1
|
Kozachek CC, Btoush RM. Smoking behaviors among Middle Eastern college women in the United States. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-11. [PMID: 38652640 DOI: 10.1080/07448481.2024.2337003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024]
Abstract
Objective: to examine factors associated with cigarette and hookah smoking among Middle Eastern (ME) Arab college women. Participants: 406 adult women of ME Arabic background, currently enrolled in or recently graduated from a US college. Methods: a cross-sectional design, using an anonymous online survey of demographic characteristics, sociocultural factors, and access to health care factors. Data analysis included regression model to identify predictors of smoking behaviors. Results: Smoking rates were 21% and 19% for cigarette and hookah smoking. Cigarette smoking was higher with having liberal attitudes toward sexuality and lower among those having a healthcare provider. Hookah smoking was higher among students who are Muslim, involved in student organizations, have higher acculturation-heritage levels, and have more liberal attitudes toward women. Hookah smoking was lower among students born in the US, attending college part-time, and having higher religiosity levels. Conclusions: The study findings have several implications for interventions to address smoking behaviors among ME Arab college women through community organizations and within college campuses.
Collapse
Affiliation(s)
| | - Rula M Btoush
- School of Nursing, Rutgers University, Newark, New Jersey, USA
| |
Collapse
|
2
|
Hajjar R, Tsolakian I, Chaaya M, Daher A, Bazi T. Overactive bladder syndrome in nulliparous female university students: prevalence and risk factors including waterpipe smoking. Int Urogynecol J 2021; 33:1207-1223. [PMID: 34825923 DOI: 10.1007/s00192-021-05004-5] [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] [Received: 07/28/2021] [Accepted: 09/17/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to assess the prevalence of symptoms of overactive bladder syndrome (OAB) among healthy nulliparous female university students, and to evaluate the correlation of these symptoms with a variety of factors, including waterpipe (WP) smoking. METHODS This is a cross-sectional study. A questionnaire was administered to evaluate symptoms of OAB in healthy nulliparous female university students. Variables assessed included body mass index (BMI), cigarette smoking, WP smoking, consumption of alcohol, coffee, and tea with and without artificial sweeteners, soft drinks, and energy drinks. Adjusted odds ratio were calculated to determine the correlation of these variables with OAB symptoms. RESULTS A total of 767 out of 2,900 females responded to the questionnaire. Bothersome frequency was reported in 32.3%, and nocturia in 47.5% of the women. Urgency and urgency urinary incontinence (UUI) were present in 25.5 and 24.7% of the study participants respectively. Urgency was associated with WP smoking (p value 0.048). Bothersome frequency was associated with artificial sweeteners used with coffee and tea (p value 0.013). UUI was associated with cigarette smoking (p value 0.034) and elevated BMI (p value < 0.001). OAB symptoms were not found to be significantly associated with soft drink and energy drink consumption. A lower prevalence of nocturia (p value 0.009) and urgency was associated with alcohol consumption (p value 0.017). More than two-thirds (69.2%) of WP smokers expressed readiness to decrease WP smoking if this would improve their lower urinary tract symptoms (LUTS). CONCLUSION Overactive bladder is common in healthy young nulliparous women and is associated with multiple risk factors, including WP smoking.
Collapse
Affiliation(s)
- Rima Hajjar
- Department of Obstetrics and Gynecology, American University in Beirut-Medical Center, PO Box 11-0236, Beirut, Riad El Solh, 1107 2020, Lebanon
| | - Ibrahim Tsolakian
- Department of Obstetrics and Gynecology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Monique Chaaya
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - Alaa Daher
- Department of Obstetrics and Gynecology, American University in Beirut-Medical Center, PO Box 11-0236, Beirut, Riad El Solh, 1107 2020, Lebanon
| | - Tony Bazi
- Department of Obstetrics and Gynecology, American University in Beirut-Medical Center, PO Box 11-0236, Beirut, Riad El Solh, 1107 2020, Lebanon.
| |
Collapse
|
3
|
Bashirian S, Barati M, Karami M, Hamzeh B, Afshari M, Ezati E. Determinants of Waterpipe Smoking Among Women: A Systematic Review. Int J Prev Med 2021; 12:25. [PMID: 34249274 PMCID: PMC8218800 DOI: 10.4103/ijpvm.ijpvm_116_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 09/11/2020] [Indexed: 12/30/2022] Open
Abstract
Background The present study aimed to assess the determinants of waterpipe smoking among women based on a systematic review regarding the increasing prevalence of waterpipe smoking in women and the tendency of them to this type of tobacco. Methods The present study was a systematic review. The search strategies were based on using a combination of MeSH and free-text terms. Searches were performed inIranian databasesand PubMed, ScienceDirect, Web of Science, EMBASE, Scopus and Medline. Databases inclusion criteria included articles and gray literature in English or Persian, published between January 2000 and December 2018. The keywords were related to women and waterpipe and related terms. The quality of the articles was assessed using the EPHPP tool. Results In the initial search, out of 1027 articles, 15 articles were studied. Inclusion criteria in this study were the target population of women and girl and descriptive and qualitative studies on waterpipe use among women. The mean prevalence of waterpipe smoking in quantitative studies was 13.980/0. Studies have shown that waterpipe smoking in women is influenced by several individual (awareness, favorable attitudes, and positive prototype), interpersonal (role of family and friends), and socio-political factors. Conclusions Due to the influence of various determinants on women's inclination to waterpipe smoking, there is a necessity to act and impose interventions such as lessening women's favorable attitude toward waterpipe, increasing women's awareness, encouraging negative prototype about waterpipe smoking, and restricting access to tobacco products that can be useful. Interpersonal factors such as the role of family and friends are one of the major determinants in waterpipe smoking. It seems that developing the skill of saying "no" to the pressure of friends can help prevent waterpipe use. Furthermore, educating the family about the risks of waterpipe use is an effective strategy in this respect.
Collapse
Affiliation(s)
- Saeed Bashirian
- Social Determinants of Health Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinacies of Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Afshari
- Department of Public Health, School of Health, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Elahe Ezati
- Department of Public Health, School of Health, Hamedan University of Medical Sciences, Hamedan, Iran
| |
Collapse
|
4
|
Ayed Y, Elsayed SA, Abu-Hammad O, Turki A, Saleh M, Karbouji M, Alsaedi R, Laher I, Althagafi N, Dar-Odeh N. Tobacco Smoking, Secondhand Smoke Exposure and Cessation Perceptions by Dental Students in Al Madinah, a Conservative Saudi Society. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Yosra Ayed
- Taibah University, Saudi Arabia; Monastir University, Tunisia
| | - Shadia A Elsayed
- Taibah University, Saudi Arabia; Al-Azhar University (Girls Branch), Egypt
| | | | | | | | | | | | | | | | - Najla Dar-Odeh
- Taibah University, Saudi Arabia; University of Jordan, Jordan
| |
Collapse
|
5
|
Awareness and Practice of Oral Health Measures in Medina, Saudi Arabia: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239112. [PMID: 33291281 PMCID: PMC7730934 DOI: 10.3390/ijerph17239112] [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: 11/07/2020] [Revised: 11/27/2020] [Accepted: 12/03/2020] [Indexed: 11/30/2022]
Abstract
The aim of this observational study is to investigate the oral health status and practices in the multicultural community of Medina, Saudi Arabia. A cross-sectional questionnaire was distributed that asked about oral health, dental and periodontal conditions, personal attitudes toward dental care, and smoking habits. Cross tabulation with chi-squared testing was carried out to investigate the association of toothbrush usage and smoking with several variables. Four-hundred and sixty subjects enrolled in the study. The majority of the respondents were students and Saudi males. More than 75% of the participants had neither a family dentist nor dental insurance; 7% were smokers, 84% used a toothbrush, 17% used dental floss and 34% used miswak (a teeth cleaning twig made from the Salvadora persica tree). Some of the individuals complained of tooth sensitivity, halitosis and bleeding gums. The main reason for dental visits was pain, with 23% of the participants having never visited a dentist. Tooth brushing was significantly associated with gender, nationality, occupation, education, marital status, having kids and dental insurance (p ≤ 0.05). Tobacco consumption was significantly associated with age, occupation, education level, marital status, having children, having bleeding gingivae and halitosis. Effective dental education programs are needed to improve dental knowledge and awareness in the Medina community.
Collapse
|
6
|
Attachment style and addictions (alcohol, cigarette, waterpipe and internet) among Lebanese adolescents: a national study. BMC Psychol 2020; 8:33. [PMID: 32299500 PMCID: PMC7164203 DOI: 10.1186/s40359-020-00404-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/07/2020] [Indexed: 12/29/2022] Open
Abstract
Background The prevalence in the Lebanese general population of cigarette and waterpipe smoking, alcohol drinking and internet use seems to be increasing lately. So far, no study was done relating the above to attachment styles in Lebanese adolescents. Consequently, the objective of our study was to assess the relationship between attachment styles (secure, preoccupied, fearful, and dismissing) and addictions (cigarettes, water pipes, alcohol, and internet) among this population. Methods It is a cross-sectional study that took place between January and May 2019. Two thousand questionnaires were distributed out of which 1810 (90.5%) were completed and collected back. A proportionate random sample of schools from all Lebanese Mohafazat was used as recruitment method. Results A secure attachment style was significantly associated with lower addiction to alcohol, cigarette, and waterpipe, whereas insecure attachment styles (preoccupied, dismissing and fearful) were significantly associated with higher addiction to cigarette, waterpipe, alcohol, and internet. Conclusion Lebanese adolescents with insecure attachment had higher rates of addiction to cigarette, waterpipe, alcohol, and internet. They should be closely monitored in order to reduce the risk of future substance use disorder and/or behavioral addiction development.
Collapse
|
7
|
Darawad MW, Rezk-Hanna M, Alhussami M, Lee J, Mostafa A, Abu-Rmeileh N, Kheirallah K, Salama M, Nakkash R, Saleh Z, Salloum R. Poly-Tobacco Use among Young Adult Waterpipe Smokers: Insights from University Students in Three Eastern Mediterranean Countries. Subst Use Misuse 2020; 55:2099-2108. [PMID: 32666880 DOI: 10.1080/10826084.2020.1790010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION There is a tendency of waterpipe smokers to advance their practice toward concurrent use (poly-tobacco use) of other tobacco products and nicotine delivery systems. This study investigated poly-tobacco use among waterpipe smokers, and its effect on their quit intention. METHODS Descriptive cross-sectional design was utilized to recruit a convenience sample of university students who used waterpipe in three East Mediterranean countries. Using an internet-based survey, data were collected regarding participants' demographics, use of alternative tobacco products and nicotine delivery systems, and waterpipe quitting profile. Results: A total of 2290 students agreed to participate, among which 1116 (45.3%) reported using at least one tobacco product beside waterpipe. Poly-tobacco use was highest (61.1%) in Egypt, followed by Jordan (45.1%) and Palestine (33.1%). Across countries, cigarettes were the most common product (45.2%, n = 924) followed by cigar (18.6%, n = 374) and e-shisha (17.5%, n = 353). Conversely, the least reported product was smokeless tobacco (7.5%, n = 151) preceded by regular pipe (9.5%, n = 193). Participants who were males (OR = 2.83, 95% CI: 2.18-3.65), older (22-29 years) (OR = 1.15, 95% CI: 1.09-1.22), unemployed (OR = 1.58, 95% CI: 1.22-2.04), and those who initiated waterpipe at a younger age (OR = 0.87, 95% CI: 0.87-0.91) had higher odds of being poly-smokers. Poly-tobacco users were significantly more resistant to quit waterpipe. Conclusion: This study demonstrates poly-tobacco use as a rising phenomenon among waterpipe smokers and highlights the necessity for initiating advanced interventions to help waterpipe poly-tobacco users quit this dangerous type of addiction. Various country-specific programs are needed considering the various products used by the users.
Collapse
Affiliation(s)
| | - Mary Rezk-Hanna
- School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | | | - Juhan Lee
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Aya Mostafa
- Department of Community Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Niveen Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Khalid Kheirallah
- Department of Public Health-Medical School, Jordan University of Science & Technology, Irbid, Jordan
| | - Mohammed Salama
- Clinical Nursing Department, Mansoura University, Mansoura, Egypt
| | - Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Zeyad Saleh
- School of Nursing, The University of Jordan, Amman, Jordan
| | - Ramzi Salloum
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
8
|
Dadipoor S, Kok G, Aghamolaei T, Ghaffari M, Heyrani A, Ghanbarnezhad A. Explaining the determinants of hookah consumption among women in southern Iran: a qualitative study. BMC Public Health 2019; 19:1655. [PMID: 31823785 PMCID: PMC6902318 DOI: 10.1186/s12889-019-7917-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 11/07/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The prevalence of hookah consumption has been on the increase in Iran over the past two decades. This rate is higher among women than men in the south of Iran than other geographical areas. The purpose of this study was to explain the determinants of hookah consumption among indigenous women of Bandar Abbas city, southern Iran. METHODS This is the first qualitative study with the conventional content analysis approach that has examined the factors affecting the consumption of hookah at all ecological levels in 2018-2019. Participants, with a maximum variation in terms of age, education, occupation, hookah consumption and geographical areas of the city, were selected purposefully to take part in a semi-structured interview. The data were recorded, typed and analyzed according to the framework of the ecological model of health promotion at five levels (intrapersonal, interpersonal, organizational, social and political). The interview continued until data saturation. MAXQDA software version 10 was used for data management. RESULTS Interviews were conducted with 56 participants (21 female hookah smokers, 15 female ex- smokers, and 20 experienced experts). A total of eight main categories were extracted from the data including; positive attitude towards hookah consumption, psychosocial needs, sensory charms of hookah, individual factors, family factors, cultural-environmental backgrounds, social-political backgrounds, and economic challenges. CONCLUSIONS The results indicated the extensive influence of internal and external factors on the consumption of hookah. In order to successfully reduce the consumption of hookah, it is essential to consider intrapersonal, interpersonal, organizational, social and political factors.
Collapse
Affiliation(s)
- Sakineh Dadipoor
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Gerjo Kok
- Department of Work and Social Psychology, School of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Heyrani
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Amin Ghanbarnezhad
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| |
Collapse
|
9
|
Dadipoor S, Kok G, Aghamolaei T, Heyrani A, Ghaffari M, Ghanbarnezhad A. Factors associated with hookah smoking among women: A systematic review. Tob Prev Cessat 2019; 5:26. [PMID: 32411889 PMCID: PMC7205165 DOI: 10.18332/tpc/110586] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/10/2019] [Accepted: 07/10/2019] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The present study aimed to determine factors associated with hookah smoking among women on a global scale based on a systematic review of related literature. Intervention Mapping was the guiding framework for this review. METHODS Searches were performed in Web of Science, PubMed, Iranian databases, Elsevier, Embase, Scopus, Medline, Google Scholar, and the World Health Organization (WHO) website, using keywords related to hookah and associated terms. Studies in English or Persian, published between 1990 and 2018, were included in this review if they were available in full text and had a target population of women. Determinants of hookah smoking at the intrapersonal, interpersonal, institutional/organizational, community, and political levels, were extracted. RESULTS Positive attitude, social-psychological needs, low perceived risk, social-cultural acceptance of hookah, easy access and lack of laws were among the reasons given for consuming hookah. Because hookah smoking is a multifactorial issue, the qualitative method alone was not sufficient to identify the determinants of hookah smoking among women. The opinions of experts in the field of smoking control had been largely neglected in the obtained studies, and most quantitative studies lacked a theoretical framework. CONCLUSIONS To reduce the rate of hookah consumption, actions to be taken include changing women’s positive attitude toward hookah, learning to resist friends’ pressure to smoke, highlighting the unpleasantness of hookah smoking by segregating places with transparent walls within public places, showing in the virtual world that hookah smoking is socially unacceptable, limiting access to hookah tobacco products, and effectively implementing rules that restrict hookah smoking in public places.
Collapse
Affiliation(s)
- Sakineh Dadipoor
- Health Education and Health Promotion, Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Gerjo Kok
- Department of Work and Social Psychology, School of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Teamur Aghamolaei
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ali Heyrani
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Centre, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Ghanbarnezhad
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| |
Collapse
|
10
|
Al-Sawalha N, Alzoubi K, Khabour O, Alyacoub W, Almahmmod Y, Eissenberg T. Effect of Prenatal Exposure to Waterpipe Tobacco Smoke on Learning and Memory of Adult Offspring Rats. Nicotine Tob Res 2019. [PMID: 28637174 DOI: 10.1093/ntr/ntx142] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction Waterpipe tobacco smoking has increased in prevalence worldwide, including among pregnant women. In this study, we investigated the effect of prenatal maternal waterpipe tobacco smoke (WTS) exposure during different stages of pregnancy on learning and memory of adult offspring rats. Methods Pregnant rats received either fresh air or mainstream WTS (2 hours daily) during early, mid, late, or whole gestational period. Male offspring rats were followed through 20 weeks. Outcomes included (1) spatial learning and memory using the radial arm water maze (RAWM), (2) levels of brain derived neurotrophic factor (BDNF) in the hippocampus, and (3) oxidative stress biomarkers (superoxide dismutase, catalase, glutathione peroxidase and thiobarbituric acid reactive substances). Results Relative to offspring whose mothers were exposed to fresh air, prenatal exposure to WTS at any stage of pregnancy resulted in short- and long-term memory impairment in adult offspring rats (p < .05). This impairment was associated with reduced levels of BDNF in hippocampus (p < .05). However, prenatal WTS did not affect the level of oxidative stress biomarkers in hippocampus. Prenatal WTS during late gestation increased the activity of catalase as compared to control. Conclusion Prenatal maternal WTS exposure can impair the memory of adult male offspring. These results support development of interventions that target pregnant women who smoke waterpipe during pregnancy. Implications We examined for the first time the effect of prenatal waterpipe tobacco smoke exposure on learning and memory of offspring. The results showed that in utero exposure to waterpipe tobacco smoke was associated with impaired memory and decreased brain derived neurotrophic factor in hippocampus of adult male offspring rats.
Collapse
Affiliation(s)
- Nour Al-Sawalha
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.,Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia
| | - Weam Alyacoub
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Yehya Almahmmod
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Thomas Eissenberg
- Department of Psychology (Health Program) and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| |
Collapse
|
11
|
Stroud L, Werner E, Matteson K, Carey M, Helen GS, Eissenberg T, Scott-Sheldon LAJ. Waterpipe (hookah) tobacco use in pregnancy: use, preferences and perceptions of flavours. Tob Control 2019; 29:s62-s71. [PMID: 31320397 DOI: 10.1136/tobaccocontrol-2019-054984] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Waterpipe tobacco (WPT; hookah) use is common in pregnant and reproductive-age women. Sweet flavours contribute to the appeal of WPT and are a potential regulatory target. This study investigated use, preferences and perceptions of WPT flavours in pregnant WPT users, and the impact of flavour preferences on preconception/prenatal WPT use and exposure biomarkers. METHODS 58 pregnant WPT users (mean age=27 years) completed a detailed interview regarding their WPT flavours use, preferences and perceptions. Biomarkers of nicotine and carcinogen exposure (eg, cotinine, benzene, butadiene) were also collected. RESULTS 55% of participants were dual/poly WPT users (ie, reported use of one or more other tobacco products in addition to WPT). Pregnant WPT users reported nearly exclusive use of flavoured WPT, with greater use of menthol/mint (68%) followed by fruit flavours (48%) (p<0.001), and greater preferences for fruit followed by menthol/mint flavours (ps<0.05). Harm perceptions did not differ among flavours. Compared with dual/poly WPT users, WPT-only users reported more total WPT use events, greater use of and preference for menthol/mint flavoured WPT (ps<0.001), and decreased exposure biomarkers (ps≤0.040). Preference for menthol/mint and fruit flavours predicted more flavoured WPT use events during preconception and pregnancy; preference for menthol/mint predicted detectable cotinine and benzene levels but not butadiene. CONCLUSIONS This is the first study of WPT flavour use, preferences and perceptions in pregnant women. Use of and preference for menthol/mint and fruit WPT flavours in this vulnerable population could be considered in regulating WPT flavours to protect the health of women and children.
Collapse
Affiliation(s)
- Laura Stroud
- Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA .,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
| | - Erika Werner
- Obstetrics and Gynecology, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA.,Women & Infants' Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Kristen Matteson
- Obstetrics and Gynecology, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA.,Women & Infants' Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Michael Carey
- Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA.,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
| | - Gideon St Helen
- Division of Clinical Pharmacology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Lori A J Scott-Sheldon
- Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA .,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
| |
Collapse
|
12
|
Abu-Rmeileh NM, Alkhuffash O, Kheirallah K, Mostafa A, Darawad M, Al-Farsi Y, Yusufali A, Thomas J, Salama M, Hamadeh RR, Nakkash R, Salloum RG. Harm perceptions of waterpipe tobacco smoking among university students in five Eastern Mediterranean Region countries: A cross-sectional study. Tob Induc Dis 2018; 16:20. [PMID: 31516420 PMCID: PMC6659482 DOI: 10.18332/tid/89966] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Waterpipe tobacco smoking (WTS) continues to be very common in the Eastern Mediterranean Region (EMR), partially because of cultural acceptance but also because of misconceptions of its harm. This paper aimed to describe the beliefs towards waterpipe harm of university students who smoked waterpipe in five EMR countries. METHODS This study was conducted in 2016 across five EMR countries: Egypt, Jordan, Occupied Palestinian Territories, Oman and United Arab Emirates (UAE). Participants were recruited from among university students in each country. Students' characteristics, smoking behavior, flavor preference and knowledge of WTS harm were collected using an internet-based survey. Participants were included if they were ever waterpipe tobacco smokers and between 18 and 29 years of age. Bivariate analyses assessed variations in student-perceived WTS harm across the countries. Linear regression analysis was used to assess WTS perceived harm differences between students in the different countries. RESULTS A total of 2 544 university students participated from the five countries. Among ever smoking students, 66% reported WTS in the past 30 days, with the highest proportions (40%) from Occupied Palestinian Territories (OPT) and (41%) Jordan. Dual smoking of waterpipe and cigarettes was highest among students from Egypt. Most participants from the five countries had high level of perceived harm related to WTS during pregnancy. Less than 50% of the students believed that WTS could lead to the death of the smoker, can be harmful for non-smokers and have an addictive effect. Female students, those older than 22 years, and those who didn't smoke waterpipe in the last 30 days significantly had a higher level of WTS perceived harm. Participating students believed that cigarettes are more addictive and contain more nicotine compared to waterpipe. CONCLUSIONS Misperceptions of waterpipe harm are common among university students in the five EMR countries. Immediate public health action is needed, including enforcement of waterpipe tobacco control regulations along with awareness campaigns.
Collapse
Affiliation(s)
- Niveen M.E. Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Occupied Palestinian Territories
| | - Ola Alkhuffash
- Statistic Department, Hacettepe University, Ankara, Turkey
| | - Khalid Kheirallah
- Department of Public Health, Medical School, Jordan University of Science and Technology, Irbid, Jordan
| | - Aya Mostafa
- Department of Community Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | | | | | | | - Randah R. Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Ramzi G. Salloum
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, Florida, United States
| |
Collapse
|
13
|
Daou KN, Bou-Orm IR, Adib SM. Factors associated with waterpipe tobacco smoking among Lebanese women. Women Health 2018; 58:1124-1134. [PMID: 29240535 DOI: 10.1080/03630242.2017.1414102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Waterpipe tobacco smoking (WTS) has become a serious public health threat in the Middle East and beyond. To estimate the prevalence rates of cigarette and WTS among Lebanese women and describe characteristics associated with each behavior. Secondary analysis of women's health data obtained in a national survey in 2010. Of 2,255 selected women, 78 percent reported no or past long-term WTS. Among the 12 percent of regular waterpipe smokers, 40 percent were light users (mean three waterpipe heads weekly), while 60 percent were heavy users (mean of 11 heads per week). About 70 percent were never or past long-term cigarette smokers. Younger age, location within Greater Beirut (GB) and having professional employment were significantly associated with use of WTS. Older age, GB location, lower education, and ever-married were significantly associated with cigarette smoking. WTS is becoming a socially normative behavior among empowered professional women, who can spare the time and expense to engage in this behavior in easily accessible cafés, which prohibit cigarette smoking. Government, media, and NGO campaigns against smoking should target waterpipe use, not only in Lebanon but also across the Arab world and among Arab communities in the Diaspora with messages different from anti-cigarette campaigns.
Collapse
Affiliation(s)
- Karim N Daou
- a Department of Epidemiology and Population Health, Faculty of Health Sciences , American University of Beirut , Beirut , Lebanon
| | - Ibrahim R Bou-Orm
- b Non-Communicable Diseases (NCD) Unit , Ministry of Public Health , Beirut , Lebanon
| | - Salim M Adib
- a Department of Epidemiology and Population Health, Faculty of Health Sciences , American University of Beirut , Beirut , Lebanon
| |
Collapse
|
14
|
Dar-Odeh NS, Aleithan FA, Alnazzawi AA, Al-Shayyab MH, Abu-Hammad SO, Abu-Hammad OA. Factors affecting oral health determinants in female university students: a cross-sectional survey in Saudi Arabia. Int J Adolesc Med Health 2017; 32:/j/ijamh.ahead-of-print/ijamh-2017-0084/ijamh-2017-0084.xml. [PMID: 28782348 DOI: 10.1515/ijamh-2017-0084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 06/08/2017] [Indexed: 06/07/2023]
Abstract
Objective This study aims at investigating factors affecting oral health patterns, attitudes and health risk behaviors among female university students. Methods An online questionnaire was distributed to female university students in Al Madinah in the western region of Saudi Arabia. Students were requested to answer questions on demographic data, oral hygiene practices, dental attendance, smoking history, practice of sports and body weight and height. Results Two hundred and fourteen students participated with age range of 18-31 years (mean = 21.64 ± 1.72 years). Oral hygiene habits were reported by a percentage of 97.2%, 34.6%, 30.8% and 19.2% who used a tooth brush, dental floss, mouthwash, and a miswak (a teeth cleaning twig made from the Salvadora persica tree), respectively. The only factor that was significantly associated with a good oral hygiene level was a university major of non-healthcare specialties (p = 0.009). Conclusion It is concluded that female university students use various oral hygiene methods, however, dental attendance is poor and a number of health risk factors are noticed like smoking, lack of practicing sport and unhealthy body mass index (BMI).
Collapse
Affiliation(s)
- Najla S Dar-Odeh
- College of Dentistry, Taibah University, Al Madina Al Munawarah, Saudi Arabia
- Faculty of Dentistry, University of Jordan, Amman, Jordan, Phone: 00966/592231888
| | | | - Ahmad A Alnazzawi
- College of Dentistry, Taibah University, Al Madina Al Munawarah, Saudi Arabia
| | | | | | - Osama A Abu-Hammad
- College of Dentistry, Taibah University, Al Madina Al Munawarah, Saudi Arabia
- Faculty of Dentistry, University of Jordan, Amman, Jordan
| |
Collapse
|
15
|
Alajmi B, Abu-Hammad O, Al-Sharrad A, Dar-Odeh N. Tobacco cessation support among dentists: A cross-sectional survey in Saudi Arabia and Kuwait. Tob Prev Cessat 2017; 3:121. [PMID: 32432195 PMCID: PMC7232810 DOI: 10.18332/tpc/75795] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/01/2017] [Accepted: 07/10/2017] [Indexed: 12/17/2022]
Abstract
INTRODUCTION This study aims to explore the smoking prevalence among a sample of dentists working in two Gulf countries, and to assess the association between smoking habit and socio-professional factors affecting their attitude towards tobacco cessation activities, including barriers that prevent them from practicing such activities. METHODS This was a cross-sectional, online questionnaire-based, survey among dentists from Saudi Arabia and Kuwait, during summer 2016. The questionnaire consisted of questions on socio-professional characteristics, tobacco use and attitudes towards the adoption of tobacco cessation programs in dental practices. The questionnaire also enquired about the barriers to adoption of tobacco cessation. Descriptive statistics were used to describe demographic and smoking characteristics while cross tabulation with chi-square test was used to find out statistical significance of association between the groups (P≤0.05). RESULTS A total number of 466 responses were included in statistical analysis with 286 males (61.4%) and 180 females (38.6%), age ranged from 23 to 79 years (mean=32.7± 9.32). Most of the sample (N=437, 93.8%) indicated that the dentist has a vital role in educating patients on the health hazards of smoking. A positive attitude toward adoption of tobacco cessation campaigns was associated with older, more experienced, medically compromised, non-smoker dentists. The most frequently cited barrier to tobacco cessation was lack of time (39.2%). CONCLUSIONS Dentists who smoke are less likely to adopt smoking cessation campaigns in their clinics. More experienced dentists and those older than 40 years are more likely to engage in smoking cessation activities.
Collapse
Affiliation(s)
- Basais Alajmi
- Riyadh Colleges for Dentistry and Pharmacy, Riyadh, Saudi Arabia
- Kuwaiti Ministry of Health, Kuwait
| | - Osama Abu-Hammad
- College of Dentistry, Taibah University, Al Madinah Al Monawara, Saudi Arabia
- Faculty of Dentistry, University of Jordan, Amman, Jordan
| | | | - Najla Dar-Odeh
- College of Dentistry, Taibah University, Al Madinah Al Monawara, Saudi Arabia
- Faculty of Dentistry, University of Jordan, Amman, Jordan
| |
Collapse
|
16
|
Alshaikh MK, Filippidis FT, Al-Omar HA, Rawaf S, Majeed A, Salmasi AM. The ticking time bomb in lifestyle-related diseases among women in the Gulf Cooperation Council countries; review of systematic reviews. BMC Public Health 2017; 17:536. [PMID: 28578688 PMCID: PMC5455090 DOI: 10.1186/s12889-017-4331-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 04/27/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study aims to review all published systematic reviews on the prevalence of modifiable cardiovascular disease risk factors among women from the Gulf Cooperation Council countries (GCC). This is the first review of other systematic reviews that concentrates on lifestyle related diseases among women in GCC countries only. METHOD Literature searches were carried out in three electronic databases for all published systematic reviews on the prevalence of cardiovascular disease risk factors in the GCC countries between January 2000 and February 2016. RESULTS Eleven systematic reviews were identified and selected for our review. Common reported risk factors for cardiovascular disease were obesity, physical inactivity, diabetes, metabolic syndrome and hypertension. In GCC countries, obesity among the female population ranges from 29 to 45.7%, which is one of the highest rates globally, and it is linked with physical inactivity, ranging from 45 to 98.7%. The prevalence of diabetes is listed as one of the top ten factors globally, and was reported with an average of 21%. Hypertension ranged from 20.9 to 53%. CONCLUSIONS The high prevalence of lifestyle-related diseases among women population in GCC is a ticking time bomb and is reaching alarming levels, and require a fundamental social and political changes. These findings highlight the need for comprehensive work among the GCC to strengthen the regulatory framework to decrease and control the prevalence of these factors.
Collapse
Affiliation(s)
- Mashael K Alshaikh
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Charing Cross Campus, St Dunstan's Road, 3rd Floor, Reynolds Building, London, W6 8RP, UK.
- Pharmacy Department, King Saud University, Medical City, Riyadh, Saudi Arabia.
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Charing Cross Campus, St Dunstan's Road, 3rd Floor, Reynolds Building, London, W6 8RP, UK
| | - Hussain A Al-Omar
- Pharmacy Department, King Saud University, Medical City, Riyadh, Saudi Arabia
| | - Salman Rawaf
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Charing Cross Campus, St Dunstan's Road, 3rd Floor, Reynolds Building, London, W6 8RP, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Charing Cross Campus, St Dunstan's Road, 3rd Floor, Reynolds Building, London, W6 8RP, UK
| | - Abdul-Majeed Salmasi
- National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| |
Collapse
|
17
|
El Khateeb SM, Abu-Hammad O, Fadel H, Dar-Odeh N. A Retrospective Analysis of Radiographic Jaw Findings in Young Women; Prevalence and Predictors. J Int Soc Prev Community Dent 2017; 7:22-27. [PMID: 28316945 PMCID: PMC5343679 DOI: 10.4103/2231-0762.200707] [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: 10/20/2016] [Accepted: 12/23/2016] [Indexed: 12/20/2022] Open
Abstract
AIMS AND OBJECTIVES To determine the prevalence and types of jaw pathologic findings as detected in panoramic radiographs of a sample of young women attending a teaching hospital in Al Madinah Al Munawarah, Saudi Arabia, and to determine the most important factors that predict the occurrence of jaw pathologic findings. MATERIALS AND METHODS The electronic clinical files of a representative sample of female patients who attended the outpatient dental clinics were retrieved. Patients were aged 18 to 25 years. Types of pathologic radiographic jaw findings and their prevalence were determined through screening of panoramic radiographs. Data were analyzed using the statistical analysis software [SPSS version 21 (IBM Corp.)]. Multiple linear regression was used to explore the significance of some types of dental lesions as predictor variables for the occurrence of jaw pathologic findings. RESULTS A total of 190 patients (mean age, 22.4 ± 2.46 years) were included in the study. Periapical lesions, retained roots, and alveolar bone loss were detected in 53.6%, 24.8%, and 17.4% of the participants, respectively. Other odontogenic abnormalities such as supernumerary and impacted teeth (6.4% and 33.7%, respectively) were also detected. Patients' age was found to be a good predictor for alveolar bone loss and number of periapical lesions (P ≤ 0.05). CONCLUSIONS A high prevalence of periapical lesions, retained roots, and alveolar bone loss was found among a sample of young female dental attendees, as shown by their panoramic radiographs. Further studies are needed to explore potential risk factors for such a noticeable trend of poor oral health, and the needed strategies to counteract this trend.
Collapse
Affiliation(s)
- Sara M. El Khateeb
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Ain Shams University, Cairo, Egypt
- Department of Basic and Clinical Oral Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
| | - Osama Abu-Hammad
- Department of Removable Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan
- Department of Substitutive Dental Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
| | - Hani Fadel
- Department of Preventive Dental Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
| | - Najla Dar-Odeh
- Department of Basic and Clinical Oral Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
- Department of Oral Surgery, Oral Medicine and Periodontics, Faculty of Dentistry, Amman, Jordan
| |
Collapse
|
18
|
Dar-Odeh N, Alnazzawi A, Shoqair N, Al-Shayyab MH, Abu-Hammad O. Waterpipe Tobacco Smoking Among Dental Practitioners: Prevalence and Health Perceptions. Tob Use Insights 2016; 9:29-33. [PMID: 27695374 PMCID: PMC5038825 DOI: 10.4137/tui.s40568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/17/2016] [Accepted: 08/23/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Waterpipe tobacco smoking prevalence, practice, and the associated health perceptions among dental practitioners have not been previously reported. This study aims to determine the prevalence of waterpipe smoking among dental practitioners and to evaluate their awareness of health hazards of waterpipe smoking, particularly the adverse effects on oral health. METHODS This was a cross-sectional questionnaire-based survey among dental practitioners. Surveyed dental practitioners practiced dentistry in the holy city of Al-Madinah Al-Munawarah, a city in the Central-Western Region of Saudi Arabia, and the study was conducted during March 2015. The questionnaire consisted of questions on demographic data, history and practices of tobacco use, and perceptions toward the health hazards of smoking. Dentists were approached at their work places and invited to participate. Descriptive statistics were used to describe the sample’s demographic and smoking characteristics, while cross-tabulation and chi-square test were used to determine the statistical significance of association between the groups (P ≤ 0.05). RESULTS One hundred dental practitioners participated in the survey, with 55 males and 45 females. Twenty-six percent indicated that they were waterpipe smokers. Male gender and cigarette smoking were the only factors to be significantly associated with waterpipe smoking (P = 0.008 and P = 0.000, respectively). Most participants stated that waterpipe smoking is harmful to health, and the most commonly reported health hazard was respiratory disease, which was reported by 81% of participants. CONCLUSIONS Prevalence of waterpipe smoking among dental practitioners is comparable to adult populations but lower than younger populations of university students. Health awareness of dental practitioners regarding waterpipe smoking was judged to be insufficient.
Collapse
Affiliation(s)
- Najla Dar-Odeh
- Professor, Faculty of Dentistry, University of Jordan, Amman, Jordan.; College of Dentistry, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Ahmad Alnazzawi
- Assistant Professor, College of Dentistry, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Noora Shoqair
- Intern, College of Dentistry, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | | | - Osama Abu-Hammad
- Professor, Faculty of Dentistry, University of Jordan, Amman, Jordan.; College of Dentistry, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| |
Collapse
|
19
|
Dehneh N, Rajab M, Zarzour W, Jouma M. Profile of healthy female students in Syria: Investigation on anthropometric, lifestyle, and dietary characteristics, along with hematological and plasma biochemical parameters. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1180741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Nada Dehneh
- Faculty of Pharmacy, Biochemistry Department, Arab International University, Damascus, Syrian Arab Republic
| | - Mazen Rajab
- Faculty of Pharmacy, Biochemistry Department, Arab International University, Damascus, Syrian Arab Republic
| | - Wafika Zarzour
- Faculty of Pharmacy, Biochemistry Department, Arab International University, Damascus, Syrian Arab Republic
| | - Muhidien Jouma
- Faculty of Pharmacy, Biochemistry Department, Arab International University, Damascus, Syrian Arab Republic
| |
Collapse
|
20
|
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.
Collapse
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
| |
Collapse
|
21
|
Alzyoud S, Kheirallah KA, Ward KD, Al-Shdayfat NM, Alzyoud AA. Association of Religious Commitment and Tobacco Use Among Muslim Adolescents. JOURNAL OF RELIGION AND HEALTH 2015; 54:2111-2121. [PMID: 25080891 DOI: 10.1007/s10943-014-9921-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to examine the relationship between religious observance and tobacco use among a sample of Jordanian youth. Using multistage, random sampling, a cross-sectional survey of middle and high school students was conducted. Of the 950 Muslim students in the study, 32% were daily tobacco users and 72% prayed regularly. Frequency of praying was negatively associated with tobacco smoking. Religious observance was found to be strongly associated with tobacco smoking among Jordanian youth. Our results indicate that religion can be a culturally important tool in health professionals' efforts for tobacco control.
Collapse
Affiliation(s)
- Sukaina Alzyoud
- Department of Community and Mental Health, Faculty of Nursing, Hashemite University, P.O. Box 150459, Zarqa, 13115, Jordan.
| | - Khalid A Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA
| | | | - Abd Albaset Alzyoud
- Faculty of Arts, Hashemite University, P.O. Box 150459, Zarqa, 13115, Jordan
| |
Collapse
|
22
|
Moradi-Lakeh M, El Bcheraoui C, Tuffaha M, Daoud F, Al Saeedi M, Basulaiman M, Memish ZA, AlMazroa MA, Al Rabeeah AA, Mokdad AH. Tobacco consumption in the Kingdom of Saudi Arabia, 2013: findings from a national survey. BMC Public Health 2015; 15:611. [PMID: 26141062 PMCID: PMC4491232 DOI: 10.1186/s12889-015-1902-3] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 06/03/2015] [Indexed: 11/21/2022] Open
Abstract
Background Tobacco consumption is a major risk factor for morbidity and mortality. The Saudi Ministry of Health started a national tobacco control program in 2002 with increased and intensified efforts after joining the World Health Organization Framework Convention for Tobacco Control in 2005. Methods In order to assess the status of tobacco consumption in the Kingdom of Saudi Arabia (KSA), we conducted a survey on 10735 individuals aged 15 years or older (5253 men and 5482 women) which was performed between April and June 2013. The Saudi Health Interview Survey had a multistage sampling and was nationally representative. Data were collected through face-to-face interviews. The survey included questions on socio-demographic characteristics, tobacco consumption, diet, physical activity, health care utilization, different health-related behaviors, and self-reported chronic conditions. Results Overall prevalence of current smoking was 12.2 % and males were more likely to smoke than females (21.5 % vs. 1.1 %). Mean age of smoking initiation was 19.1 years (±6.5 years) with 8.9 % of ever smokers starting before the age of 15 years. Daily shisha smoking was reported by 4.3 % of the population (7.3 % of men and 1.3 % of women). Around 1.4 % of population (2.6 % of men and 0.1 % of women) were daily smokers of cigarette/cigar and shisha. Receiving advice for quitting smoking by health care professionals during the last 12 months was reported by 53.2 % (95 % confidence interval [CI]: 49.8–56.5) of ever smokers. Among ever smokers, 51.3 % of individuals reportedly attempted to quit smoking during the last 12 months. Of those, 25.3 % were successful by the time of the survey. Around 23.3 % of the entire population, 32.3 % of men and 13.5 % of women, were exposed to secondhand smoke for at least one day during the past 7 days at home, work, or school. Conclusions Although the indicators of tobacco consumption in KSA are better than most of the countries of the Middle East region and high-income countries, there are many potential areas for improvement. Our findings call for the development and implementation of programs to prevent smoking initiation and encourage quitting. To achieve its health goals, KSA may consider increasing taxation on tobacco products as well as other measures.
Collapse
Affiliation(s)
- Maziar Moradi-Lakeh
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA, 98121, USA.
| | - Charbel El Bcheraoui
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA, 98121, USA.
| | - Marwa Tuffaha
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA, 98121, USA.
| | - Farah Daoud
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA, 98121, USA.
| | - Mohammad Al Saeedi
- Ministry of Health of the Kingdom of Saudi Arabia, Assadah, Al Murabba, Riyadh, 12613, Saudi Arabia.
| | - Mohammed Basulaiman
- Ministry of Health of the Kingdom of Saudi Arabia, Assadah, Al Murabba, Riyadh, 12613, Saudi Arabia.
| | - Ziad A Memish
- Ministry of Health of the Kingdom of Saudi Arabia, Assadah, Al Murabba, Riyadh, 12613, Saudi Arabia.
| | - Mohammad A AlMazroa
- Ministry of Health of the Kingdom of Saudi Arabia, Assadah, Al Murabba, Riyadh, 12613, Saudi Arabia.
| | - Abdullah A Al Rabeeah
- Ministry of Health of the Kingdom of Saudi Arabia, Assadah, Al Murabba, Riyadh, 12613, Saudi Arabia.
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Suite 600, Seattle, WA, 98121, USA.
| |
Collapse
|
23
|
Alzyoud S, Veeranki SP, Kheirallah KA, Shotar AM, Pbert L. Validation of the Waterpipe Tolerance Questionnaire Among Jordanian School-Going Adolescent Waterpipe Users. Glob J Health Sci 2015; 8:198-208. [PMID: 26383198 PMCID: PMC4804001 DOI: 10.5539/gjhs.v8n2p198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 03/17/2015] [Indexed: 11/20/2022] Open
Abstract
Introduction: Waterpipe use among adolescents has been increasing progressively. Yet no studies were reported to assess the validity and reliability of nicotine dependence scale. The current study aims to assess the validity and reliability of an Arabic version of the modified Waterpipe Tolerance Questionnaire WTQ among school-going adolescent waterpipe users. Methods: In a cross-sectional study conducted in Jordan, information on waterpipe use among 333 school-going adolescents aged 11-18 years was obtained using the Arabic version of the WTQ. An exploratory factor analysis and correlation matrices were conducted to assess validity and reliability of the WTQ. Results: The WTQ had a 0.73 alpha of internal consistency indicating moderate level of reliability. The scale showed multidimensionality with items loading on two factors, namely waterpipe consumption and morning smoking. Conclusion: This study report nicotine dependence level among school-going adolescents who identify themselves as waterpipe users using the WTQ.
Collapse
|
24
|
Alomari MA, Khabour OF, Alzoubi KH, Shqair DM, Eissenberg T. Central and peripheral cardiovascular changes immediately after waterpipe smoking. Inhal Toxicol 2015; 26:579-87. [PMID: 25144473 DOI: 10.3109/08958378.2014.936572] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Tobacco cigarette smoking is a global health problem that kills millions each year. Recently, tobacco smoking using a waterpipe (WP) has become popular worldwide. However, unlike cigarettes, the cardiovascular (CV) risks associated with WP smoking are uncertain. In this study, the immediate effects of WP smoking on central and peripheral CV indices were evaluated in 53 young healthy smokers. MATERIALS AND METHODS Strain-gauge plethysmography was used to measure forearm blood flow (Bf), vascular resistance (Vr), and venous capacitance (Vc) and outflow (Vf) at rest (R) and after occlusion (Oc), whereas heart rate (HR) and blood pressure (BP) were measured using standard automated auscultatory methods immediately before and after a 30-min WP smoking session. RESULTS Smoking resulted in HR, diastolic BP, mean arterial BP, rate pressure product and OcVr increases (p < 0.05) 6.6, 3.6, 2.5, 8.0 and 16%, respectively, whereas OcBf and OcVf decreased (p < 0.05) 8.8 and 14.3%, respectively. Additionally, smoking-induced changes in the central CV components correlated (p < 0.05) with changes in the periphery. CONCLUSION These results demonstrated changes in the CV central and peripheral components immediately after WP smoking. The correlations between the changes in these components suggest that the periphery is controlled, at least partially, by the same mechanism(s) affecting the central CV components during WP smoking.
Collapse
|
25
|
Kheirallah KA, Alzyoud S, Ward KD. Waterpipe use and cognitive susceptibility to cigarette smoking among never-cigarette smoking Jordanian youth: analysis of the 2009 Global Youth Tobacco Survey. Nicotine Tob Res 2015; 17:280-4. [PMID: 25159679 PMCID: PMC5479504 DOI: 10.1093/ntr/ntu140] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/10/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Susceptibility to cigarette smoking, defined as lack of a firm decision to not initiate smoking, predicts youth smoking initiation and experimentation and is a first step in the transition to regular smoking. This study investigated whether waterpipe (WP) smoking, an increasingly prevalent form of tobacco use among Arab adolescents, was associated with increased susceptibility to cigarette smoking. METHODS A secondary analysis of the 2009 Jordan Global Youth Tobacco Survey was conducted to assess the association between WP use and cigarette susceptibility, after adjusting for important confounders. RESULTS A total of 1,476 youth aged 13-15 years old who had never smoked cigarettes were identified and represented 166,593 never-cigarette smoking Jordanian youth. We found 40% of boys and 29% of girls were susceptible to cigarette smoking, and both boys (adjusted odds ratio [AOR] = 1.49, 95% confidence interval [CI] = 1.41-1.54) and girls (AOR = 1.95, 95% CI = 1.83-2.04) who had ever smoked WP were more susceptible to cigarette smoking than those who never smoked WP. CONCLUSION This is the first study to report that WP use may increase youth's susceptibility to initiate cigarette smoking.
Collapse
Affiliation(s)
- Khalid A Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan;
| | - Sukaina Alzyoud
- Department of Community and Mental Health, Faculty of Nursing, Hashemite University, Zarqa, Jordan
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN
| |
Collapse
|
26
|
Schröder C, Chaaya M, Saab D, Mahfoud Z. The determinants of intention to smoke waterpipe among adolescents in Lebanon: a national household survey. J Public Health (Oxf) 2015; 38:84-91. [PMID: 25665877 DOI: 10.1093/pubmed/fdv004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The phenomenon of waterpipe smoking (WPS) among adolescents has become eminent, and it is especially prevalent in Lebanon. Unlike cigarette smoking, WPS is parentally and socially acceptable. This study aims at examining the association between intention to smoke waterpipe in the next 6 months, and knowledge, attitudes and parental and social influences. METHODS This is a secondary data analysis from a national survey in 2007 on 1028 households. This study addresses 258 non-smoking adolescents and their parents. Consent was sought and the study was approved by the Institutional Review Board at the American University of Beirut. Face-to-face interviews were conducted. Descriptive analysis, crude and adjusted odds ratios (ORs) were generated. RESULTS At the bivariate level, late adolescence, mothers without university education, prior adolescents' WPS experiences, best friends' and parents' WPS habits and adolescents' and parents' lower attitude scores were associated with smoking intention. In the adjusted model, adolescents' beliefs about positive effects, best friends' similar habits and prior smoking remained significant (respective ORs [95% confidence interval ]: 1.81 [1.33-2.45], 2.51 [1.24-5.10], 4.91 [2.35-10.36]). Parents' perceived attitude against smoking was protective (OR: 0.57 [0.39-0.83]). CONCLUSIONS Adolescents' intention to smoke is highly influenced by parents' permissive attitudes and peer pressure. Interventions targeting these two groups and limiting access to smoking by adolescents should be instigated.
Collapse
Affiliation(s)
| | - Monique Chaaya
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Dahlia Saab
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | | |
Collapse
|
27
|
Akl EA, Ward KD, Bteddini D, Khaliel R, Alexander AC, Lotfi T, Alaouie H, Afifi RA. The allure of the waterpipe: a narrative review of factors affecting the epidemic rise in waterpipe smoking among young persons globally. Tob Control 2015; 24 Suppl 1:i13-i21. [PMID: 25618895 PMCID: PMC4345979 DOI: 10.1136/tobaccocontrol-2014-051906] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Objective The objective of this narrative review is to highlight the determinants of the epidemic rise in waterpipe tobacco smoking (WTS) among youth globally. The Ecological Model of Health Promotion (EMHP) was the guiding framework for the review. Data sources The following electronic databases were searched: Cochrane library, MEDLINE, EMBASE, PsycINFO, Web of Science and CINAHL Plus with Full Text. Search terms included waterpipe and its many variant terms. Study selection Articles were included if they were published between 1990 and 2014, were in English, were available in full text and included the age group 10–29 years. Data extraction Articles which analysed determinants of WTS at any of the levels of the EMHP were retained regardless of methodological rigour: 131 articles are included. Articles were coded in a standard template that abstracted methods as well as results. Data synthesis The review found that methodologies used to assess determinants of WTS among youth were often conventional and lacked rigor: 3/4 of the studies were cross-sectional surveys and most enrolled non-representative samples. Within the framework, the review identified determinants of WTS at the intrapersonal, interpersonal, organisational, community and policy levels. Conclusions The review suggests potential interventions to control WTS among youth, with emphasis on creative utilisation of social media, and tobacco control policies that include the specificities of WTS. The review further suggests the need for rigorous qualitative work to better contextualise determinants, and prospective observational and experimental studies that track and manipulate them to assess their viability as intervention targets.
Collapse
Affiliation(s)
- E A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - K D Ward
- School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - D Bteddini
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - R Khaliel
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - A C Alexander
- School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - T Lotfi
- Faculty of Medicine, Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - H Alaouie
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - R A Afifi
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
28
|
Prevalence, patterns and correlates of cigarette smoking in male adolescents in northern Jordan, and the influence of waterpipe use and asthma diagnosis: a descriptive cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:9008-23. [PMID: 25257355 PMCID: PMC4199003 DOI: 10.3390/ijerph110909008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 08/15/2014] [Accepted: 08/26/2014] [Indexed: 11/29/2022]
Abstract
Our study investigates the prevalence, patterns and predictors of tobacco smoking among early adolescent males in Northern Jordan and whether asthma diagnosis affects smoking patterns. A descriptive cross sectional design was used. Males in grades 7 and 8 from four randomly selected high schools in the city of Irbid were enrolled. Data on waterpipe (WP) use and cigarette smoking patterns were obtained (n = 815) using a survey in Arabic language. The overall prevalence of ever having smoked a cigarette was 35.6%, with 86.2% of this group smoking currently. Almost half of the sample reported WP use. The most common age in which adolescents started to experiment with cigarettes was 11–12 years old (49.1%), although 10 years was also common (25.3%). Significant predictors of male cigarette smoking were WP use (OR = 4.15, 95% CI = 2.99–5.76), asthma diagnosis (OR = 2.35, 95% CI = 1.46–3.78), grade 8 (OR = 1.52, 95% CI = 1.10–2.11), and having a sibling who smokes (OR = 2.23, 95% CI = 1.53–3.24). However, this cross-sectional study cannot establish causality, thus longitudinal studies are needed. Public health programs and school-based anti-tobacco smoking interventions that target children in early years at high schools are warranted to prevent the uptake of tobacco use among this vulnerable age group. High school students with asthma should be specifically targeted.
Collapse
|
29
|
Alzyoud S, Kheirallah KA, Weglicki LS, Ward KD, Al-Khawaldeh A, Shotar A. Tobacco smoking status and perception of health among a sample of Jordanian students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7022-35. [PMID: 25019264 PMCID: PMC4113858 DOI: 10.3390/ijerph110707022] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 06/05/2014] [Accepted: 06/27/2014] [Indexed: 11/23/2022]
Abstract
Limited data are available from Jordan examining patterns of tobacco use among adolescents, or how use is related to health perceptions. This study aims to estimate the prevalence of tobacco use and to assess the relationship between use and health-related perceptions. A cross-sectional survey was conducted among a sample of 11–18 year old school students from a major governorate in Jordan. Using a multistage random sampling 1050 students were selected. Students were categorized as non-smokers, cigarette-only smokers, waterpipe-only smokers, or dual smokers. Rates of waterpipe-only and cigarette-only smoking were 7% and 3%, respectively, and were similar for boys and girls. In contrast, the rate of dual use was much higher than for single product use and was double in girls compared to boys (34% vs. 17%). Dual-smokers were significantly more likely to think that it is safe to smoke as long as the person intends to quit within two years compared to non-smokers, and had lower self-rated health status than other groups. This is the first study among Arab adolescents to document high rates of dual tobacco use, especially pronounced among girls. The study findings have significant implications for designing tobacco smoking prevention programs for school health settings.
Collapse
Affiliation(s)
- Sukaina Alzyoud
- Department of Community and Mental Health, Faculty of Nursing, Hashemite University, P.O. Box 150459, Zarqa 13115, Jordan.
| | - Khalid A Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
| | - Linda S Weglicki
- College of Nursing, Wayne State University, Detroit, MI 48202, USA.
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA.
| | - Abdallah Al-Khawaldeh
- Department of Community and Mental Health, Faculty of Nursing, Hashemite University, P.O. Box 150459, Zarqa 13115, Jordan
| | - Ali Shotar
- Department of Legal Medicine, Toxicology and Forensic science, School of Medicine, Jordan University of Science and Technology (JUST), P.O. Box 3030, Irbid 22110, Jordan.
| |
Collapse
|
30
|
Ismail SI, Soubani M, Nimri JM, Al-Zeer AH. Cancer incidence in Jordan from 1996 to 2009--a comprehensive study. Asian Pac J Cancer Prev 2014; 14:3527-34. [PMID: 23886140 DOI: 10.7314/apjcp.2013.14.6.3527] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer is a major health problem facing the entire world, and Jordan is no exception. However, patterns of cancer incidence and cancer burden in Jordan have never been explored thoroughly, and the aim of this study was to close this knowledge gap. MATERIALS AND METHODS The study was based on data obtained from the Jordan cancer registry from 1996 to 2009. All cancer cases that were diagnosed during the study period were registered and included in this study. RESULTS A total of 51,626 cases were registered in Jordan during the 14- year period. The incidence rate showed no significant increase in males (percent change PC 6.8%), while in females a marked increase was observed (PC 14.8%). The major cancer sites for males were bronchus and lung, colorectal, bladder, leukemia and prostate. In females, the leading cancer sites were breast, colorectal, leukemia, thyroid and NHL. CONCLUSIONS Compared to other countries in the region, Jordan has comparable rates. On the other hand the rates of cancer are markedly lower in Jordan compared to more industrialized countries such as the US and Europe. There was an overall increase in the incidence of cancer in Jordan, especially among females, which stresses the need for programs to raise awareness on the importance of early diagnosis and preventive life style measures.
Collapse
|
31
|
Usmanova G, Mokdad AH. Results of the Global Youth Tobacco Survey and implementation of the WHO Framework Convention on Tobacco Control in the WHO Eastern Mediterranean Region (EMR) countries. J Epidemiol Glob Health 2013; 3:217-34. [PMID: 24206793 PMCID: PMC7320414 DOI: 10.1016/j.jegh.2013.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/13/2013] [Accepted: 07/17/2013] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED We used Global Youth Tobacco Survey (GYTS) data collected over time to monitor articles of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in WHO Eastern Mediterranean Region (EMR). METHODS The GYTS is a school-based survey, conducted in 23 countries in WHO EMR countries from 1999-2008. RESULTS The prevalence of current smokeless tobacco use was high compared to cigarette use in all countries. In general, the following changes were observed between baseline and repeated surveys: in five countries fewer youth supported a ban on smoking in public places. In four countries more youth saw actors smoking on TV and were exposed to second-hand smoke (SHS) outside of home. Fewer youth were offered free cigarettes in ten countries; in eight countries youth saw less advertisement on TV; in seven countries youth had fewer items with a tobacco logo, discussed more reasons for smoking and dangers of smoking, and were less exposed to SHS at home; in six countries youth saw less advertisement at sports events. CONCLUSION The GYTS data can be used for monitoring, evaluation of national tobacco control plans and defining future directions for tobacco control.
Collapse
Affiliation(s)
- Gulnoza Usmanova
- Institute for Health Metrics and Evaluation, 2301 5th Avenue, Suite 600, Seattle, WA 98121, United States
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, 2301 5th Avenue, Suite 600, Seattle, WA 98121, United States
| |
Collapse
|
32
|
Jawad M, McEwen A, McNeill A, Shahab L. To what extent should waterpipe tobacco smoking become a public health priority? Addiction 2013; 108:1873-84. [PMID: 23863044 DOI: 10.1111/add.12265] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 04/08/2013] [Accepted: 05/23/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Waterpipe tobacco smoking (WTS) popularity is increasing world-wide, and health effects are emerging in the light of evidence that WTS is perceived by users as less harmful than cigarette smoking. However, there remains a paucity of available evidence from which to draw firm conclusions about its public health significance. AIMS This narrative review aims to summarize WTS literature to date to inform tobacco control specialists and health-care professionals about this phenomenon and help them to assess whether or not WTS should become a public health priority. METHODS Standard electronic databases as well as conference proceedings and personal libraries were searched in English, French and Arabic with inclusive terminology for the variety of names given to WTS. FINDINGS Waterpipe smoke contains significant levels of toxins, some of which are known to be carcinogenic to humans. Recent epidemiological trends have established an increasing prevalence of WTS in the Middle East and the United States, particularly among adolescents. It is used commonly across multiple ethnicities and both genders with less of a social gradient than cigarette smoking. Attitudes and beliefs have been researched widely and several reasons for believing it is less harmful than cigarette smoking include water filtration and social acceptability. A wide range of diseases have been associated with WTS, but research in this area is relatively underdeveloped and a better evidence base is needed. Worryingly, the waterpipe industry, including waterpipe cafes, operates in an almost completely unregulated market and employs deceptive marketing techniques to attract new users. CONCLUSIONS Waterpipe tobacco smoking (WTS) appears to be on the increase, especially among younger users, and therefore represents a potential public health concern. While legislators should consider enforcing and extending existing tobacco laws to a growing WTS industry, further research is required to fill gaps in the literature and provide evidence-based interventions for tobacco control specialists and health-care professionals.
Collapse
Affiliation(s)
- Mohammed Jawad
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | | | | | | |
Collapse
|
33
|
Afifi R, Khalil J, Fouad F, Hammal F, Jarallah Y, Abu Farhat H, Ayad M, Nakkash R. Social norms and attitudes linked to waterpipe use in the Eastern Mediterranean Region. Soc Sci Med 2013; 98:125-34. [PMID: 24331890 DOI: 10.1016/j.socscimed.2013.09.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 07/10/2013] [Accepted: 09/06/2013] [Indexed: 10/26/2022]
Abstract
Waterpipe tobacco smoking (WTS) is on the rise globally, particularly among vulnerable populations such as youth and women. Increasing knowledge about toxicant yield from waterpipe tobacco and deleterious health effects points to the potential for a health epidemic. WTS is often viewed as a safe alternative to cigarette smoking. Though the original objective of the research was to explore the social norms and attitudes that lead to waterpipe being a more acceptable form of tobacco smoking for women than cigarettes in the Eastern Mediterranean Region, the use of a qualitative research methodology resulted in rich data that helped to understand more generally the phenomenon of waterpipe smoking. Both focus group discussions (FGDs) and key informant interviews were used. Participants were recruited to represent genders, various age groups, socioeconomic status, waterpipe smoking status, and residents of urban and rural areas. A total of 81 FGDs and 38 in-depth interviews were conducted in 2007. Thematic analysis was used to analyze the transcripts. A total of ten themes emerged: socio-cultural norms, gender differences, motivation to smoke, sensory characteristics of waterpipe, metaphors, consumerism, indicators of dependence, comparison between cigarettes and waterpipe, health effect of smoking, and intervention. Results indicated that WTS has socio-cultural dynamics associated with it that are far more pronounced than health considerations. An increased socio-cultural acceptability, the perceived reduced harm and the advent of the fruity Moassel tobacco are among the many reasons for WTS acceptability. Findings point to the need for a unified strategy to address this health issue at all levels of the ecological framework and have important implications for future policy and practice.
Collapse
Affiliation(s)
- Rima Afifi
- Department of Health Promotion and Community Health, Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Joanna Khalil
- Department of Health Promotion and Community Health, Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Fouad Fouad
- Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Fadi Hammal
- Department of Anesthesiology and Pain Medicine, University of Alberta, Alberta, Canada
| | - Yara Jarallah
- Egyptian Smoking Prevention Research Institute, Egypt
| | - Hala Abu Farhat
- Department of Health Promotion and Community Health, Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Maha Ayad
- Sociology Department, Faculty of Social Sciences, Brown University, RI, United States
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon.
| |
Collapse
|
34
|
Akl EA, Jawad M, Lam WY, Co CN, Obeid R, Irani J. Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review. Harm Reduct J 2013; 10:12. [PMID: 23816366 PMCID: PMC3706388 DOI: 10.1186/1477-7517-10-12] [Citation(s) in RCA: 203] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 06/26/2013] [Indexed: 11/10/2022] Open
Abstract
Background In spite of the negative health effects of waterpipe tobacco smoking, its use is becoming more common. The objective of this study is to systematically review the medical literature for motives, beliefs and attitudes towards waterpipe tobacco smoking. Methods We electronically searched MEDLINE, EMBASE, and the ISI the Web of Science in January 2012. We included both quantitative and qualitative studies. We selected studies and abstracted data using standard systematic review methodology. We synthesized data qualitatively. Results We included 58 papers reporting on 56 studies. The main motives for waterpipe tobacco smoking were socializing, relaxation, pleasure and entertainment. Peer pressure, fashion, and curiosity were additional motives for university and school students while expression of cultural identity was an additional motive for people in the Middle East and for people of Middle Eastern descent in Western countries. Awareness of the potential health hazards of waterpipe smoking was common across settings. Most but not all studies found that the majority of people perceived waterpipe smoking as less harmful than cigarette smoking. Waterpipe smoking was generally socially acceptable and more acceptable than cigarette smoking in general. In Middle Eastern societies, it was particularly more acceptable for women’s use compared to cigarette use. A majority perceived waterpipe smoking as less addictive than cigarette smoking. While users were confident in their ability to quit waterpipe smoking at any time, willingness to quit varied across settings. Conclusions Socializing, relaxation, pleasure and entertainment were the main motives for waterpipe use. While waterpipe users were aware of the health hazards of waterpipe smoking, they perceived it as less harmful, less addictive and more socially acceptable than cigarette smoking and were confident about their ability to quit.
Collapse
Affiliation(s)
- Elie A Akl
- Department of Medicine, State University of New York at Buffalo ECMC-DKM C216, Buffalo, NY 14215, USA.
| | | | | | | | | | | |
Collapse
|