Smoking Habits and the Influence of War on Cigarette and Shisha Smoking in Syria
Abstract Background: Tobacco smoking is a major risk factor for various preventable medical conditions. Our present study aimed at assessing Shisha and cigarette smoking in a sample of the Syrian population as well as assessing the interactions between smoking status and various war-related and sociodemographic variables.Methods: A community-based cross-sectional survey was conducted from March to April 2019 using an anonymous online questionnaire. The survey questionnaire solicited data on sociodemographic profile, medical history, smoking status and patterns along with some war-related impacts. Results: The sample comprised of 987 participants and had a mean age of 24.69 years. Around two-thirds of the overall cohort were females. Concerning smoking, a total of 371 participants (37.9%) were identified to be smokers, of whom 211, 84, 76 were exclusive shisha smokers, exclusive cigarette smokers, and dual smokers, respectively. Cigarette and shisha smoking was more common in males with p<0.0001. Males also smoked cigarettes and shisha daily, and in larger quantities than females p<0.05, while females were found to be more social smokers. Although cigarette smoking was more prevalent in older ages, shisha use was more prominent in younger ages. Losing someone close due to war was associated with smoking cigarettes p=0.002, and smoking in general p<0.001Conclusions: In our study, males tend to smoke more and be heavier smokers than females while females smoked shisha more frequently and socially. War and peer pressure were among the major contributors to smoking. Policies should aim to target young adults as shisha is becoming more popular among them.