癌症死亡风险之间的关系。这项队列研究基于以下数据：河内前瞻性队列研究是一项正在进行的研究，对 2007 年至 2019 年越南北部 15 岁或以上的参与者进行中位（范围）随访 11.0（0.1-11.6）年。数据分析时间为 6 月 1 日至 9 月 1 日，2023。吸烟和 WTP 吸烟状态。总体和特定部位癌症死亡率。使用 Cox 比例回归模型计算单独吸烟、单独吸烟以及双重 WTP 和吸烟与癌症死亡风险之间关联的风险比 (HR) 和 95% CI。 总共有 554 例癌症死亡在 39401 名研究参与者中确定（平均 [SD] 年龄，40.4 [18.8] 岁；20 616 名女性 [52.3%]）。在多变量模型中，与从不吸烟者相比，曾经吸烟者的癌症死亡风险显着增加（HR，1.87；95% CI，1.48-2.35）。与从不吸烟者相比，仅 WTP 吸烟者的癌症死亡风险最高（HR，2.66；95% CI，2.07-3.43）。 WTP 和卷烟双重吸烟者的癌症死亡风险（HR，2.06；95% CI，1.53-2.76）高于仅吸烟者（HR，1.86；95% CI，1.41-2.45）。由于大多数吸烟者（95.6% [9312 人中的 8897 人]）是男性，因此这些模式在男性参与者中更为明显。与从不吸烟者相比，男性中完全WTP吸烟与肝癌（HR，3.92；95% CI，2.25-6.85）、肺癌（HR，3.49；95% CI，2.08-5.88）死亡风险升高相关。 、鼻咽癌（HR，2.79；95% CI，1.27-6.12）和胃癌（HR，4.11；95% CI，2.04-8.27）。对于只吸 WTP 的吸烟者来说，每天吸烟 11 至 15 次（HR，3.42；95% CI，2.03-5.75）、26 至 30 岁开始吸烟（HR，4.01；95）的癌症死亡风险最高。 % CI，2.63-6.11），吸烟 9 至 20 年（HR，4.04；95% CI，2.16-7.56），每年吸烟 61 至 160 次（HR，3.68；95% CI，2.38-5.71）。对于男性来说，与戒烟1年内的人相比，戒烟超过10年的人患癌症死亡的风险较低（HR，0.27；95% CI，0.11-0.66；趋势P < .001 ）。在越南的这项队列研究中，单独吸烟或与吸烟相结合的 WTP 与肝癌、肺癌、鼻咽癌和胃癌等癌症死亡风险增加相关。在越南和吸烟率较高且解决吸烟相关问题的资源有限的低收入和中等收入国家，有必要制定专门的计划来控制 WTP 吸烟。

There has been an increasing trend of using noncigarette products, including waterpipe tobacco (WTP), worldwide. While cigarette smoking is a well-established risk factor for numerous cancers, little is known about the association between WTP smoking and cancer mortality.To assess the association between WTP smoking and risk of cancer mortality in Vietnam.This cohort study was based on data from the Hanoi Prospective Cohort Study, an ongoing study with a median (range) follow-up of 11.0 (0.1-11.6) years for participants aged 15 years or older in Northern Vietnam from 2007 through 2019. Data were analyzed from June 1 to September 1, 2023.Tobacco smoking and WTP smoking statuses.Overall and site-specific cancer mortality. Cox proportional regression models were used to calculate the hazard ratio (HR) and 95% CIs for the associations between WTP smoking alone, cigarette smoking alone, and dual WTP and cigarette smoking and the risk of cancer death.A total of 554 cancer deaths were identified among the 39 401 study participants (mean [SD] age, 40.4 [18.8] years; 20 616 females [52.3%]). In multivariable models, compared with never smokers, ever smokers had a significantly increased risk of cancer mortality (HR, 1.87; 95% CI, 1.48-2.35). Exclusive WTP smokers had the highest risk of cancer mortality compared with never smokers (HR, 2.66; 95% CI, 2.07-3.43). Risk of cancer mortality was higher for dual smokers of WTP and cigarettes (HR, 2.06; 95% CI, 1.53-2.76) than for exclusive cigarette smokers (HR, 1.86; 95% CI, 1.41-2.45). As most smokers (95.6% [8897 of 9312]) were male, these patterns were more apparent in male participants. Compared with never smokers, exclusive WTP smoking among males was associated with an elevated risk of death from liver cancer (HR, 3.92; 95% CI, 2.25-6.85), lung cancer (HR, 3.49; 95% CI, 2.08-5.88), nasopharyngeal carcinoma (HR, 2.79; 95% CI, 1.27-6.12), and stomach cancer (HR, 4.11; 95% CI, 2.04-8.27). For exclusive WTP smokers, the risk of cancer mortality was highest among those who smoked 11 to 15 sessions per day (HR, 3.42; 95% CI, 2.03-5.75), started smoking at age 26 to 30 years (HR, 4.01; 95% CI, 2.63-6.11), smoked for 9 to 20 years (HR, 4.04; 95% CI, 2.16-7.56), and smoked 61 to 160 sessions annually (HR, 3.68; 95% CI, 2.38-5.71). For males, the risk of cancer death was lower for those who had quit smoking for more than 10 years, compared with those who quit smoking within 1 year (HR, 0.27; 95% CI, 0.11-0.66; P for trend < .001).In this cohort study in Vietnam, WTP smoking alone or in combination with cigarette smoking was associated with an increased risk of cancer death due to liver cancer, lung cancer, nasopharyngeal carcinoma, and stomach cancer. A tailored program to control WTP smoking is warranted in Vietnam and low- and middle-income countries with a high prevalence of smoking and modest resources to address smoking-related issues.