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Arifoglu AT, Artan T. A systematic review of the factors influencing the risky behaviors of syrian forced migrant children and adolescents in Turkey. Clin Child Psychol Psychiatry 2024; 29:1195-1212. [PMID: 38330210 DOI: 10.1177/13591045241231336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Risky behaviors are defined as emotional and behavioral problems that harm mental and physical health. The present study aimed to systematically review and synthesize research investigating the risky behaviors of Syrian children living in Turkey. The study was conducted through a systematic review of articles published in the Scopus and Web of Science database between 2013 and the present day, and met the STROBE reporting criteria. The inclusion criteria for studies in the systematic review were established, and studies that focused on Syrian-origin forced migrant child-adolescents aged 7-18 years and investigated risky behaviors without a clinical diagnosis and treatment purpose were included. Four studies with a sample of 790 children were examined. According to the findings of this study, there is a measurement issue for risky behaviors. In this study, there are numerous factors influencing risky behaviors, including those related to traumatic life events due to war, psychopathology, acculturation-related factors, and sociodemographic factors. The most significant finding highlighted in the study is the need for methodological improvements and context-specific studies to be repeated in future research, to ensure statistical generalizability and clinical implications in research on this subject.
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Affiliation(s)
- Ahmed Taha Arifoglu
- Social Work Department, PhD Student at Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Taner Artan
- Faculty of Health Sciences Social Work Department, Istanbul University-Cerrahpasa, Istanbul, Turkey
- UNEC Social Work and Social Innovations Research Center, Azerbaijan State University of Economics, Baku, Azerbaijan
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Yan R, Liu Y, Huang L, Li Y, Huang Y, Tong J, Deng Y, Yuan Q. Susceptibility to e-cigarette adoption among tobacco-naïve youths: a cross-sectional study in Shenzhen, China. Front Public Health 2024; 12:1320863. [PMID: 38818444 PMCID: PMC11137244 DOI: 10.3389/fpubh.2024.1320863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 05/06/2024] [Indexed: 06/01/2024] Open
Abstract
Background The rise in e-cigarette use among youth is a significant global public health issue. It is important to identify those at increased risk and implement effective strategies to reduce e-cigarette popularity among the youth. Objective This study aims to identify predictors of e-cigarette uptake in youths with no prior tobacco use, considering individual, familial and the broader societal environmental factors. Methods For this investigation, a group of 2,487 tobacco-free youths was selected from 15 high schools in Shenzhen, China. Susceptibility to e-cigarettes was determined by assessing the possibility of future use and the openness to trying e-cigarettes if presented by friends. Both chi-square tests and logistic regression were applied to identify factors linked to susceptibility to e-cigarette use. Results Among the respondents, 5.5% (n = 136) were found to be susceptible to e-cigarette use. The analysis revealed factors tied to this risk: perceptions of e-cigarettes, the impact of vaping peers, paternal parenting styles, the extent of social support, exposure to messages both for and against e-cigarettes use, and secondhand smoke (SHS) exposure. Youths who downplayed the addictive nature of e-cigarettes (aOR = 2.01; 95% CI: 1.14-3.55; p = 0.016), those with friends who engaged in vaping (aOR = 3.43-7.64; 95%CI: 2.36-20.42; p < 0.001), those experiencing over-protective or rejective maternal parenting (aOR = 1.68-3.01; 95%CI: 1.11-5.77; p = 0.001-0.014) or rejective paternal parenting (aOR = 3.63; 95%CI: 1.99-6.59; p < 0.001), those aware of e-cigarette advertisements (aOR = 1.82; 95%CI: 1.28-2.60; p = 0.001), and those exposed to SHS at home (aOR = 1.68; 95%CI: 1.17-2.41; p = 0.005) or at public places (aOR = 1.72-1.79; 95%CI: 1.21-2.57; p = 0.002-0.003) were more prone to e-cigarettes. In contrast, youths who believed using e-cigarettes reduces one's attractiveness (aOR = 0.34; 95%CI: 0.16-0.72; p = 0.005) or perceived that vaping made social interactions less enjoyable (aOR = 0.26; 95%CI: 0.12-0.58; p = 0.001), those who benefited from high social support (aOR = 0.30-0.60; 95%CI: 0.17-0.97; p < 0.001), and those who noticed message about e-cigarettes' adverse consequence (aOR = 0.54; 95%CI: 0.38-0.77; p = 0.001) were less likely to be inclined toward e-cigarette use. Conclusion The propensity of the youth to e-cigarette usage is shaped by a multiple element. An all-encompassing strategy that addresses the individual, familial, and the broader societal aspects is imperative for the effective prevention of e-cigarette initiation among youth.
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Affiliation(s)
- Ruilin Yan
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Yanhong Liu
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Li Huang
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Yanrou Li
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Yun Huang
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Jing Tong
- Bao'an Public Health Service Center of Shenzhen, Shenzhen, China
| | - Yongzheng Deng
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Qing Yuan
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
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Shevorykin A, Hyland BM, Robles D, Ji M, Vantucci D, Bensch L, Thorner H, Marion M, Liskiewicz A, Carl E, Ostroff JS, Sheffer CE. Tobacco use, trauma exposure and PTSD: a systematic review. Health Psychol Rev 2024:1-32. [PMID: 38711288 DOI: 10.1080/17437199.2024.2330896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/11/2024] [Indexed: 05/08/2024]
Abstract
Tobacco use remains one of the most significant preventable public health problems globally and is increasingly concentrated among vulnerable groups, including those with trauma exposure or diagnosed with PTSD. The goal of this systematic review was to update and extend previous reviews. Of the 7224 publications that met the initial criteria, 267 were included in the review. Summary topic areas include conceptual frameworks for the relation between trauma or PTSD and tobacco use; associations between trauma exposure or PTSD and tobacco use; number and type of trauma exposures and tobacco use; PTSD symptoms and tobacco use; Treatment-related studies; and the examination of causal relations. Evidence continues to indicate that individuals exposed to trauma or diagnosed with PTSD are more likely to use tobacco products, more nicotine dependent and less likely to abstain from tobacco even when provided evidence-based treatments than individuals without trauma. The most commonly cited causal association proposed was use of tobacco for self-regulation of negative affect associated with trauma. A small proportion of the studies addressed causality and mechanisms of action. Future work should incorporate methodological approaches and measures from which we can draw causal conclusions and mechanisms to support the development of viable therapeutic targets.
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Affiliation(s)
- Alina Shevorykin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bridget M Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Daniel Robles
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, Canada
| | - Mengjia Ji
- Department of Psychology, The City College of New York (CUNY), New York, NY, USA
| | - Darian Vantucci
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lindsey Bensch
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Hannah Thorner
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Matthew Marion
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Amylynn Liskiewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ellen Carl
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Mahamid F, Bdier D. Life stressors, tobacco use, and mental health among Palestinian youths: The mediating role of quality of life and physical activity. J Ethn Subst Abuse 2024:1-15. [PMID: 38165359 DOI: 10.1080/15332640.2023.2297387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
The current study tested the association between life stressors and tobacco use and mental health outcomes, including depression and anxiety, among Palestinian youths and whether quality of life (QoL) and physical activity can mediate the association between these variables. The sample consisted of 405 Palestinian youths, 245 male and 160 female; all were selected using online methods. Our findings revealed that life stressors were positively correlated with tobacco use (r = .20, p < .01), anxiety (r = -0.32, p < .01), and depression (r = .23, p < .01), while life stressors were negatively correlated with physical activity (r = -0.15, p < .01) and QoL (r = -0.41, p < .01). Results of structural equation modeling (SEM) indicated that QoL and physical activity mediated the association between life stressors and depression and anxiety. Our findings underline the importance of increasing physical activity levels among youths as a protective factor against tobacco use, depression, and anxiety. Moreover, community and school-based interventions to promote QoL and positive mental health in adolescents and youths should incorporate frequent physical activity and engagement in individual or team sports.
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Affiliation(s)
| | - Dana Bdier
- An-Najah National University, Nablus, Palestine
- University of Milano-Bicocca, Milan, Italy
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Rizk Y, Hoteit R, Khater B, Naous J. Psychosocial wellbeing and risky health behaviors among Syrian adolescent refugees in South Beirut: a study using the HEEADSSS interviewing framework. Front Psychol 2023; 14:1019269. [PMID: 37205080 PMCID: PMC10187139 DOI: 10.3389/fpsyg.2023.1019269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
Purpose Adolescent refugees are at risk of mental health disorders and underdiagnosed risky behaviors. Limited research exists in the Middle East and North Africa. This study aims to assess psychosocial wellbeing and risk-taking behaviors among adolescent refugees displaced to South Beirut following a standardized framework. Methods A cross-sectional study using face-to-face confidential HEEADSSS (Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Safety and Suicide/Depression) interviews was conducted among 52 Syrian adolescent refugees, between the ages of 14 and 21, in a health center in South Beirut. Results The mean age of the interviewees was 17.04 ± 1.77 years, with a male predominance 34 (65.4%). Five (9.6%) were married, 38 (73.1%) were not attending school 27 (52.9%) lived in a place with a crowding index ≥3.5 and 21 (40.4%) were working. Risky health concerns or behaviors detected included no activities or exercise 38 (73.1%), eating one to two meals per day 39 (75%) and smoking 22 (42.3%). Eleven (21.2%) have been ever offered drugs and 22 (42.3%) believed they should carry a weapon for protection. Twenty one out of 32 (65.7%) had major depressive disorders and 33 (63.5%) screened positive for behavioral problems. Exposure to home verbal or physical violence, male gender, smoking, and employment were associated with high scoring in behavioral problems. Smoking and ever been touched in an unwanted way were found to be associated with depression. Conclusion and practical implications Implementing the HEEADSSS interviewing assessment within medical encounters with refugee adolescents is one efficient way to detect risky health behaviors and mental health problems. Interventions need to be implemented as early as possible in the refugees' journey to help them cope and gain resilience. Training health care providers to conduct the questionnaire and delivering brief counseling when required is recommended. Establishing a network of referrals to provide multidisciplinary care to adolescents can be helpful. Obtaining a fund to distribute safety helmets for adolescent motorbike drivers can be a way to reduce injuries. More research among adolescent refugees in multiple settings, including teenagers in the host country, is needed to serve this population better.
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Affiliation(s)
- Youssef Rizk
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon
| | - Reem Hoteit
- Faculty of Medicine, Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Beatrice Khater
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jihane Naous
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
- *Correspondence: Jihane Naous,
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Alkouri O, Khader Y, Al-Bashaireh AM. Prevalence of Cigarettes and Waterpipe Smoking among Jordanians, Refugees, and Migrants in Jordan and Its Associated Factors: A Secondary Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:82. [PMID: 36612400 PMCID: PMC9819960 DOI: 10.3390/ijerph20010082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 06/15/2023]
Abstract
Smoking is a major public health threat resulting in increased morbidity and mortality. This study aimed to determine the prevalence of current smoking among different adult populations in Jordan, including Jordanians, refugees, and migrants and determine the factors associated with smoking. A cross-sectional survey was conducted during the period of June-September 2021 among Jordanians, Syrian refugees (both urban and camp refugees), and migrants living in four governorates in Jordan, including Amman, Zarqa, Mafraq, and Irbid. The selection of the four governorates was based on criteria related to the presence of Syrian refugees in host communities. The highest prevalence of cigarette smoking was among urban Jordanians (51.1%), followed by non-camp refugees (46.7%), while the highest prevalence for waterpipe (43.2%) and dual smoking (28.7%) was among non-camp refugees. Being male, aged 25-45 years old, unemployed, and having less than a high school education, as well as being urban Jordanians, were all associated with higher odds of cigarette smoking. Being male, unemployed, and urban Jordanians or non-camp refugees were variables associated with higher odds of waterpipe smoking. The study findings indicate that the identification of smoking prevalence in Jordan and its associated factors, including gender, educational level, employment status, regional area, migration, and exposure to traumas, should be considered by healthcare providers to formulate smoking cessation programs tailored to their needs and ultimately reduce smoking prevalence.
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Affiliation(s)
- Osama Alkouri
- Faculty of Nursing, Yarmouk University, Irbid 2116, Jordan
| | - Yousef Khader
- Department of Public Health, Community Medicine, Jordan University of Science and Technology, Irbid 21163, Jordan
| | - Ahmad M. Al-Bashaireh
- Faculty of Health Science, Higher Colleges of Technology, Fujairah 23036, United Arab Emirates
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Kanan J, Leão T. Post-traumatic stress disorder in youth exposed to the Syrian conflict: A systematic review and meta-analysis of prevalence and determinants. J Health Psychol 2022:13591053221123141. [PMID: 36124723 DOI: 10.1177/13591053221123141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A decade of ongoing armed conflict in Syria has damaged the physical and mental health of millions of adults and children. This study aimed to systematically review the prevalence of post-traumatic stress disorder among youth exposed to the Syrian conflict, and understand its individual and contextual determinants. The screening procedure resulted in 26 studies, with a total of 11,400 Syrian children and adolescents. The prevalence was 36% (95% CI (0.29-0.43), p < 0.001). Loss of family members or acquaintances, witnessing violence, and social withdrawal increased the risk of post-traumatic stress disorder, while social trust and social support were protective factors.
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Affiliation(s)
- Jebraiel Kanan
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto (ISPUP), Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Teresa Leão
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto (ISPUP), Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto (FMUP), Porto, Portugal
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Kheirallah KA, Al-Zureikat SH, Al-Mistarehi AH, Alsulaiman JW, AlQudah M, Khassawneh AH, Lorettu L, Bellizzi S, Mzayek F, Elbarazi I, Serlin IA. The Association of Conflict-Related Trauma with Markers of Mental Health Among Syrian Refugee Women: The Role of Social Support and Post-Traumatic Growth. Int J Womens Health 2022; 14:1251-1266. [PMID: 36092127 PMCID: PMC9462433 DOI: 10.2147/ijwh.s360465] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Syrian refugee women not only suffered the refuging journey but also faced the burden of being the heads of their households in a new community. We aimed to investigate the mental health status, traumatic history, social support, and post-traumatic growth (PTG) of Syrian refugee women. Methods A cross-sectional study was conducted using a structured interviewer-administered survey between August and November 2019. Syrian refugee women who head their households and live outside camps were eligible. The survey included items investigating socio-demographic characteristics and conflict-related physical trauma history. The Refugee Health Screener-15 (RHS-15) scale was used to screen for emotional distress symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD), with a score range of 0−4 and higher scores indicating emotional distress. The Multidimensional Scale of Perceived Social Support (MSPSS) was utilized to assess the perceived support from family, friends, and significant others (score range 1−7), with scores of 3−5 and 5.1−7.0 representing moderate and high support, respectively. The PTG Inventory (PTGI) scale investigated the positive transformation following trauma; the score range was 0−5, and the cutoff point of ≥3 defined moderate-to-high growth levels. Results Out of 140 invited refugee women, 95 were included, with a response rate of 67.9%. Their mean (SD) age was 41.30 (11.75) years, 50.5% were widowed, and 17.9% reported their husbands as missing persons. High levels of conflict-related traumatic exposure were found, including threats of personal death (94.7%), physical injury (92.6%), or both (92.6%); and a history of family member death (92.6%), missing (71.6%), or injury (53.7%). The mean (SD) RHS-15 score was above average (2.08 (0.46)), and most women (90.5%) were at high risk for depression, anxiety, and PTSD symptoms. The mean (SD) MSPSS score was 5.08 (0.71), representing moderate social support, with friends’ support being the highest (5.23 (0.85)). The mean (SD) PTGI score was 2.44 (0.48), indicating low growth, with only 12.6% of women experiencing moderate-to-high growth levels. Spiritual change and personal strength had the highest sub-scores, with moderate-to-high growth levels experienced by 97.9% and 84.2%, respectively. Most women were more optimistic and religious, had feelings of self-reliance and better difficulties adapting, and were stronger than they thought. Statistically significant correlations of MSPSS and its subscales with RHS-15 and PTGI were detected. Conclusion Significant but unspoken mental health problems were highly prevalent among Syrian refugee women and an imminent need for psychological support to overcome traumatic exposure. The role of social support seems to be prominent and needs further investigation.
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Affiliation(s)
- Khalid A Kheirallah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sarah H Al-Zureikat
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | | | - Mohammad AlQudah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Adi H Khassawneh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Saverio Bellizzi
- World Health Organization (WHO), Jordan Country Office, Amman, Jordan
| | - Fawaz Mzayek
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ilene A Serlin
- International Institute for Advanced Training in Dance Movement Therapy, San Francisco, CA, USA
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Xiong T, Milios A, McGrath PJ, Kaltenbach E. The influence of social support on posttraumatic stress symptoms among children and adolescents: a scoping review and meta-analysis. Eur J Psychotraumatol 2022; 13:2011601. [PMID: 35340789 PMCID: PMC8942489 DOI: 10.1080/20008198.2021.2011601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Several risk and protective factors play a role in the development of posttraumatic stress symptoms (PTSS) in children and youth. The evidence for social support (SS) as a protective factor is rising; however, a review of the evidence is lacking. OBJECTIVE This scoping review and meta-analysis aims to map out and synthesize the present research on the influence of social support on PTSS in children and adolescents. METHOD The literature searched through PubMed, MEDLINE, Embase, PsycInfo, and CINAHL identified 3629 abstracts. Ninety articles published from 1999 to 2020 were selected, including a total of 77,439 participants. RESULTS Most papers focused on social and emotional support from family members (36/88) and peers (26/88); other types of support (e.g., informational support and support from professionals) were not widely reported. The cross-sectional studies illustrated an overall significant, but weak, negative correlation between global social support and PTSS. A similar weak negative association was found between family support and PTSS. The association between peer support and PTSS was not significant. For longitudinal studies, 4 of 5 indicated that SS was a significant negative predictor of PTSS. CONCLUSIONS There was conceptual, methodological, and statistical heterogeneity of the identified studies. This review suggests a weak negative relationship between global SS and PTSS in children and adolescents. Higher global SS was related to less PTSS. The evidence regarding family support revealed a more stable negative relationship with PTSS than that for peer support. Investigating social support without specifying the form of support confounds the effect. Studies on informational, teacher, or professional support seem to be lacking. More studies are needed on the longitudinal effects of SS on PTSS.
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Affiliation(s)
- Ting Xiong
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Athena Milios
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Patrick J McGrath
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Research in Family Health, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Elisa Kaltenbach
- Centre for Research in Family Health, IWK Health Centre, Halifax, Nova Scotia, Canada
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Kakaje A, Alhalabi MM, Alyousbashi A, Ghareeb A, Hamid L, Al-Tammemi AB. Smoking habits and the influence of war on cigarette and shisha smoking in Syria. PLoS One 2021; 16:e0256829. [PMID: 34473786 PMCID: PMC8412248 DOI: 10.1371/journal.pone.0256829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/16/2021] [Indexed: 12/04/2022] Open
Abstract
Tobacco smoking might be impacted by various influences, including psychological, socio-cultural, and economic factors. A community-based cross-sectional survey was conducted in Syrian Arab Republic from March to April 2019 using a web-based questionnaire. The survey aimed at assessing tobacco use (shisha and cigarettes) as well as examining the association between current tobacco use and various sociodemographic and war-related factors. The sample comprised 978 participants (251 males: 727 females) and had a mean age of 24.7 years (SD: 7.60). Most participants were single (n = 825, 84.4%), reside in Damascus and Rif-Dimashq (n = 579, 59.2%), and had a college/university education (n = 911, 93.1%). Concerning smoking, a total of 371 participants (37.9%) were identified to be current tobacco smokers, of whom 211, 84, 76 were exclusive shisha smokers, exclusive cigarette smokers, and dual smokers, respectively. The prevalence of cigarette smoking (exclusive and dual) among males and females was found to be 34.7%, and 10.0%, respectively. On the other hand, the prevalence of shisha smoking (exclusive and dual) among males and females was around 34.3% and 27.6%, respectively. Additionally, various factors have predicted a higher likelihood of cigarette smoking including male gender (AOR = 4.152; 95% CI: 2.842-6.064; p<0.001), and losing someone due to the war (AOR = 1.487; 95% CI: 1.028-2.151; p = 0.035), while unemployed individuals were found to have lower odds of being cigarette smokers (AOR = 0.634; 95% CI: 0.429-0.937; p = 0.022). Concerning shisha smoking, married (AOR = 0.622; 95% CI: 0.402-0.963; p = 0.033), and unemployed individuals (AOR = 0.679; 95% CI: 0.503-0.916; p = 0.011) were found to have lower odds of shisha smoking. Amid the tobacco epidemic in the region, rates of tobacco use in Syria are still worrying. The Syrian armed conflicts may possess a double-edged effect on smoking, and tobacco users who adopt smoking to cope with various stressors should be targeted with well-structured health education, along with appropriate psychological services.
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Affiliation(s)
- Ameer Kakaje
- Faculty of Medicine, Damascus University, Damascus, Syria
- University Hospital Geelong, Barwon Health, Victoria, Australia
| | | | | | - Ayham Ghareeb
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Loura Hamid
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Ala’a B. Al-Tammemi
- Faculty of Medicine, Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
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Jawad M, Blanchet K, Leaning J. Revisiting public health response in times of war. J Public Health (Oxf) 2020; 42:e285-e286. [PMID: 32633328 DOI: 10.1093/pubmed/fdaa097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/21/2020] [Accepted: 06/07/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London W6 8RP, UK
| | - Karl Blanchet
- Geneva Centre for Education and Research in Humanitarian Action, Université de Genève/The Graduate Institute, Geneva, Switzerland
| | - Jennifer Leaning
- FXB Center for Health and Human Rights, Harvard University, Boston, MA, USA
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