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Effects of Waterpipe Tobacco Smoking on the Spirometric Profile of University Students in Palestine: A Cross-Sectional Study. Can Respir J 2020; 2020:5949834. [PMID: 32676133 PMCID: PMC7336226 DOI: 10.1155/2020/5949834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/05/2020] [Indexed: 12/15/2022] Open
Abstract
Background Waterpipe smoking in young individuals is increasing with limited studies addressing its respiratory health effects. The aim of the study was to determine the effect of waterpipe smoking on young adults' lung functions. Spirometric parameters were compared between waterpipe smokers and nonsmokers. Methods A comparative cross-sectional study of university students, including males and females, was conducted. An interviewer-administered questionnaire was used to record students' characteristics. The spirometry test was performed to assess students' lung functions; we recorded the forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, peak expiratory flow (PEF), and forced expiratory flow between 25 and 75% of FVC (FEF25–75%). Results A total of 300 apparently healthy students (150 waterpipe smokers and 150 nonsmokers) were included in the study. Waterpipe smokers showed significantly lower values in FEV1, FEV1/FVC ratio, PEF, and FEF25–75% compared to the nonsmoker group (P < 0.05 to P < 0.001). The subgroup analysis on female students (50 WP smokers and 50 nonsmokers) showed a significant decrease in FEV1/FVC ratio, PEF, and FEF25–75% parameters (P < 0.001). Conclusion Waterpipe smoking is associated with reduced spirometric parameters in healthy young adults with relatively limited smoking years.
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Agent-based Modeling in Tobacco Regulatory Science: Exploring 'What if' in Waterpipe Smoking. TOB REGUL SCI 2020; 6:171-178. [PMID: 32582820 DOI: 10.18001/trs.6.3.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives Waterpipe tobacco smoking (WTS) is an emerging public health crisis, particularly among youth and young adults. Different from the use of other tobacco products and e-cigarettes, WTS tends to be a social activity occurring among friends or persons associated with social networks. In this paper, we review a potential strategy for WTS-related research. Methods As a bottom-up computational model, agent-based modeling (ABM) can simulate the actions and interactions of agents, as well as the dynamic interactions between agents and their environments, to gain an understanding of the functioning of a system. ABM is particularly useful for incorporating the influence of social networks in WTS, and capturing people's space-time activity and the spatial distribution of WTS venues. Results Comprehensive knowledge of WTS-related behaviors at the individual level is needed to take advantage of ABM and use it to examine policies such as the interaction between WTS and cigarette smoking and the effect of flavors used in waterpipe tobacco. Longitudinal and WTS-specific surveys and laboratory experiments are particularly helpful to understand WTS basic mechanisms and elicit individual preferences, respectively. Conclusions We argue that the uniqueness of WTS makes ABM a promising tool to be used in WTS-related research, as well as understanding use of other tobacco products.
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Haddad C, Sacre H, Hajj A, Lahoud N, Akiki Z, Akel M, Saade D, Zeidan RK, Farah R, Hallit S, Salameh P. Comparing cigarette smoking knowledge and attitudes among smokers and non-smokers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:19352-19362. [PMID: 32212070 DOI: 10.1007/s11356-020-08162-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 02/19/2020] [Indexed: 06/10/2023]
Abstract
Smoking prevalence in Lebanon was reported by the World Health Organization to be 43%, which is among the highest rates in the Arab nation. The objectives of this study were to assess cigarette smoking knowledge and attitude among smokers and non-smokers using validated scales in the Lebanese general population and evaluate their association with current cigarette smoking; a secondary objective is to assess the dose effect relationship of knowledge and attitude with cumulative smoking. This cross-sectional took place between May and December 2018, and enrolled a sample of 2623 participants, representative from all Lebanese governorates. A questionnaire about knowledge of the harmful effects of tobacco and attitude toward smoking bans retrieved from other studies was used to collect data. Male gender (ORa = 0.75), having a low monthly income (ORa = 1.56) and a higher passive smoking score (ORa = 1.25), were significantly associated with higher odds of being current smokers. Higher knowledge score (ORa = 0.97) and positive attitude toward smoking ban score (ORa = 0.94) were significantly associated with lower odds of being current smokers. In addition, increased age (ß = 15.21) and higher passive smoking score (ß = 26.58) were significantly associated with higher cumulative cigarette smoking. More positive attitude toward smoking ban score (ß = - 6.51) and having a university degree (ß = - 68.35) were significantly associated with lower cumulative cigarette smoking. Higher knowledge about the smoking-related health problems and better attitudes toward smoking ban were observed among non-smokers compared to smokers. It is important to increase awareness campaigns and to propose effective interventions to put in place an adequate culture of smoking cessation among the general population.
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Affiliation(s)
- Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon.
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.
- University of Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology,GEIST, 87000, Limoges, France.
- Department of Psychiatry, CH Esquirol, 87025, Limoges, France.
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Aline Hajj
- Laboratory of Pharmacology, Clinical Pharmacy and Quality Control of Drugs, Faculty of Pharmacy, Pôle Technologie- Santé (PTS), Faculty of Pharmacy, Saint-Joseph University, Beirut, 1107 2180, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, 1107 2180, Lebanon
| | - Nathalie Lahoud
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Zeina Akiki
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Health Sciences, University of Balamand (UOB), Beirut, Lebanon
- Faculty of Nursing and Health Sciences, Notre Dame University Louaize (NDU), Zouk, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Danielle Saade
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Rouba Karen Zeidan
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Rita Farah
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Alturki K, Hamza A, Walton P. Islam and Motivation to Quit Smoking: Public Health Policy Implications. JOURNAL OF RELIGION AND HEALTH 2020; 59:1175-1188. [PMID: 29948792 DOI: 10.1007/s10943-018-0649-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In the WHO Eastern Mediterranean Regional Office some 14 years ago, a 'religiously inspired approach' was proposed to combat tobacco use. This promoted a useful debate in the region. The purpose of this paper is to argue the need to identify the role which Islamic beliefs and teachings play (1) in influencing individual motivation to quit smoking and (2) in gaining support for public policies to reduce smoking. Ramadan and Hajj are taken as key points. These, it is argued, are times when Muslim religious motivation to abstain from smoking is strongest. This paper concludes that there is an insufficient evidence base on which to adopt a religiously inspired approach. All of civil society, including religious Muslim authorities, should rather supplement the efforts of health professionals to encourage smoking cessation.
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Affiliation(s)
- Khaled Alturki
- Medical Services Department (MSD), PO Box 395839, Riyadh, 11375, Saudi Arabia
| | - Ahmed Hamza
- Princess Nora Bint Abdul Rahman University, PO Box 844228, Riyadh, 11671, Saudi Arabia
| | - Peter Walton
- Edificio Itamaraty, Rua Luis Pasteur, Monte Castelo, Sao Jose dos Campos, Brazil.
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Bashirian S, Barati M, Ahmadi F, Abasi H, Sharma M. Male students' experiences on predictors of waterpipe smoking reduction: A qualitative study in Iran. Tob Prev Cessat 2020; 5:30. [PMID: 32411893 PMCID: PMC7205133 DOI: 10.18332/tpc/112249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/04/2019] [Accepted: 09/10/2019] [Indexed: 12/30/2022]
Abstract
INTRODUCTION In recent years, waterpipe smoking (WPS) has increased among adolescents in Iran. This study aimed to explain the experiences of high school students in Iran on predictors of WPS reduction based on a multi-theory model (MTM) of health behaviour change. METHODS This study was a qualitative study of directed content analysis that was conducted in high school male students in Hamadan, Iran, in 2017. In this study, 34 students who had smoked waterpipe (WP) in the last month were recruited through snowball sampling that was continued until data saturation. The data were collected through semi-structured, individual interviews and were then analyzed using directed qualitative content analysis. RESULTS The data analysis resulted in the extraction of 104 final codes around the six themes of predetermined MTM constructs consisting of participatory dialogue, behavioural confidence, changes in the physical environment, emotional transformation, practice for change, and changes in the social environment. The findings of this study showed that this model has the potential to explain the behaviour of WPS reduction. The main predictors of reduction in WPS are behavioural confidence, social environment change, and participatory dialogue. CONCLUSIONS Findings of the research showed that the belief in an individual’s ability, support from friends and the benefits of WPS reduction are the most important factors in reducing WPS among students. Therefore, it is suggested that comprehensive interventions be developed to improve the individual and social factors that are effective in WPS reduction.
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Affiliation(s)
- Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fazlolah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hamid Abasi
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Manoj Sharma
- Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, United States
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Joveini H, Dehdari T, Hashemian M, Maheri M, Shahrabadi R, Rohban A, Mehri A, Eftekhar Ardebili H. Effects of an Educational Intervention on Male Students’ Intention to Quit Water Pipe Smoking: an Application of the Theory of Planned Behavior (TPB) and Health Action Process Approach (HAPA). JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2020. [DOI: 10.29252/jech.7.2.73] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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High Particulate Matter Burden of Cigarettes from the United Arab Emirates and Germany: Are There Country-Specific Differences? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072415. [PMID: 32252343 PMCID: PMC7177534 DOI: 10.3390/ijerph17072415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 01/08/2023]
Abstract
Although the big tobacco companies offer the same cigarette brands across countries, little is known about the potential regional differences of the particulate matter (PM) emissions of apparently equal brands. PM emissions of three cigarette brands (Marlboro Gold, Winston Red resp. Classic, Parliament Platinum resp. Night Blue) from the United Arab Emirates (UAE) and Germany were analysed. Second-hand smoke was produced in a 2.88 m3 measuring cabin by an automatic environmental tobacco smoke emitter. PM size fractions PM10, PM2.5, and PM1 were detected in real-time using laser aerosol spectrometry. Depending on the PM fraction Marlboro cigarettes from UAE showed 33%-35% higher PM amounts. Moreover, Winston cigarettes from UAE showed distinctly higher PM values (28-31%) than the German counterparts. The "lighter" Parliament from UAE emitted 3%-9% more PM than the German one. The measured mean PM10 values laid between 778 and 1163 µg/m3 (mean PM2.5: 777-1161 µg/m3; mean PM1: 724-1074 µg/m3). That means smoking in enclosed rooms causes massive PM burden. The PM emission of equal or similar tobacco products from different countries can differ distinctly. Hence, the declaration of PM emission values, besides nicotine, tar, and carbon monoxide amounts, should be obligatory worldwide. Furthermore, complete information about the ingredients and production processes of tobacco products should be provided to health officials and the public. This can help to minimise or ban substances or product designs that make smoking even more harmful, and to enhance the awareness of the risks of smoking.
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El Hourani M, Salman R, Talih S, Saliba NA, Shihadeh A. Does the Bubbler Scrub Key Toxicants from Waterpipe Tobacco Smoke?: Measurements and Modeling of CO, NO, PAH, Nicotine, and Particulate Matter Uptake. Chem Res Toxicol 2020; 33:727-730. [PMID: 31957423 DOI: 10.1021/acs.chemrestox.9b00521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Waterpipe tobacco smoking is a global epidemic. A persistent perception among users is that the water bubbler filters the smoke, reducing its risk profile. The objectives of this study were to quantify the purported filtering effect by comparing toxicant yield when a waterpipe was machine smoked with and without the smoke passing through the water bubbler. We found that the water bubbler did not reduce CO, NO, polycyclic aromatic hydrocarbons (PAHs), or dry particulate matter (DPM) yields but did reduce nicotine and carbonyl compounds (CCs) yields by approximately 50%. These mixed results were consistent with theoretical simulations of the mass transport processes involved.
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Affiliation(s)
- Mario El Hourani
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - Rola Salman
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - Soha Talih
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - Najat Aoun Saliba
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.,Chemistry Department, American University of Beirut, Beirut, Lebanon
| | - Alan Shihadeh
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia 23220, United States
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59
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Romani M, Jawhar S, Shalak M, Antoun J. Waterpipe smoking cessation: knowledge, barriers, and practices of primary care physicians- a questionnaire-based cross-sectional study. BMC FAMILY PRACTICE 2020; 21:21. [PMID: 32000696 PMCID: PMC6990485 DOI: 10.1186/s12875-020-1095-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 01/23/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND While cigarette smoking has been considered the most relevant tobacco product worldwide, waterpipe tobacco smoking (WTS) has increased in prevalence globally and calls for more considerable attention now. However, little is known about WTS cessation knowledge and clinical practices among physicians, particularly in Lebanon. This study aims to examine the knowledge, barriers, and cessation practices of primary care practitioners towards WTS. METHODS A cross-sectional study where an anonymous self-reported questionnaire was completed by physicians attending the Annual Conference of the Lebanese Society of Family Medicine for family medicine physicians, general practitioners, and internists in Lebanon. RESULTS Out of 180 attendees, 105 primary care practitioners (PCPs) responded to the questionnaire. Only 38.1% of the physicians think similar techniques are used for the cessation of smoking of both cigarette and waterpipe. Similarly, 30.5% of the physicians believe that nicotine replacement therapy works in the cessation of waterpipe smoking. There was a statistically significant difference between the percentage of physicians who counsel for cigarette smoking and those who counsel for waterpipe smoking cessation (p = 0.005) where 30% of the physicians tend to counsel against cigarette smoking more than waterpipe smoking. CONCLUSIONS This study shows a difference in the attitude and behavior of PCPs towards cigarette and waterpipe smoking cessation. Moreover, there is a lack of knowledge about water pipe smoking cessation techniques. There is a great room for continued medical education to PCPs in their private practice to improve their knowledge.
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Affiliation(s)
- Maya Romani
- Department of Family Medicine, American University of Beirut, Riad El Solh, Beirut, 11-0236, Lebanon
| | - Sarah Jawhar
- Department of Family Medicine, American University of Beirut, Riad El Solh, Beirut, 11-0236, Lebanon
| | - Manar Shalak
- Department of Family Medicine, American University of Beirut, Riad El Solh, Beirut, 11-0236, Lebanon
| | - Jumana Antoun
- Department of Family Medicine, American University of Beirut, Riad El Solh, Beirut, 11-0236, Lebanon.
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KHODADOST M, MAAJANI K, ABBASI-GHAHRAMANLOO A, NASERBAKHT M, GHODUSI E, SARVI F, MOHAMMADZADEH A, MOTEVALIAN SA, HAJEBI A. Prevalence of Hookah Smoking among University Students in Iran: A Meta-Analysis of Observational Studies. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1-13. [PMID: 32309218 PMCID: PMC7152648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The rise in popularity of waterpipe smoking among younger people cause increase its deleterious effects on health in recent years. The aim of this study was to estimate the pooled prevalence of water-pipe smoking in university students in Iran. METHODS We performed the literature search from 1946 to January 21, 2019, in several international and national databases such as Medline/PubMed, Web of Science, Scopus, Google Scholar, Magiran, Iranmedex, and IranPsych. To investigate the between-study heterogeneity we used the chi-squared test and I2 index. We used a random-effects model to estimate the pooled prevalence of water-pipe smoking. The potential source of heterogeneity was assessed by subgroup analysis and meta-regression. RESULTS According to the eligibility criteria, we included 37 relevant studies in our meta-analysis. The pooled prevalence of lifetime water-pipe smoking was 25% (95% CI: 22-29) and in male and female subgroups was 37% (95%CI: 30-45), 17% (95%CI: 15-19) respectively. The pooled prevalence of water-pipe smoking in last year was 21% (95%CI: 16-25) and in last month was 8% (95%CI: 5-11). Results of meta-regression analysis showed that there was not any significant association between suspected variables and the prevalence of water-pipe smoking. CONCLUSION The higher prevalence rate of water pipe smoking among university students indicates the emergency need for planning preventive program.
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Affiliation(s)
- Mahmoud KHODADOST
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Khadije MAAJANI
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas ABBASI-GHAHRAMANLOO
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Morteza NASERBAKHT
- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim GHODUSI
- Mental and Social Health Office, Ministry of Health, Tehran, Iran
| | - Fatemeh SARVI
- Department of Epidemiology, School of Health, Larestan University of Medical Sciences, Larestan, Iran
| | - Azar MOHAMMADZADEH
- Clinical Research Development Center, Aliasghar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Abbas MOTEVALIAN
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran,Corresponding Author: ;
| | - Ahmad HAJEBI
- Research Center for Addiction & Risky Behaviors (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran,Corresponding Author: ;
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Khoury SJ, Tintore M. Multiple sclerosis in the Middle East and North Africa region. Mult Scler J Exp Transl Clin 2020; 6:2055217319895540. [PMID: 35145729 PMCID: PMC8822444 DOI: 10.1177/2055217319895540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Samia J Khoury
- Nehme and Therese Tohme Multiple Sclerosis Center American University of Beirut, Lebanon
| | - Mar Tintore
- Cemcat Neurology/Neuroimmunology Department, Hospital Universitari Vall d'Hebron, Spain
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Joveini H, Rohban A, Eftekhar Ardebili H, Dehdari T, Maheri M, Hashemian M. The effects of an education program on hookah smoking cessation in university students: an application of the Health Action Process Approach (HAPA). JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1664655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hamid Joveini
- Department of Health Education and Promotion, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Alireza Rohban
- Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Dehdari
- Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Maheri
- Department of Public Health, School of Health, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Masoumeh Hashemian
- Department of Health Education and Promotion, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
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Nilan K, McKeever TM, McNeill A, Raw M, Murray RL. Prevalence of tobacco use in healthcare workers: A systematic review and meta-analysis. PLoS One 2019; 14:e0220168. [PMID: 31344083 PMCID: PMC6657871 DOI: 10.1371/journal.pone.0220168] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/10/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To estimate tobacco use prevalence in healthcare workers (HCW) by country income level, occupation and sex, and compare the estimates with the prevalence in the general population. METHODS We systematically searched five databases; Medline, EMBASE, CINHAL Plus, CAB Abstracts, and LILACS for original studies published between 2000 and March 2016 without language restriction. All primary studies that reported tobacco use in any category of HCW were included. Study extraction and quality assessment were conducted independently by three reviewers, using a standardised data extraction and quality appraisal form. We performed random effect meta-analyses to obtain prevalence estimates by World Bank (WB) country income level, sex, and occupation. Data on prevalence of tobacco use in the general population were obtained from the World Health Organisation (WHO) Global Health Observatory website. The review protocol registration number on PROSPERO is CRD42016041231. RESULTS 229 studies met our inclusion criteria, representing 457,415 HCW and 63 countries: 29 high-income countries (HIC), 21 upper-middle-income countries (UMIC), and 13 lower-middle-and-low-income countries (LMLIC). The overall pooled prevalence of tobacco use in HCW was 21%, 31% in males and 17% in females. Highest estimates were in male doctors in UMIC and LMLIC, 35% and 45%, and female nurses in HIC and UMIC, 21% and 25%. Heterogeneity was high (I2 > 90%). Country level comparison suggest that in HIC male HCW tend to have lower prevalence compared with males in the general population while in females the estimates were similar. Male and female HCW in UMIC and LMLIC tend to have similar or higher prevalence rates relative to their counterparts in the general population. CONCLUSIONS HCW continue to use tobacco at high rates. Tackling HCW tobacco use requires urgent action as they are at the front line for tackling tobacco use in their patients.
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Affiliation(s)
- Kapka Nilan
- UK Centre for Tobacco and Alcohol Studies, School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, United Kingdom
| | - Tricia M. McKeever
- UK Centre for Tobacco and Alcohol Studies, School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, United Kingdom
| | - Ann McNeill
- UK Centre for Tobacco and Alcohol Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Martin Raw
- NYU College of Global Public Health, New York University, New York, New York, United States of America
- NYU Medical School, New York University, New York, New York, United States of America
| | - Rachael L. Murray
- UK Centre for Tobacco and Alcohol Studies, School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, United Kingdom
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Pre-pregnancy BMI, gestational weight gain and birth outcomes in Lebanon and Qatar: Results of the MINA cohort. PLoS One 2019; 14:e0219248. [PMID: 31265481 PMCID: PMC6605672 DOI: 10.1371/journal.pone.0219248] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/20/2019] [Indexed: 11/19/2022] Open
Abstract
Accumulating evidence has highlighted the role of maternal nutritional status on fetal development, birth outcomes and child health. The Mother and Infant Nutritional Assessment (MINA) cohort is a 3-year follow-up study of pregnant women and their children in Qatar and Lebanon. This study reports on the characteristics and determinants of pre-pregnancy BMI and Gestational Weight Gain (GWG) of MINA particiants, as well as birth outcomes. A total of 272 pregnant women were recruited during their first trimester from primary healthcare centers as well as private clinics in Beirut (n = 194) and Doha (n = 147). During the first visit, data collection included pre-pregnancy weight, sociodemographic and lifestyle characteristics. The weight before delivery and neonatal outcomes were extracted from the medical records. GWG was calculated as the difference between weight before delivery and pre-pregnancy weight and was classified into insufficient, adequate, and excessive, as per the IOM criteria. Overall, 42.1% of women had a pre-pregnancy BMI≥25 Kg/m2 (58% in Qatar vs 30.8% in Lebanon, p<0.001). Only 30.2% of women had adequate GWG, while 25.7% and 44.1% of women had insufficient and excessive GWG, respectively. In the cohort 68.7% of infants had a weight adequate-for-gestational age (AGA), 6.7% were SGA and 24.6% were LGA. The proportions of LGA were higher with greater GWG (p<0.05). After adjustment, Qatari women were 3 times more likely to be overweight or obese before pregnancy while a higher education level was associated with significantly lower odds of pre-pregnancy BMI≥25 Kg/m2. Pre-pregnancy BMI≥25 Kg/m2 and regular breakfast consumption were predictors of excessive GWG (OR: 3.20, CI: 1.48–6.91; OR: 2.84, CI: 1.15–7.02, respectively). The high prevalence of pre-pregnancy overweight and excessive GWG among MINA participants underscores the need for culture-specific intervention programs to promote healthy body weight in women of childbearing age, and prevent excessive weight gain during pregnancy.
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Lasebikan VO, Ola BA, Lasebikan TO. Shisha smoking in selected nightclubs in Nigeria. Pan Afr Med J 2019; 33:136. [PMID: 31565115 PMCID: PMC6756782 DOI: 10.11604/pamj.2019.33.136.17149] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/13/2019] [Indexed: 02/01/2023] Open
Abstract
Introduction Shisha consumption is a growing public health issue all over the globe and public health awareness about its deleterious health consequences is still not sufficiently raised. Methods In this location-based study of nightclubs in Ibadan, Nigeria, 633 patrons of selected nightclubs were interviewed in order to obtain information on prevalence, correlates and predictors of shisha smoking. Results The overall prevalence of shisha smoking was 7.1%. The age of initiation into shisha smoking was lower among women, p = 0.03, but men were significantly more likely to be more frequent users, daily or weekly users, p < 0.001 and also to be current cigarette smokers, p = 0.03. There was no significant gender variability in the stage of readiness to quit. Regression analysis showed that after adjusting for age, the predictors of shisha smoking were: cigarette smoking, OR = 4.83, 95% CI (1.49-15.70) and more than 12 years of education, OR = 7.55, 95% CI (1.88 - 30.37), while being a rural dweller was a protective factor, OR = 0.05, 95% CI (0.01-0.20). Conclusion Shisha smoking has emerged as a prevalent public health issue in Nigeria. There is a need for an immediate response from policy providers towards shisha smoking intervention in Nigeria.
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Affiliation(s)
| | - Bolanle Adeyemi Ola
- Department of Behavioral Medicine, College of Medicine, Lagos State University, Ikeja, Nigeria
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Monshi SS, Halpern MT. Factors associated with smoking cessation and smoking cessation interventions in the Gulf Cooperation Council countries. Saudi Med J 2019; 40:119-125. [PMID: 30723855 PMCID: PMC6402472 DOI: 10.15537/smj.2019.2.23904] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives: To examined published literature describing the predictors of smoking cessation (SC) and cessation interventions in Gulf Cooperation Council (GCC) countries. Methods: Systematic literature review using PubMed, Google Scholar, and grey literature. The study was conducted between October and December of 2017. Inclusion criteria were studies reporting factors associated with SC or studies of utilization or delivery of SC medications in GCC countries. Results: Twenty-one articles met the study criteria. Thematic analysis revealed factors associated with SC that were classified as individual or clinician level. Individual-level factors were access and cost of SC medications, knowledge about harms, concern about health, self-efficacy, perceived stress, level of tobacco consumption, belief about SC medications, clinician advice, social support, and enforcement of smoke-free ban. Clinician-level factors were time to provide counseling, training to assist patients, patient acceptance, best practice for treating patients, resources, perception related to responsibilities, and knowledge about effective medications. Conclusion: This review revealed perceived barriers to SC among smokers and clinicians in GCC countries. It highlighted cultural factors that need to be addressed by tobacco use policies in GCC countries to help smokers quit.
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Affiliation(s)
- Sarah S Monshi
- Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia (PA), United States of America. E-mail.
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67
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Al-Sawalha NA, Al-Filali MS, Alzoubi KH, Khabour OF. Effect of Prenatal Waterpipe Tobacco Smoke Exposure on Cardiac Biomarkers in Adult Offspring Rats. J Cardiovasc Pharmacol Ther 2019; 24:567-574. [DOI: 10.1177/1074248419849424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: The prevalence of waterpipe tobacco smoke (WTS) consumption is increased among pregnant woman. Prenatal cigarette smoke exposure increased the risk of developing cardiovascular diseases in offspring. The current study examined the effect of prenatal WTS exposure on inflammatory profile, oxidative stress, and cardiac biomarkers in adult offspring rats. Methods: Female rats received WTS (2 hours per day) or fresh air 1 day prior to mating and throughout the pregnancy period. The body and heart masses were measured in male offspring rats. The level of oxidative stress biomarkers, nitrate, inflammatory mediators (interleukin 6 [IL-6], tumor necrosis factor alpha [TNF-α]), and gene expression of protein kinase C epsilon, angiotensin 2 receptor one, and transforming growth factor beta1 were measured in cardiac tissue homogenates of 13-week-old male offspring rats. Results: Prenatal WTS exposure reduced body weight and increased heart to body weight ratio ( P < .05). Prenatal WTS exposure did not affect oxidative stress biomarkers (superoxide dismutase, glutathione peroxidase, and thiobarbituric acid reactive substances) but significantly increased catalase activity and nitrate level ( P < .05) in cardiac tissue of adult male offspring rats. In addition, prenatal exposure to WTS did not affect cardiac level of TNF-α and IL-6 as well as the gene expression of different cardiac modulators in adult male offspring rats ( P > .05). Conclusion: Prenatal WTS exposure has detrimental consequences on adult offspring rats by increasing the ratio of heart to body mass, increasing the catalase activity and nitrate level in cardiac tissue of adult male offspring rats.
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Affiliation(s)
- Nour A. Al-Sawalha
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Maria S. Al-Filali
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F. Khabour
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Patil S, Babu N, Subbannayya T, Mohan S, Sathe G, Solanki H, Rajagopalan P, Patel K, Advani J, Bhandi S, Sidransky D, Chatterjee A, Gowda H, Ferrari M. Secretome analysis of oral keratinocytes chronically exposed to shisha. Cancer Biomark 2019; 25:29-41. [DOI: 10.3233/cbm-182099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Shankargouda Patil
- Department of Medical Biotechnologies, School of Dental Medicine, University of Siena, Siena, Italy
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
- Department of Medical Biotechnologies, School of Dental Medicine, University of Siena, Siena, Italy
| | - Niraj Babu
- Institute of Bioinformatics, International Technology Park, Bangalore, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Medical Biotechnologies, School of Dental Medicine, University of Siena, Siena, Italy
| | | | - Sonali V. Mohan
- Institute of Bioinformatics, International Technology Park, Bangalore, India
| | - Gajanan Sathe
- Institute of Bioinformatics, International Technology Park, Bangalore, India
| | - Hitendra S. Solanki
- Institute of Bioinformatics, International Technology Park, Bangalore, India
| | | | - Krishna Patel
- Institute of Bioinformatics, International Technology Park, Bangalore, India
| | - Jayshree Advani
- Institute of Bioinformatics, International Technology Park, Bangalore, India
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - David Sidransky
- Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aditi Chatterjee
- Institute of Bioinformatics, International Technology Park, Bangalore, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Harsha Gowda
- Institute of Bioinformatics, International Technology Park, Bangalore, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Marco Ferrari
- Department of Medical Biotechnologies, School of Dental Medicine, University of Siena, Siena, Italy
- Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, UK
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Asfar T, Schmidt M, Ebrahimi Kalan M, Wu W, Ward KD, Nakkash RT, Thrasher J, Eissenberg T, Ben Romdhane H, Maziak W. Delphi study among international expert panel to develop waterpipe-specific health warning labels. Tob Control 2019; 29:159-167. [PMID: 30696784 DOI: 10.1136/tobaccocontrol-2018-054718] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/20/2018] [Accepted: 12/20/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Waterpipe (WP) smoking is increasing globally. The rise of WP has been fuelled by widespread misperception of reduced-harm compared to cigarettes. Health warning labels (HWLs) are one strategy to communicate smoking-related risks and address reduced-harm misperceptions. Therefore, the development of WP-specific HWLs represents a priority for WP control. METHODS A panel of experts in WP science developed 28 WP-specific HWLs corresponding to five themes (health risks, addiction, harm to others, WP-specific harm, WP harm compared to cigarettes). Subsequently, a three-round Delphi study was conducted among international expert panel to reach consensus on a set of the most effective HWLs for each theme. Levels of agreement between participants were assessed using interquartile deviations, and the rank between the tied HWLs was based on the median. RESULTS Starting with 28 candidate HWLs stratified according to five WP-related themes, our international expert panel reached consensus on the 13 most important WP-specific HWLs. Labels with the highest agreement were related to oral and heart disease, WP's harmful effects on newborn children and the amount of smoke inhaled from WP compared to cigarettes. CONCLUSION This study is the first to systematically develop and evaluate potential WP-specific HWLs based on the scientific evidence about WP's harmful effects, scientific understanding of HWL for cigarettes and the opinions of experts in WP science, tobacco control and health communication. The final selected HWLs can be adapted based on the context and policy landscape of the target country and can be further fine-tuned based on feedback from WP smokers and non-smokers.
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Affiliation(s)
- Taghrid Asfar
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.,Syrian Center for Tobacco Studies, Aleppo, Syria.,Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, US
| | - Michael Schmidt
- Department of Art, The University of Memphis, Memphis, Tennessee, USA
| | - Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, USA
| | - Wensong Wu
- Department of Mathematics and Statistics, Florida International University, Miami, Florida, USA
| | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria.,School of Public Health, The University of Memphis, Miami, Florida, USA
| | - Rima T Nakkash
- Health Behaviour and Education Department, American University of Beirut, Beirut, Lebanon
| | - James Thrasher
- Health Promotion, Education, and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria.,USA Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Habiba Ben Romdhane
- Cardiovascular Epidemiology and Prevention Research Laboratory, Faculty of Medicine of Tunis-Tunisia, Tunis, Tunisia
| | - Wasim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria.,Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, USA
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Salloum RG, Lee J, Mostafa A, Abu-Rmeileh NME, Hamadeh RR, Darawad MW, Kheirallah KA, Salama M, Maziak W, Nakkash R. Waterpipe Tobacco Smoking among University Students in Three Eastern Mediterranean Countries: Patterns, Place, and Price. Subst Use Misuse 2019; 54:2275-2283. [PMID: 31347433 DOI: 10.1080/10826084.2019.1645177] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: The objective of this study was to examine waterpipe tobacco smoking patterns, places of smoking, and prices paid among university students in the Eastern Mediterranean Region. Methods: A cross-sectional online survey was administered to a convenience sample of university students in three countries. Participants were young adults (18-29 years) who were ever waterpipe smokers, from Egypt (n = 728), Jordan (n = 790), and Palestine (n = 722). Measures included past-30-day waterpipe smoking, frequency, intensity, place of smoking, and prices paid per waterpipe smoking session and for packaged waterpipe tobacco. Logistic regression models evaluated the factors associated with past-30-day waterpipe smoking. Results: Past-30-day waterpipe smoking (prevalence) was observed among 60.7%, 67.7% and 63.1% of students from Egypt, Jordan, and Palestine, respectively. Among past-30-day smokers, past-5-day waterpipe smoking (frequency) was observed among 28.9%, 51.5%, and 48.6% of participants, respectively. Smoking in a café was highest among participants from Egypt (74.0%), followed by those from Palestine (44.8%), and Jordan (43.0%). Mean price paid per session was USD 0.99 (Egypt), USD 8.07 (Jordan), USD 6.05 (Palestine). The corresponding mean prices per packet were USD 0.86, USD 4.96, and USD 5.55, respectively. Predictors of past-30-day waterpipe smoking included younger age of initiation, male gender, employment, and smoking waterpipe alone. Conclusions: This study contributes to our understanding of waterpipe smoking patterns, places of smoking, and prices paid among young adults in a region with alarmingly high smoking rates. Understanding waterpipe smoking behaviors can inform the design of policy and educational interventions to curb its rising threat.
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Affiliation(s)
- Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA.,Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - JuHan Lee
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Aya Mostafa
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Randah R Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | | | - Khalid A Kheirallah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamed Salama
- Medical Experimental Research Center, Mansoura University, Mansoura, Egypt
| | - Wasim Maziak
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Ibrahim BA, Al-Humaish S, Al-Obaide MAI. Tobacco Smoking, Lung Cancer, and Therapy in Iraq: Current Perspective. Front Public Health 2018; 6:311. [PMID: 30416993 PMCID: PMC6212484 DOI: 10.3389/fpubh.2018.00311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 10/09/2018] [Indexed: 01/16/2023] Open
Abstract
Tobacco smoking is a research topic of high interest to the public health in Iraq. Although Iraq is a country with a high percentage of smokers, we noticed the dearth of adequate studies and programs to deal with this problem. The percentage of smokers exceed 30% of the population and smoking problem becomes a permanent habit in adults and young people. The problems associated with tobacco smoking behavior related to individuals' post-traumatic stress disorder following post-war conflicts, and the social and cultural environment. The health consequences of tobacco smoking can harm almost every organ in the body, and there are reports confirmed the tobacco smoking is a high-risk factor for lung cancer and other diseases. The relative risk of lung cancer increases with increasing duration and intensity of smoking. Also, smoking associated with bladder, prostate, and head and neck cancers, in addition to respiratory diseases. Intervention efforts should focus on reducing the prevalence of cigarette smoking, introduce effective treatments for cancer and quit smoking. In this perspective article, we present our viewpoint and three scenarios to deal with the problem of tobacco smoking in Iraq. We recommend introducing educational, health and legislative policies for quitting smoking and using effective treatments for cancer.
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Mostafa A, Mohammed HT, Hussein WM, Elhabiby M, Safwat W, Labib S, Aboul Fotouh A, Hoek J. Plain packaging of waterpipe tobacco? A qualitative analysis exploring waterpipe smokers' and non-smokers' responses to enhanced versus existing pictorial health warnings in Egypt. BMJ Open 2018; 8:e023496. [PMID: 30355793 PMCID: PMC6224725 DOI: 10.1136/bmjopen-2018-023496] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/20/2018] [Accepted: 08/08/2018] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Despite the global increase in waterpipe tobacco smoking (WTS) including in Egypt, few studies have assessed the effectiveness of waterpipe tobacco (WT) health warnings. Egypt has used pictorial health warnings (PHWs) on waterpipe tobacco packs (WTPs) and has rotated these every two years since 2008. We explored in this qualitative study how participants perceived existing PHWs on WTPs, assessed how they interpreted novel plain packaging of WT featuring enhanced PHWs, and probed perceptions of how existing and novel sets would affect uptake or cessation of WTS. DESIGN We conducted ten qualitative focus groups and ten in-depth interviews. We explored participants' views of the four existing PHWs (occupied 50% of the front and back of WTPs, displayed cancers, and featured colourful fruits and flavors) and four novel PHWs (occupied 80% of the front and back of WTPs, displayed different topical content, with plain packaging). Transcripts were analyzed using thematic analysis. SETTING Rural Menoufia, urban and semi-urban Cairo, Egypt. PARTICIPANTS 90 waterpipe smokers and non-smokers, men and women, aged 18 years or older. OUTCOMES Perceived potential effect on WTS uptake or cessation, probing factors related to PHW content and WTP design. RESULTS Participants in focus groups and in-depth interviews thought existing WT PHWs elicited affective responses, but found them unclear or unrealistic and thought the colourful packaging detracted from the warnings. In contrast, they thought novel and larger WT PHWs presented in plain packaging might prevent WTS initiation or trigger quit attempts. Participants regarded warnings featuring proximal health risks as most likely to be acceptable. CONCLUSIONS Our exploratory study suggests larger WT PHWs featuring proximal risks and presented on plain WTPs could potentially deter experimentation with WT products among non-users and promote cessation among existing users.
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Affiliation(s)
- Aya Mostafa
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba Tallah Mohammed
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- School of Pharmacy, University of Waterloo, Ontario, Canada
| | - Wafaa Mohamed Hussein
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Elhabiby
- Department of Psychiatry Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Wael Safwat
- Egyptian Tobacco Control Coalition, Cairo, Egypt
- Egypt Health Foundation, Cairo, Egypt
| | - Sahar Labib
- Tobacco Control Unit, Ministry of Health, Cairo, Egypt
| | - Aisha Aboul Fotouh
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Janet Hoek
- Departments of Public Health and Marketing, University of Otago, Otago, New Zealand
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Al-Maweri SA, Al-Soneidar WA, AlMaqtari A, Hunaish A, Al-Sufyani G, Halboub E. Tobacco Cessation Counseling: Attitudes and Practices among Yemeni Dental Professionals. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:1088-1093. [PMID: 28324226 DOI: 10.1007/s13187-017-1212-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Tobacco use is a significant health problem in Yemen and worldwide. Dental practitioners can play a pivotal role in educating their patients on the risk of smoking and motivating them to quit. This study aimed to assess the attitudes towards and practices of tobacco cessation counseling (TCC) among Yemeni dental professionals and to evaluate whether such attitudes and practices are associated with gender, smoking status, and years since graduation. In this cross-sectional study, a self-administered questionnaire containing questions regarding the practice and attitudes towards TCC in dental clinic was used. SPSS version 20 was used for data analysis. For statistical analysis, Chi-square test was used with a significance level of P < 0.05. Of the 400 distributed questionnaires, 182 were completed and analyzed. 53.3% of the respondents were males and 46.7% were females. Around one fifth of the respondents were smokers. The majority reported that they routinely ask their patients about their tobacco habits (83.5%), and advise against tobacco use (85%). Around half of the respondents believed that tobacco cessation intervention may affect their clinical practice and their income negatively through decreasing number of attending patients and believed that provision of dental treatment is more important than TCC. The majority (92%) believe that health professionals should refrain from tobacco, and 83% agree that TCC should be included in dental school curricula. Recent graduates and non-smokers showed relatively better attitudes and practices. There is an urgent need for continuing educational programs in TCC. Also, inclusion of TCC to dental curriculum is highly required.
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Affiliation(s)
- Sadeq Ali Al-Maweri
- Department of Oral Medicine and Diagnostic Sciences, AlFarabi Colleges, Riyadh, Saudi Arabia.
- Department of Oral Medicine, Faculty of Dentistry, Sanaa University, Sana'a, Yemen.
| | - Walid A Al-Soneidar
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC, USA
- Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | | | - Abdulrahman Hunaish
- Department of Oral and Maxillofacial Surgery, AlFarabi Colleges, Riyadh, Saudi Arabia
| | | | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Gurmeet Singh A, Chaturvedi P. Smoking and other addictions related to cancer of the head and neck. REVISTA MÉDICA CLÍNICA LAS CONDES 2018. [DOI: 10.1016/j.rmclc.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Alqudah MAY, Alzoubi KH, Ma’abrih GM, Khabour OF. Vitamin C prevents memory impairment induced by waterpipe smoke: role of oxidative stress. Inhal Toxicol 2018; 30:141-148. [DOI: 10.1080/08958378.2018.1474977] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Mohammad A. Y. Alqudah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Ghida’a M. Ma’abrih
- Department of Toxicology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F. Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Mugyenyi AEK, Haberer JE, O'Neil I. Pleasure and practice: a qualitative study of the individual and social underpinnings of shisha use in cafes among youth in the UK. BMJ Open 2018; 8:e018989. [PMID: 29654007 PMCID: PMC5905732 DOI: 10.1136/bmjopen-2017-018989] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 02/16/2018] [Accepted: 02/19/2018] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To explore (1) the social function of shisha cafes for young people living in the UK and (2) other alternative activities (existing or potential) that do not involve tobacco smoking. METHODS We conducted qualitative interviews with young adults (age 18-30) in Leeds, UK. Snowballing sampling was used in selecting the participants. Interviews were audio-recorded and explored the perspectives and experiences of young people in as well as potential alternative activities. Data were transcribed and analysed thematically. RESULTS Shisha use plays a central role in social interactions. Youth described using shisha because of emotional and sensory pleasure. Shisha use was implicitly endorsed by respected professionals, such as doctors and university lecturers, who were seen smoking it. Most, but not all, shisha smokers acknowledged that shisha use is harmful. Suggestions for reducing shisha use included use of non- tobacco alternatives, legislation to reduce access and alternative means for socialising, such as sports. CONCLUSION For young people in the UK, the known health dangers of shisha are outweighed by its social benefits and shisha is perceived as acceptable. Interventions to reverse the increase in shisha cafes should focus on both individual smoker as well as the community, without sacrificing the importance of social interactions.
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Affiliation(s)
| | - Jessica E Haberer
- Department of Medicine, Havard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ivy O'Neil
- Health Promotion Department, Leeds Beckett University, Leeds, UK
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Zyoud SH. Estimates of global research productivity in using nicotine replacement therapy for tobacco cessation: a bibliometric study. Global Health 2018; 14:14. [PMID: 29382348 PMCID: PMC5791372 DOI: 10.1186/s12992-018-0335-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/18/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Tobacco use is a major healthcare problem worldwide. Tobacco smoking remains the most important risk factor for both cancer and heart diseases. This study was initiated due to the lack of published data concerning the real progress in research output in the use of nicotine replacement therapy (NRT) for tobacco cessation. This study was aimed to use bibliometric analysis to estimate the NRT literature indexed in Scopus database at global level. METHODS Core of the search strategy was the documents that contained specific words or phrases regarding NRT as keywords in the title. Publication output of most prolific countries was adjusted to the gross domestic product and population size. All citations analysis were accomplished on December 22, 2017. RESULTS A total of 2138 references were retrieved and published from 56 countries, which were published between 1970 and 2016. The USA has the most number of published articles accounted to 986, followed by the UK (312 publications) and then Australia (102 publications), and Sweden (102 publications). No data related to NRT were published from 156 countries. No significant correlation was found between the country population size or 2016 gross domestic product values and the number of publications of the top-10 most prolific countries in the field of NRT (r = - 0.156, P = 0.664; and r = - 0.173, P = 0.632, respectively). Furthermore, there is no correlation between prevalence of tobacco smoking and number of publications of the top-10 most prolific countries in the field of NRT (r = - 0.235, P = 0.514). CONCLUSIONS The present data reveal a solid mass of research activity on NRT. The USA was by far the predominant country in the amount of NRT-based research activity. NRT-based research activities were low or not available in most countries. The results of this study delineate a framework for better understanding the situations of current NRT research and prospective directions of the research in this field which could be applied for managing and prioritizing future research efforts in NRT research.
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Affiliation(s)
- Sa'ed H Zyoud
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
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78
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Jallow IK, Britton J, Langley T. Prevalence and determinants of tobacco use among young people in The Gambia. BMJ Glob Health 2017; 2:e000482. [PMID: 29333286 PMCID: PMC5759717 DOI: 10.1136/bmjgh-2017-000482] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/30/2017] [Accepted: 09/01/2017] [Indexed: 11/05/2022] Open
Abstract
Introduction Tobacco consumption and consequent morbidity and mortality are expected to grow most markedly over coming decades in low-income and middle-income countries (LMICs). Preventing tobacco experimentation and uptake among young people in LMICs is therefore vital. However, data on smoking in these countries, particularly in sub-Saharan Africa, remain sparse. Method We used two-stage cluster random sampling to select students in upper and senior secondary schools throughout The Gambia, and a self-administered questionnaire to collect data on their tobacco use, risk factors and demographic details. Results Of 10 392 eligible students, 10 289 (99%; 55% girls and 44% boys, age 12–20 years) participated. The prevalence of ever smoking cigarettes, cigars or pipes was 16.7% (25.7% boys and 9.4% girls) and current (past 30 days) smoking 4.5% (7.9% boys and 1.5% girls). Smoking was more common among students attending private schools (OR 1.69, 95% CI 1.29 to 2.22), of Christian or other faiths compared with Muslims, living with parents (OR 1.39, 95% CI 1.06 to 1.81), who had smoking allowed in their homes (OR 1.67, 95% CI 1.30 to 2.13), with family members who smoked or had one or more friends who smoked. Most (55.6%) smokers want to stop, but only 22% received any stop smoking support. Ever smoking of shisha, at 8.1%, was unexpectedly high, and relatively prevalent among girls (11.4% of boys and 5.4% of girls). Conclusions Tobacco use is common among young people in The Gambia. Shisha smoking is also common in this population, and in relative terms especially among girls. Further work is required to determine whether this is a problem local to The Gambia or reflects a wider pattern of tobacco use in sub-Saharan Africa.
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Affiliation(s)
- Isatou K Jallow
- Division of Epidemiology and Public Health, UK Center for Tobacco and Alcohol Studies, University of Nottingham, Clinical Science Building, CityHospital, Nottingham NG5 1PB, UK.,Ministry of Health & Social Welfare, National Public Health Laboratory, Banjul, The Gambia
| | - John Britton
- Division of Epidemiology and Public Health, UK Center for Tobacco and Alcohol Studies, University of Nottingham, Clinical Science Building, CityHospital, Nottingham NG5 1PB, UK
| | - Tessa Langley
- Division of Epidemiology and Public Health, UK Center for Tobacco and Alcohol Studies, University of Nottingham, Clinical Science Building, CityHospital, Nottingham NG5 1PB, UK
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79
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Salloum RG, Abu-Rmeileh N, Hamadeh R, Thomas J, Mostafa A, Yusufali A, Kheirallah KA, Macauda MM, Theis RP, El Kadi L, Johnson EJ, Darawad MW, Nakkash R. Policy-Relevant Context of Waterpipe Tobacco Smoking among University Students in Six Countries Across the Eastern Mediterranean Region: A Qualitative Study. Asian Pac J Cancer Prev 2017; 18:2533-2540. [PMID: 28952296 PMCID: PMC5720662 DOI: 10.22034/apjcp.2017.18.9.2533] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Waterpipe tobacco smoking rates in the Eastern Mediterranean region are some of the highest worldwide, especially among young people. This study aimed to improve our knowledge of the policy-relevant context of waterpipe smoking among six countries in the Eastern Mediterranean region. Methods: In-depth interviews were conducted in Bahrain, Egypt, Jordan, Lebanon, Palestine, and the United Arab Emirates. Participants were young adult university students (18-29 years) from both genders who had ever smoked the waterpipe, recruited from universities participating in this study. Directed content analysis was used to analyze the transcripts. Results: A total of 53 in-depth interviews were conducted in Arabic in 2016. Findings were organized around 5 themes: waterpipe product characteristics; patterns of waterpipe smoking; the waterpipe café setting; perceived health consequences; and health warning labels. Waterpipe smoking was commonly perceived as a safe alternative to cigarettes. Waterpipe tobacco was reported to be widely accessible and affordable to young participants. There is a lack of knowledge among waterpipe smokers about the associated health effects. Warning labels are effective at communicating health risks associated with waterpipe smoking. Conclusions: Regulatory frameworks for waterpipe tobacco smoking should be developed and enforced, including waterpipe-specific health warning labels that elucidate the harmful effects of waterpipe smoking.
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Affiliation(s)
- Ramzi G Salloum
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA.
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80
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Al-Hemiery N, Dabbagh R, Hashim MT, Al-Hasnawi S, Abutiheen A, Abdulghani EA, Al-Diwan JK, Kak N, Al Mossawi H, Maxwell JC, Brecht ML, Antonini V, Hasson A, Rawson RA. Self-reported substance use in Iraq: findings from the Iraqi National Household Survey of Alcohol and Drug Use, 2014. Addiction 2017; 112:1470-1479. [PMID: 28238214 DOI: 10.1111/add.13800] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/15/2016] [Accepted: 02/22/2017] [Indexed: 11/29/2022]
Abstract
AIMS To estimate the prevalence of tobacco, alcohol and drug use in Iraq using data from the Iraqi National Household Survey of Alcohol and Drug Use (INHSAD). DESIGN A cross-sectional survey was conducted using a multi-stage cluster sampling method. Trained surveyors conducted face-to-face household interviews. SETTING Iraq, from April 2014 to December 2014. PARTICIPANTS A total of 3200 adult, non-institutionalized Iraqi citizens residing across all 18 governorates of Iraq. MEASUREMENTS We estimated weighted prevalence and 95% confidence intervals (CIs) for life-time, past-year and past-month use of a variety of substances (tobacco, alcohol, prescription drugs and illicit drugs). For each substance, we also estimated whether individuals knew people who currently use the substance. FINDINGS Self-reported past-month tobacco use was 23.2% (95% CI = 21.40, 25.19). Past-month alcohol use was 3.2% (95% CI = 2.58, 3.93). Women reported significantly lower prevalence for both tobacco and alcohol use compared with men (P-value < 0.01 for both). Only 1.4% (95% CI = 0.67, 3.02) reported past-month non-medical use of any prescription drugs. None of the women reported using any illicit drugs, and only 0.2% (95% CI = 0.07, 0.49) of men reported using any illicit drugs in the past month. Approximately 90.5% (95% CI = 88.58, 92.11) knew someone who uses tobacco, 42.4% (95% CI = 39.53, 45.24) knew someone who drinks alcohol, 27.9% (95% CI = 25.53, 30.45) knew someone who uses medication outside a doctor's instructions and 9.2% (95% CI = 7.87, 10.75) knew someone who uses an illicit drug. CONCLUSIONS Psychoactive drug use is generally low in Iraq, tobacco being highest at an estimated 23.2%. Iraqi women report significantly less substance use than Iraqi men, which may be related to cultural gender norms. Discrepancy between self-report and 'knowing someone who uses a substance' suggests under-reporting in this population.
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Affiliation(s)
- Nesif Al-Hemiery
- Psychiatry Division, Department of Medicine, College of Medicine, University of Baghdad, Iraq
| | - Rufaidah Dabbagh
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
| | - Mushtaq T Hashim
- Psychiatry Division, Department of Medicine, College of Medicine, University of Baghdad, Iraq
| | | | - Ali Abutiheen
- Department of Family and Community, Medicine College of Medicine, Kerbala University, Iraq
| | | | - Jawad K Al-Diwan
- Department of Community Medicine, College of Medicine, University of Baghdad, Iraq
| | - Neeraj Kak
- University Research Co. LLC, Center for Human Services, Bethesda, ND, USA
| | - Hala Al Mossawi
- University Research Co. LLC, Center for Human Services, Bethesda, ND, USA
| | | | - Mary-Lynn Brecht
- Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
| | - Valerie Antonini
- Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
| | - Albert Hasson
- Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
| | - Richard A Rawson
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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81
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Banks C, Rawaf S, Hassounah S. Factors influencing the tobacco control policy process in Egypt and Iran: a scoping review. Glob Health Res Policy 2017; 2:19. [PMID: 29202087 PMCID: PMC5683450 DOI: 10.1186/s41256-017-0039-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 05/05/2017] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Tobacco control policy is essential for addressing the growing tobacco consumption seen in the Eastern Mediterranean Region, the single greatest preventable contributor to the non-communicable disease epidemic. Egypt and Iran have had varied success in using policy to combat this issue. The study aims to identify and compare the factors which have influenced different stages of the policy process - evidence generation, development and implementation. METHODS A scoping review was conducted with a systematic search of 7 databases which was conducted along with searches of Google Scholar, and the World Health Organisation and Eastern Mediterranean Regional Office websites to identify influencing factors at each stage of the policy process. RESULTS Twenty-seven relevant articles were identified from the literature search. Factors identified as influencing tobacco control policy in these countries were lobbying by the tobacco industry, the rise of water-pipe smoking, lack of political commitment and the lack of resources to for policy implementation. Iran was found to be leading Egypt on all three areas of the policy process. Implementation was found to be the most pivotal part of the policy process and the area in which Egypt was weakest compared to Iran. CONCLUSION This study addresses a gap in knowledge concerning tobacco control in the Middle East and has identified multiple factors which are potentially slowing the process of enforcing policy to address tobacco consumption. Iran is the regional leader for tobacco control and it is important for Egypt to assess the transferability of its tactics and immediately start implementing measures to control tobacco use.
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Affiliation(s)
- C. Banks
- WHO Collaborating Centre for Public Health Education & Training, Department of Primary Care & Public Health, School of Public Health, Imperial College London, Charing Cross Campus, 3rd Floor, The Reynolds Building, St Dunstan’s Road, London, W6 8RF UK
| | - S. Rawaf
- WHO Collaborating Centre for Public Health Education & Training, Department of Primary Care & Public Health, School of Public Health, Imperial College London, Charing Cross Campus, 3rd Floor, The Reynolds Building, St Dunstan’s Road, London, W6 8RF UK
| | - S. Hassounah
- WHO Collaborating Centre for Public Health Education & Training, Department of Primary Care & Public Health, School of Public Health, Imperial College London, Charing Cross Campus, 3rd Floor, The Reynolds Building, St Dunstan’s Road, London, W6 8RF UK
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82
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Alimohammadi M, Jafari-Mansoorian H, Hashemi SY, Momenabadi V, Ghasemi SM, Karimyan K. Review on the Implementation of the Islamic Republic of Iran about Tobacco Control, Based on MPOWER, in the Framework Convention on Tobacco Control by the World Health Organization. ADDICTION & HEALTH 2017; 9:183-189. [PMID: 29657699 PMCID: PMC5894798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 05/01/2017] [Indexed: 10/27/2022]
Abstract
BACKGROUND Smoking is the largest preventable cause of death in the world, killing nearly 6 million people annually. This article is an investigation of measures implemented laws in the Iran to study the proposed strategy of control and reduce tobacco use based on the monitor, protect, offer, warn, enforce and raise (MPOWER) policy. METHODS All laws approved by the Parliament along with the instructions on tobacco control prepared by the Ministry of Health and Medical Education, Ministry of Industry, Mine and Trade were collected and studied. Moreover, practical steps of Ministry of Health and other organizations were examined in this regard. FINDINGS Iranian Parliament after the adoption of the Framework Convention on Tobacco Control (FCTC) acts to create a comprehensive and systematic program for tobacco control legislation as a first step towards comprehensive national tobacco control and combat. In this law and its implementing guidelines and based on the strategy of MPOWER, specific implement is done to monitor tobacco use and prevention policies, protect people from tobacco smoke, offer help to quit tobacco use, warn about the dangers of tobacco, enforce bans on tobacco advertising, promotion and sponsorship and raise taxes on tobacco. However, the full objectives of the legislation have not achieved yet. CONCLUSION According to Iran's membership in the FCTC and executive producer of tobacco control laws and regulations, necessary infrastructure is ready for a serious fight with tobacco use. In Iran, in comparison with developed countries, there is a huge gap between ratified laws and performing of laws.
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Affiliation(s)
- Mahmood Alimohammadi
- Associate Professor, Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Jafari-Mansoorian
- Lecturer, Environmental Health Engineering Research Center, School of Public Health, Kerman University of Medical Sciences, Kerman AND Young Researchers and Elite Club, Hamedan Branch, Islamic Azad University, Hamedan, Iran
| | - Seyed Yaser Hashemi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Victoria Momenabadi
- Department of Health Education and Health Promotion, School of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mehdi Ghasemi
- Department of Environmental Health Engineering, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamaladdin Karimyan
- Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj AND PhD Student, Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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83
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The frequency of bladder cancer in Alexandria, Egypt, over the last two decades. Eur J Cancer Prev 2017; 27:477-478. [PMID: 28538041 DOI: 10.1097/cej.0000000000000368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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84
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Lopez AA, Eissenberg T, Jaafar M, Afifi R. Now is the time to advocate for interventions designed specifically to prevent and control waterpipe tobacco smoking. Addict Behav 2017; 66:41-47. [PMID: 27871044 DOI: 10.1016/j.addbeh.2016.11.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/30/2016] [Accepted: 11/10/2016] [Indexed: 12/26/2022]
Abstract
Waterpipe tobacco usage is spreading rapidly worldwide, with reports of more youth being waterpipe users compared to adults. In many areas of the world, waterpipe usage surpasses cigarette smoking. Waterpipes and cigarettes are both mechanisms for inhalation of tobacco smoke and therefore have serious health consequences. However, because of the many differences between the two products, prevention and control strategies that have proven effective for cigarettes may not transfer readily to waterpipe. This report highlights the differences between waterpipes and cigarettes in toxicant exposure and physiologic effects, patterns of use, social norms, the extent of evidence, and the policy environment. There is little evidence to date around effective interventions for waterpipe prevention and control. The current state of evidence for intervention to curb or control waterpipe is at ground zero and critically needs attention from both scientists and policy makers. National and global efforts aimed at cigarette prevention have succeeded, particularly in developed countries. We suggest the time has come to harness what we know works for cigarette prevention and control and adapt it to tackle the growing epidemic of waterpipe tobacco use.
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Affiliation(s)
- A A Lopez
- Center for the Study of Tobacco Products, Virginia Commonwealth University, USA; Department of Psychology, Virginia Commonwealth University, USA
| | - T Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, USA; Department of Psychology, Virginia Commonwealth University, USA
| | - M Jaafar
- Department of Health Promotion and Community Health, American University of Beirut, Lebanon
| | - R Afifi
- Department of Health Promotion and Community Health, American University of Beirut, Lebanon.
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85
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Al Makadma AS. Adolescent health and health care in the Arab Gulf countries: Today's needs and tomorrow's challenges. Int J Pediatr Adolesc Med 2017; 4:1-8. [PMID: 30805493 PMCID: PMC6372452 DOI: 10.1016/j.ijpam.2016.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 11/29/2016] [Accepted: 12/04/2016] [Indexed: 11/24/2022]
Abstract
This review article documents the evidence regarding the health status of adolescents aged between 10 and 19 years in the Arab region and the Gulf Cooperation Council countries (GCC) and also considers the state of adolescent health care in the region compared to the recommended guidelines for such services. Adolescents make up more than 25% of the population of the GCC countries, a percentage that is far higher than that in other high-income countries, yet their health status and health care needs are not given proportional attention in the region. Thus, the burden of mortality and morbidity for adolescents in the region has shifted from communicable diseases to road traffic injuries, mental health issues, non-communicable diseases, and health-compromising behaviors and conditions that contribute to those issues. Whereas the sources of evidence are limited with respect to some issues, such as mental health issues, sexual and reproductive health, and alcohol use, other health issues, such as rising rates of tobacco use, low levels of physical activity, minimal consumption of fruit and vegetables, and high levels of obesity, are better-documented. Many health care providers see adolescents who have limited or no training in adolescent health care and adolescents who are transitioned to the adult care system at young ages without the necessary health care transition services, thus creating challenges for these individuals to access developmentally appropriate health care. Recommendations include prioritizing health care practice, health care facilities, clinical education, and adolescent health research to address key aspects of adolescent health and adolescent medical care in the GCC countries. This could be accomplished through the development of adolescent health care centers that bring together expert interdisciplinary care, excellent health provider training, and cutting-edge adolescent health research to provide leadership throughout the region and further both the health of adolescents and their access to high-quality, holistic health services.
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86
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Awan KH, Siddiqi K, Patil S, Hussain QA. Assessing the Effect of Waterpipe Smoking on Cancer Outcome - a Systematic Review of Current Evidence. Asian Pac J Cancer Prev 2017; 18:495-502. [PMID: 28345836 PMCID: PMC5454749 DOI: 10.22034/apjcp.2017.18.2.495] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background: Waterpipe smoking (WPS) is widely believed to be a safe and hazard-free tobacco habit. However,
a number of studies have indicated that exposure to several toxicants and carcinogens through WPS is strongly related
to serious health hazards. The current paper presents a narrative review on the effects of WPS on cancer outcome.
Methods: The addressed focused question was “Is there an association between waterpipe smoking and cancer outcome?”
PubMed, Medline, EMBASE, ISI Web of Science and the Cochrane databases were searched until June 2015 using the
key words “Waterpipe”, “Hookah”, “Narghileh”, “Shisha”, “Hubbly Bubbly” “cancer” in various combinations. Letters
to the Editor, review articles, case-reports and unpublished articles were excluded. Results: A total of 16 studies were
included: six on lung cancer, three on oesophageal cancer, two on gastric cancer, two on bladder cancer, and one each
on nasopharyngeal, pancreatic and prostate cancers. Our search did not yield any study that evaluated the risk of oral
cancer in WPS users. The available evidence showed a significant association of WPS with lung cancer (UOR 6.0, 95%
CI 1.78–20.26); however, no association was observed with bladder, nasopharyngeal, pancreatic and prostate cancers.
Gastric (OR 3.4, 95% CI 1.7-7.1) and oesophageal cancers (OR 1.85, 95% CI 1.41-2.44) were observed to have weak
associations with WPS. Conclusion: Regardless of the limitations, there is sufficient evidence to suggest associations
of WPS with cancer, particularly in the lung. Future well-designed studies are required to identify and quantify with
confidence all the health effects of this form of smoking.
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Affiliation(s)
- Kamran Habib Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah 84095, United States.
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87
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Gostin LO, Abou-Taleb H, Roache SA, Alwan A. Legal priorities for prevention of non-communicable diseases: innovations from WHO's Eastern Mediterranean region. Public Health 2016; 144:4-12. [PMID: 28274382 DOI: 10.1016/j.puhe.2016.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/27/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Non-communicable diseases (NCDs) are the leading cause of death globally and in the World Health Organization's (WHO) Eastern Mediterranean region (EMR). This paper reports on a research collaboration between the WHO's Eastern Mediterranean Office (EMRO) and the O'Neill Institute for National and Global Health Law at Georgetown University that aims to identify (1) regionally relevant, cost-effective and affordable legal interventions to prevent NCDs, and (2) methods to strengthen implementation and enforcement. STUDY DESIGN Comparative analysis of >200 international, regional and domestic interventions addressing key NCD risk factors, including tobacco, alcohol, diet and physical inactivity. METHODS Researchers searched legal and policy databases including the WHO Nutrition, Obesity and Physical Activity Database and drew upon academic commentary and 'grey' literature. Measures included evidence of impact; evidence of cost-effectiveness; and monitoring and enforcement mechanisms. RESULTS Researchers identified many examples of legal interventions effectively reducing NCD risk factors. Key enabling factors for effective NCD-related laws include regulatory capacity; governance mechanisms promoting multisectoral collaboration and accountability; and tailoring interventions to local legal, economic and social contexts. CONCLUSIONS In the EMR, and globally, law can be a cost-effective and affordable means of curbing underlying drivers of the NCD pandemic, such as rampant junk food marketing. Building upon this research, together with international and regional experts, EMRO has identified 10 priority interventions in the areas of tobacco control, unhealthy diets and NCD governance. The EMRO/O'Neill Institute partnership will develop guidance tools and capacity building initiatives to support Member States to harness the power of law to achieve population health improvements.
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Affiliation(s)
- L O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, 600 New Jersey Avenue NW, 20001, Washington, DC, USA.
| | - H Abou-Taleb
- World Health Organization, Regional Office for the Eastern Mediterranean, Nasr City, Cairo, 11371, Egypt.
| | - S A Roache
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, 600 New Jersey Avenue NW, 20001, Washington, DC, USA.
| | - A Alwan
- World Health Organization, Regional Office for the Eastern Mediterranean, Nasr City, Cairo, 11371, Egypt.
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88
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Tackling Chronic Disease in the Gulf Region: Swings and Roundabouts. Glob Heart 2016; 11:447-450. [PMID: 27938839 DOI: 10.1016/j.gheart.2016.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 10/03/2016] [Indexed: 11/21/2022] Open
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89
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Al-sheyab NA, Al-Fuqha RA, Kheirallah KA, Khabour OF, Alzoubi KH. Anthropometric measurements of newborns of women who smoke waterpipe during pregnancy: a comparative retrospective design. Inhal Toxicol 2016; 28:629-635. [DOI: 10.1080/08958378.2016.1244227] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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90
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Predictors of nicotine withdrawal symptoms: findings from the first randomized smoking cessation trial in a low-income country setting. Int J Public Health 2016; 61:701-708. [PMID: 27083449 DOI: 10.1007/s00038-016-0818-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 03/23/2016] [Accepted: 03/29/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To identify predictors of nicotine withdrawal symptoms among smokers who participated in a randomized cessation trial in a low-income country. METHODS We analyzed data from 269 smokers who participated in a randomized, placebo-controlled smoking cessation trial conducted in primary healthcare in Aleppo, Syria. All participants received behavioral counseling and were randomized to receive either 6 weeks of nicotine or placebo patch and were followed for one year. RESULTS Throughout the study, lower total withdrawal score was associated with greater education (p = 0.044), older age of smoking initiation (p = 0.017), lower nicotine dependence (p = 0.024), higher confidence in ability to quit (p = 0.020), lower reported depression (p < 0.001), higher adherence to patch (p = 0.026), belief of receiving nicotine patches rather than placebo (p = 0.011), and waterpipe use (p = 0.047). CONCLUSIONS Lower nicotine dependence, greater educational attainment, higher confidence in ability to quit and waterpipe use predict lower withdrawal severity. Waterpipe smoking may serve as a barrier to smoking cessation efforts in countries where its use is highly prevalent. Further, expectancies about the effects of pharmacotherapy appear to mediate the experience of nicotine withdrawal.
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91
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Al-sheyab NA, Alomari MA, Shah S, Gallagher R. “Class smoke-free” pledge impacts on nicotine dependence in male adolescents: A cluster randomized controlled trial. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.3109/14659891.2015.1112848] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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92
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Building Evidence-Based Tobacco Treatment in the Eastern Mediterranean Region: Lessons Learned by the Syrian Center for Tobacco Studies. J Smok Cessat 2016; 11:116-123. [PMID: 27563356 DOI: 10.1017/jsc.2016.5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The tobacco epidemic in Syria is characterized by high rates of cigarettes smoking in men and dramatic reemergence of waterpipe smoking, especially among youths and women. The Syrian Center for Tobacco Studies (SCTS), an NIH-funded pioneer research and capacity building institution, has developed a research infrastructure and conducted three randomized clinical trials to develop and rigorously test culturally-appropriate tobacco treatment programs integrated into primary healthcare (PHC) centers. This review aimed to discuss challenges and lessons learned from the Syrian experience. Addressing these challenges may inform future cessation research activities in Syria and other developing countries. To develop a research infrastructure, the SCTS has established Syria's first IRB and trained physicians/medical students in both tobacco treatment and research methods. Main challenges to conduct the cessation trials were difficulties of coordination between the local and international collaborators; high Smoking Rates among PHC providers; lack of pharmacological agents used in tobacco treatment; and difficulties of conducting research in a politically volatile region. Strategies to overcome these challenges were ensuring an active and regular involvement of all investigator; and advocating for a national smoking-cessation plan that involves training health care providers in smoking cessation treatment and make pharmacological agents used in smoking cessation available.
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Jawad M, Power G. Prevalence, correlates and patterns of waterpipe smoking among secondary school students in southeast London: a cross-sectional study. BMC Public Health 2016; 16:108. [PMID: 26830194 PMCID: PMC4736266 DOI: 10.1186/s12889-016-2770-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 01/22/2016] [Indexed: 12/02/2022] Open
Abstract
Background Waterpipe smoking is growing worldwide, but little is known of its epidemiology in the UK due to its absence from national health surveys. We sought to address this by calculating the prevalence of waterpipe smoking among secondary school students in southeast London. Methods We conducted a pooled secondary analysis of routine health surveillance surveys among 11–17 year olds in convenience-sampled secondary schools from three ethnically-diverse areas of southeast London. We calculated ever (lifetime) waterpipe use, and compared its sociodemographic correlates to ever (lifetime) cigarette use. In one area we collected data on patterns of waterpipe use. Results Of 2,098 respondents (mean age 14.1 ± 1.7 years, 55.7 % male, 46.6 % of black ethnicity), ever waterpipe use was 39.6 % (95 % CI 37.6–41.7 %) and was higher than that for ever cigarette use (32.4 %; 95 % CI 30.5–34.4). While waterpipe users were significantly and independently more likely to be male and of non-white ethnicities, at least 30 % of all age, gender and ethnic sub-groups had tried waterpipe smoking. In contrast, cigarette users were more likely to be older and of white ethnicity. In one of the three areas, over a quarter of waterpipe users were occasional or regular waterpipe smokers, and most were introduced to and currently used waterpipe in waterpipe-serving premises or friends’ homes. Conclusions Waterpipe smoking prevalence was high in southeast London, and users exhibited a different sociodemographic profile to cigarette users. Waterpipe should be included in national health surveys of young people. National surveillance is warranted to help develop suitable interventions to prevent uptake and promote cessation.
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Affiliation(s)
- Mohammed Jawad
- Department of Primary Care and Public Health, Imperial College London, Hammersmith, W6 8RP, UK. .,Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, Hampshire, SO16 6YD, UK.
| | - Gerald Power
- Community and Safety Enforcement on behalf of the South East London Illegal Tobacco Network, Southwark Council, London, SE1 2QH, UK
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Kheirallah KA, Alsulaiman JW, Mohammad H AS, Alzyoud S, Veeranki SP, Ward KD. Waterpipe Tobacco Smoking among Arab Youth; a Cross-Country Study. Ethn Dis 2016; 26:107-12. [PMID: 26843803 DOI: 10.18865/ed.26.1.107] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Waterpipe tobacco smoking (WTS) is considered a global epidemic that is spreading among youth. Our analysis was conducted to compare the national baseline prevalence rate estimates of WTS among Arab boys and girls. DESIGN SETTING AND PARTICIPANTS The Global Youth Tobacco Survey (GYTS) is a school-based survey using standardized self-administered questionnaires; it employs a two-stage cluster sampling technique to obtain a representative sample of youth (13-15 years of age). We conducted a secondary data analysis of nationally representative GYTSs available from 16 Arab countries. MAIN MEASURES Youth who self-reported smoking waterpipe at least once in the past 30 days were considered to be current waterpipe tobacco smokers. National weighted WTS prevalence rate estimates along with respective 95% confidence intervals were reported for boys and girls. RESULTS Pooled GYTS data from 16 Arab countries yielded a total of 31,359 youth. Overall, 10.6% of the respondents were current waterpipe tobacco smokers, with boys (13.7%) having significantly higher estimates than girls (7.2%). Overall, current WTS prevalence rate estimates ranged from .9% in Oman to 34.2%, in Lebanon. The WTS epidemic was more predominant among boys and girls, respectively, in the West Bank (42.8% and 24.2%), Lebanon (38.6% and 30.5%) and Jordan (25.7% and 14.5%). CONCLUSION Among Arab boys and girls, WTS represents a growing strain of the tobacco epidemic that requires immediate attention.
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Affiliation(s)
- Khalid A Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology
| | | | | | - Sukaina Alzyoud
- Department of Community and Mental Health Nursing, Hashemite University
| | - Sreenivas P Veeranki
- Division of Epidemiology, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis
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Erdöl C, Ergüder T, Morton J, Palipudi K, Gupta P, Asma S. Waterpipe Tobacco Smoking in Turkey: Policy Implications and Trends from the Global Adult Tobacco Survey (GATS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15559-66. [PMID: 26670238 PMCID: PMC4690940 DOI: 10.3390/ijerph121215004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 11/21/2015] [Accepted: 11/30/2015] [Indexed: 11/24/2022]
Abstract
Waterpipe tobacco smoking (WTS) is an emerging tobacco product globally, especially among adolescents and young adults who may perceive WTS as a safe alternative to smoking cigarettes. Monitoring the use of WTS in Turkey in relation to the tobacco control policy context is important to ensure that WTS does not become a major public health issue in Turkey. The Global Adult Tobacco Survey (GATS) was conducted in Turkey in 2008 and was repeated in 2012. GATS provided prevalence estimates on current WTS and change over time. Other indicators of WTS were also obtained, such as age of initiation and location of use. Among persons aged 15 and older in Turkey, the current prevalence of WTS decreased from 2.3% in 2008 to 0.8% in 2012, representing a 65% relative decline. Among males, WTS decreased from 4.0% to 1.1% (72% relative decline). While the overall smoking prevalence decreased among females, there was no change in the rate of WTS (0.7% in 2008 vs. 0.5% in 2012), though the WTS prevalence rate was already low in 2008. Comprehensive tobacco control efforts have been successful in reducing the overall smoking prevalence in Turkey, which includes the reduction of cigarette smoking and WTS. However, it is important to continue monitoring the use of waterpipes in Turkey and targeting tobacco control efforts to certain groups that may be vulnerable to future WTS marketing (e.g., youth, women).
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Affiliation(s)
- Cevdet Erdöl
- Rector of Health Science University, Istanbul 34688, Turkey.
- Former Head of the Commission on Health, Family, Labour and Social Affairs of the Grand National Assembly of Turkey, Ankara 06543, Turkey.
| | - Toker Ergüder
- World Health Organization Country Office, Ankara 06610, Turkey.
| | - Jeremy Morton
- Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Krishna Palipudi
- Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Prakash Gupta
- Healis Sekhsaria Institute for Public Health, Navi Mumbai 400701, India.
| | - Samira Asma
- Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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Asfour LW, Stanley ZD, Weitzman M, Sherman SE. Uncovering risky behaviors of expatriate teenagers in the United Arab Emirates: A survey of tobacco use, nutrition and physical activity habits. BMC Public Health 2015; 15:944. [PMID: 26399757 PMCID: PMC4580293 DOI: 10.1186/s12889-015-2261-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 09/11/2015] [Indexed: 11/10/2022] Open
Abstract
Background Tobacco use and unhealthy lifestyle habits amongst youth contribute to most major health issues in the United Arab Emirates (UAE) and worldwide. However up to date and comprehensive statistics are not available on the current behavior, experimentation and environmental influences on teenagers in the UAE’s expatriate community, who are greatly impacted by the country’s culture and environment, as well as bringing influences from their cultures of origin. Expatriates comprise a majority of the UAE population, making them an important subset of the population to study. Method To address this gap in knowledge, a survey was conducted to collect information on tobacco use, physical activity and nutrition behaviors, anti-tobacco media/legislation effectiveness and health education gaps. Results Our results provide a summary on each of these topics with regards to ninth grade expatriates in the UAE. We offer the first statistics on dokha use in this age group and uncover signs of underlying eating disorders. Conclusions In conclusion, we call for a tobacco use, nutrition and physical activity intervention targeted at this age group of UAE expatriates.
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Affiliation(s)
- Leena W Asfour
- New York University Abu Dhabi, P.O. Box 129188, Abu Dhabi, United Arab Emirates.
| | - Zachary D Stanley
- New York University Abu Dhabi, P.O. Box 129188, Abu Dhabi, United Arab Emirates.
| | - Michael Weitzman
- Departments of Pediatrics and Environmental Medicine, Professor of Global Public Health, New York University School of Medicine, New York University, New York, NY, USA.
| | - Scott E Sherman
- Division of General Internal Medicine, New York University School of Medicine, New York, NY, USA.
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Obermeyer CM, Bott S, Sassine AJ. Arab Adolescents: Health, Gender, and Social Context. J Adolesc Health 2015; 57:252-62. [PMID: 25770651 DOI: 10.1016/j.jadohealth.2015.01.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 01/02/2015] [Accepted: 01/02/2015] [Indexed: 11/18/2022]
Abstract
This article reviews the evidence about adolescent health in the Arab world, against the background of social, economic, and political change in the region, and with a particular focus on gender. For the literature review, searches were conducted for relevant articles, and data were drawn from national population- and school-based surveys and from the Global Burden of Disease project. In some parts of the Arab world, adolescents experience a greater burden of ill health due to overweight/obesity, transport injuries, cardiovascular and metabolic conditions, and mental health disorders than those in other regions of the world. Poor diets, insufficient physical activity, tobacco use, road traffic injuries, and exposure to violence are major risk factors. Young men have higher risks of unsafe driving and tobacco use and young women have greater ill-health due to depression. Several features of the social context that affect adolescent health are discussed, including changing life trajectories and gender roles, the mismatch between education and job opportunities, and armed conflict and interpersonal violence. Policy makers need to address risk factors behind noncommunicable disease among adolescents in the Arab region, including tobacco use, unhealthy diets, sedentary lifestyles, unsafe driving, and exposure to violence. More broadly, adolescents need economic opportunity, safe communities, and a chance to have a voice in their future.
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Affiliation(s)
- Carla Makhlouf Obermeyer
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
| | - Sarah Bott
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Anniebelle J Sassine
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Kassem NOF, Kassem NO, Jackson SR, Liles S, Daffa RM, Zarth AT, Younis MA, Carmella SG, Hofstetter CR, Chatfield DA, Matt GE, Hecht SS, Hovell MF. Benzene uptake in Hookah smokers and non-smokers attending Hookah social events: regulatory implications. Cancer Epidemiol Biomarkers Prev 2015; 23:2793-809. [PMID: 25416714 DOI: 10.1158/1055-9965.epi-14-0576] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Benzene is a human hematotoxicant and a leukemogen that causes lymphohematopoietic cancers, especially acute myelogenous leukemia. We investigated uptake of benzene in hookah smokers and non-smokers attending hookah social events in naturalistic settings where hookah tobacco was smoked exclusively. METHODS We quantified S-phenylmercapturic acid (SPMA), a metabolite of benzene, in the urine of 105 hookah smokers and 103 non-smokers. Participants provided spot urine samples the morning of and the morning after attending an indoor hookah-only smoking social event at a hookah lounge or in a private home. RESULTS Urinary SPMA levels in hookah smokers increased significantly following a hookah social event (P < 0.001). This increase was 4.2 times higher after hookah lounge events (P < 0.001) and 1.9 times higher after home events (P = 0.003). In non-smokers, urinary SPMA levels increased 2.6 times after hookah lounge events (P = 0.055); however, similar urinary SPMA levels were detected before and after home events, possibly indicating chronic exposure to benzene (P = 0.933). CONCLUSIONS Our data provide the first evidence for uptake of benzene in hookah smokers and non-smokers exposed to hookah tobacco secondhand smoke at social events in private homes compared with their counterparts in hookah lounges. Hookah tobacco smoke is a source of benzene exposure, a risk factor for leukemia. IMPACT Because there is no safe level of exposure to benzene, our results call for interventions to reduce or prevent hookah tobacco use, regulatory actions to limit hookah-related exposure to toxicants including benzene, initiate labeling of hookah-related products, and include hookah smoking in clean indoor air legislation.
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Ward KD, Siddiqi K, Ahluwalia JS, Alexander AC, Asfar T. Waterpipe tobacco smoking: The critical need for cessation treatment. Drug Alcohol Depend 2015; 153:14-21. [PMID: 26054945 DOI: 10.1016/j.drugalcdep.2015.05.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 04/27/2015] [Accepted: 05/18/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Waterpipe use has spread globally, and has substantial negative health effects and nicotine dependence potential. A growing literature addresses cessation-related experiences of waterpipe users, but this literature has not been summarized nor is guidance available on developing and testing cessation interventions. METHOD Authors gathered key empirical papers on waterpipe cessation-related topics, including observational studies about users' perceived ability to quit, interest in quitting, quit rates, and cessation trials. Based on this review, recommendations are made to guide the development and rigorous evaluation of waterpipe cessation interventions. RESULTS Many users want to quit and make quit attempts, but are unsuccessful at doing so on their own; therefore, developing and testing waterpipe cessation interventions should be a priority for global tobacco control efforts. Early efforts have tested waterpipe cessation interventions designed for, or adapted from, cigarette smoking programs. CONCLUSIONS Waterpipe-specific cessation programs that address unique features of waterpipe smoking (e.g., its cultural significance, social uses, and intermittent use pattern) and characteristics and motivations of users who want to quit are needed. Recommendations are provided to move waterpipe cessation intervention development forward.
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Affiliation(s)
- Kenneth D Ward
- School of Public Health, University of Memphis, 201 Robison Hall, Memphis, TN 38152-3450, United States; Syrian Center for Tobacco Studies, Tishreen Street, Sheehan, PO Box: 16542, Aleppo, Syria.
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington York YO10 5DD, England, United Kingdom
| | - Jasjit S Ahluwalia
- Rutgers School of Public Health, The State University of New Jersey, 683 Hoes Lane West, Room 235, Piscataway, NJ 08854, United States
| | - Adam C Alexander
- School of Public Health, University of Memphis, 201 Robison Hall, Memphis, TN 38152-3450, United States
| | - Taghrid Asfar
- Syrian Center for Tobacco Studies, Tishreen Street, Sheehan, PO Box: 16542, Aleppo, Syria; Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 912, Miami, FL 33136, United States
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