National prevalence, perceptions, and determinants of tobacco consumption in Saudi Arabia

2019 ◽  
Vol 2 (2) ◽  
pp. 1
Author(s):  
Aljoharah M Algabbani ◽  
Nora A Althumiri ◽  
Abdulrahman M. Almarshad ◽  
Nasser F. BinDhim

Introduction Tobacco use has been associated with many health risks that can lead to premature death. This study aims to assess the national prevalence of tobacco consumption and the associated determinants in Saudi Arabia.  Methods The study involved a cross-sectional national survey of 5175 individuals conducted across the 13 official regions of Saudi Arabia. The sample included individuals aged 18 years and above from both genders recruited using a quota sampling technique. Data collection was carried out between September 2018 and May 2019 through Web-based computer-assisted telephone interviews (CATIs). Participants were asked to report their current consumption of tobacco products including cigarettes, shisha (waterpipe), smokeless tobacco, cigars, pipes, and electronic cigarettes/vaping. Knowledge of specific health risks associated with smoking and public perceptions of the smoking phenomenon were also assessed among never smokers, smokers, and former smokers. Results The national prevalence of tobacco consumption was 24.02% (1120/5175). Cigarettes were the most prevalent tobacco product consumed (16.18%; 95% CI: 14.5881–17.7663), and daily cigarette smoking prevalence was the highest (14.12%; 95% CI: 12.6433–15.5924). Shisha smoking prevalence was 8.12% (95% CI: 6.8054–9.4352). E-cigarette use prevalence was 2.22% (95% CI: 1.5770–2.8711). The most common tobacco product used among males was cigarettes (15.13%; 95% CI: 13.58–16.67), while shisha was commonly used among females (1.57%; 95% CI: 1.11–2.04). Cigarette smoking prevalence was the highest in the Aljawf region (21.12%; 95% CI: 17.07–25.18), shisha smoking prevalence was the highest in the Makkah region (12.41%; 95% CI: 8.64–16.17), whereas smokeless tobacco use was prevalent in the Najran region (4.75%; 95% CI: 2.81–6.70). Males (AOR: 8.17; 95% CI: 5.98–11.71; P < 0.0001), young adults below 45 years of age (AOR: 2.12; 95% CI: 1.50–2.98; P < 0.0001), and those with below a bachelor’s degree (AOR: 1.34; 95% CI: 1.01–1.77; P = 0.0396) were more likely to consume tobacco compared with others. The population mean knowledge scores of health risks associated with smoking among smokers was 1.91 ± 1.72 (Range: 0–10), with the highest knowledge scores (2.16 ± 1.68) among former smokers. Only 46.53% (95% CI: 44.30–48.75) of the population are bothered “to very large extent” by smoking health consequences. Conclusions Tobacco consumption is prevalent in Saudi Arabia. Different forms of tobacco use were reported, and the most common was cigarettes, followed by shisha and then electronic cigarettes. Tobacco use remains one of the major threats to the health of the population in Saudi Arabia.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Algabbani ◽  
N BinDhim

Abstract Introduction Tobacco consumption remains a challenging issue to the global and public health that requires close monitoring of the spread of this epidemic and its impact. This study aims to assess the national prevalence and determinates of cigarette smoking and nicotine dependence in Saudi Arabia. Methods A cross-sectional national survey of a sample of 5148 of Saudi residents' ages 18 years or older was conducted through web-based-computer assisted telephone interviews. The two main measurements were current cigarette smoking status and nicotine dependence assessed using the Fagerstrom Test for Nicotine Dependence. Data was weighted by age, gender, and region to account for the different probabilities of selection. Descriptive and logistic regression analyses were used to assess cigarette smoking and nicotine dependence determinants. Results The national prevalence of cigarette smoking was 16.18% (95% CI:14.59-17.77) with 14.12% (95% CI:12.64-15.59) current daily smoking prevalence. Almost 72% of smokers started smoking before the age of 22 and 27% of smokers were highly dependent on nicotine. Having a smoker parent (AOR=1.84[95%CI:1.31-2.58], P &lt; 0.001) or a smoker close friend (AOR=6.49[95%CI:3.89-10.81], P &lt; 0.001) were significantly associated with being a smoker. Higher nicotine dependence level was significantly associated with early onset of regular smoking (ages&lt;18) (AOR=2.71 [95%CI:1.38-5.34],P&lt;0.001) and lower attempting to quit (AOR=0.51[95% CI:0.32-0.83],P&lt;0.01). Conclusions Cigarettes smoking and nicotine dependence are prevalent in Saudi Arabia. The study found the majority of smokers started regular smoking before the age of 22 and the early onset of smoking was associated with a higher nicotine dependence level. Restrict access to tobacco products to those below the age of 22 will help reduce smoking prevalence and lifetime addiction to nicotine. Key messages Majority of smokers initiated smoking by the age of 21 and early regular smoking initiation was associated with higher nicotine dependence. Strategies to prevent initiation before the age of 21 will help prevent addiction to nicotine.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Douglas Levy ◽  
Sydney L Goldberg ◽  
Emily P Hyle ◽  
Krishna P Reddy

Background: The AHA’s 2030 Impact Goals seek to increase population health-adjusted life expectancy (LE) by 2y. Tobacco is a top contributor to all-cause mortality and cardiovascular disease (CVD). We estimated the potential contribution of improved tobacco control to achieve the 2030 Impact Goals in the US. Methods: We used the validated STOP microsimulation model with NHIS estimates of age- and sex-stratified mortality and CVD incidence to project changes in LE, as well as 10y, 20y, and lifetime CVD cumulative incidence, if cigarette smoking declined among the current US population. We assessed the impact of preventing initiation (current v never smokers) or increasing cessation (current v former smokers) at different ages. To examine the maximum impact of population-wide cessation, we projected changes in population LE and CVD incidence if smoking prevalence among those ≥20yo went immediately to 0%. Results: Preventing smoking initiation increases LE by 10.2y (men [M]) and 9.1y (women [W]) and reduces lifetime CVD incidence by 16.8% (M) and 26.2% (W) compared to lifetime smoking. Even cessation at age 60 extends LE by 3.7y (M) and 2.5y (W) and reduces 10y CVD incidence by 39.1% (M) and 59.4% (W) (Table). Total elimination of cigarette smoking in the 2020 US population aged ≥20y (e.g. by outlawing cigarettes) would increase the cohort LE by 0.4 (M) and 0.2 (W) years and reduce 20y CVD incidence by 6.0% (M) and 7.0% (W). Conclusion: Preventing smoking initiation offers the greatest benefit, but cessation at any age substantially improves LE and reduces CVD risk. The modest potential contribution of tobacco elimination to achieving the 2030 Impact Goals is due to already low smoking prevalence: <14% (projected) in 2020.


2019 ◽  
pp. tobaccocontrol-2019-054951 ◽  
Author(s):  
Thi Thanh Tra Doan ◽  
Ken Wei Tan ◽  
Borame Sue Lee Dickens ◽  
Yin Ai Lean ◽  
Qianyu Yang ◽  
...  

BackgroundIn jurisdictions in which electronic cigarettes are currently prohibited, policy makers must weigh the potentially lower risk compared with conventional cigarettes against the risk of initiation of e-cigarettes among non-smokers.MethodsWe simulated a synthetic population over a 50-year time horizon with an open cohort model using data from Singapore, a country where e-cigarettes are currently prohibited, and data from the USA, the UK and Japan. Using the smoking prevalence and the quality-adjusted life year gained calculated, we compared tobacco control policies without e-cigarettes—namely, raising the minimum legal age (MLA), introducing a smoke-free generation (SFG) and tax rises on tobacco consumption—with policies legalising e-cigarettes, either taking a laissez-faire approach or under some form of restriction. We also evaluated combinations of these policies.ResultsRegardless of the country informing the transition probabilities to and from e-cigarette use in Singapore, a laissez-faire e-cigarette policy could reduce the smoking prevalence in the short term, but it is not as effective as other policies in the long term. The most effective single policies evaluated were SFG and aggressive tax rises; the most effective combination of policies considered was MLA plus moderate tax rises and e-cigarettes on prescription.ConclusionPolicy makers in jurisdictions in which e-cigarettes are not yet established may be advised not to prioritise e-cigarettes in their tobacco end-game strategy, unless their use can be restricted to current smokers seeking to quit.


2018 ◽  
Vol 28 (Suppl 1) ◽  
pp. s20-s30 ◽  
Author(s):  
Nigar Nargis ◽  
Michal Stoklosa ◽  
Jeffrey Drope ◽  
Geoffrey T Fong ◽  
Anne C K Quah ◽  
...  

BackgroundThe price of tobacco products in relation to the income of tobacco users—affordability—is recognised as a key determinant of tobacco use behaviour. The effectiveness of a price increase as a deterrent to tobacco use depends on how much price increases in relation to the income of the potential users. The aim of this paper is to examine the distribution of and trends in the affordability of tobacco products in Bangladesh.MethodUsing four waves of International Tobacco Control Survey data on Bangladesh, this study measures affordability of tobacco products at the individual level as the ratio of self-reported price and self-reported income. The trends in affordability by brand categories of cigarettes and of bidi and smokeless tobacco are estimated using multivariate linear regression analysis.ResultsDespite significant increase in price, the affordability of cigarettes increased between 2009 and 2014–2015 due to income growth outpacing price increase. The increase was disproportionately larger for more expensive brands. The affordability of bidis increased over this period as well. The affordability of smokeless tobacco products remained unchanged between 2011–2012 and 2014–2015.ConclusionThe tax increases that were implemented during 2009–2015 were not enough to increase tobacco product prices sufficiently to outweigh the effect of income growth, and to reduce tobacco consumption. The findings from this research inform policymakers that in countries experiencing rapid economic growth, significant tax increases are needed to counteract the effect of income growth, in order for the tax increases to be effective in reducing tobacco use.


2018 ◽  
Vol 49 (2) ◽  
pp. 199-205
Author(s):  
Catherine O Egbe ◽  
Charles DH Parry ◽  
Bronwyn Myers

Tobacco use is the single largest preventable cause of death globally. For years, the tobacco industry sought to create a tobacco product that is less controversial than conventional cigarettes. Electronic cigarettes were created out of the supposed need to supply consumers of tobacco products with a less harmful tobacco product. The question remains, is it really less harmful for consumers of traditional cigarettes and other tobacco products to switch to electronic cigarettes? This article takes a closer look at the overall harm in relation to benefits of using electronic cigarettes for the individual and public health and the unintended negative consequences the introduction of electronic cigarette has had on overall public health. Given the evidence that the use of electronic cigarettes is a gateway to the use of other tobacco products especially among adolescents, we view electronic cigarettes as having the potential to cause a rebound of the tobacco use glut which the global public health community has been succeeding in reversing. We therefore support the World Health Organization’s suggestion that electronic cigarettes should be regulated as other tobacco products since there is, as yet, no harmless tobacco product. In the same vein, we view the new Tobacco Products and Electronic Delivery Systems Bill seeking to regulate electronic cigarettes in South Africa as other tobacco products as a step in the right direction.


2020 ◽  
Vol 30 (3) ◽  
pp. 270-277
Author(s):  
A. G. Polupanov ◽  
A. A. Tolebaeva ◽  
I. S. Sabirov ◽  
A. T. Altymysheva ◽  
A. I. Sabirova ◽  
...  

The aim of the study was to assess the situation related to tobacco consumption among adolescents aged 13 – 15 in the Kyrgyz Republic.Materials and Methods. The study used a two-stage selection of schoolchildren in grades 7 – 9 (teenagers 13 – 15 years old) to conduct the survey. At the 1st stage, information was collected about all schools of the republic, where children of the target group study. the schools in which the survey was subsequently conducted were selected by the statistical sampling method according to the number of students in grades 7 – 9. The grades whose students participated in the questionnaire were set at stage 2 by random sampling in each school The survey includes 43 questions from the Standard main Questionnaire of the Global Youth Tobacco Survey (GYTS) and 30 supplementary questions (73 in total) with multiple choice of answers. The statistical processing was performed using the SUDAAN software package (US Centers for Disease Control and Prevention); a 95% confidence interval was calculated to calculate weighted prevalence estimates and standard errors (SE).Results. The survey found that 6.0% of schoolchildren (9.5% of boys and 2.4% of girls) currently use various types of tobacco; 4.4% of schoolchildren currently use tobacco (6.8% of boys and 2.0% of girls); 2.4% of schoolchildren smoke cigarettes; 2.4% use smokeless tobacco, 2.8% use other tobacco products (hookah); 2.8% of schoolchildren smoke electronic cigarettes (3.9% of boys and 1.7% of girls). Tobacco use most often begins before age 7 or after age 12. 16.8% of schoolchildren are exposed to tobacco smoke at home, of which 14.2% are in closed places and 14.8% in open public places. 87.2% of schoolchildren purchase cigarettes in a shop, kiosk, from a street vendor, and in the market. During the visit to the point of sale 26.7% noticed tobacco advertising and promotions; 49.7% saw anti-tobacco messages in the mass media. Definitely think that smoking tobacco by other people is bad for them, 71.2% of schoolchildren.Conclusion. A high percentage of teenagers consuming e-cigarettes, hookah, and smokeless tobacco products has been noted, although > 50% of them are aware of the dangers of tobacco use. Every 6th student is a passive smoker. The vast majority of schoolchildren aged 13 – 15 who try to quit smoking do not receive professional help in quitting tobacco use, and are exposed to protobacco media marketing campaigns.


2021 ◽  
pp. tobaccocontrol-2020-055999
Author(s):  
Alyssa F Harlow ◽  
Jessica L Fetterman ◽  
Craig S Ross ◽  
Rose Marie Robertson ◽  
Aruni Bhatnagar ◽  
...  

BackgroundFew studies assess whether electronic cigarette (e-cigarette) device characteristics or flavours impact longitudinal patterns of cigarette and e-cigarette use.DesignWe examined data from waves 2–4 of the Population Assessment of Tobacco and Health Study (2014–2018). Among adult (≥18 years) current e-cigarette users at wave 2 who were current smokers (dual users; n=1759) and former smokers (exclusive e-cigarette users; n=470), we classified participants into four use patterns at wave 3 (~12 months later) and wave 4 (~24 months later): (1) dual use of e-cigarettes and cigarettes; (2) exclusive cigarette smoking; (3) exclusive e-cigarette use; (4) non-use of both products. We used multinomial logistic regression to assess correlates of changing use patterns at 24 months, relative to no change, adjusting for sociodemographic factors.ResultsAt 24 months, 26.5% of baseline exclusive e-cigarette users, and 9% of baseline dual users, abstained from both vaping and smoking. Participants who vaped non-tobacco flavours (vs tobacco flavours), and used refillable tank or modifiable devices (vs disposable, cartridges and other devices) were less likely to transition to non-use of both products and to exclusive cigarette smoking. Baseline daily vaping (vs non-daily) was positively associated with exclusive e-cigarette use at 24 months for baseline daily cigarette smokers, but negatively associated with exclusive e-cigarette use and non-use of both products at 24 months for baseline non-daily smokers.ConclusionsNon-tobacco flavours, daily vaping and modifiable e-cigarette devices may help some smokers abstain from cigarette smoking via transitioning to exclusive e-cigarette use, but are also associated with ongoing exclusive e-cigarette use.


BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sophie Rousseaux ◽  
◽  
Emie Seyve ◽  
Florent Chuffart ◽  
Ekaterina Bourova-Flin ◽  
...  

Abstract Background Although exposure to cigarette smoking during pregnancy has been associated with alterations of DNA methylation in the cord blood or placental cells, whether such exposure before pregnancy could induce epigenetic alterations in the placenta of former smokers has never been investigated. Methods Our approach combined the analysis of placenta epigenomic (ENCODE) data with newly generated DNA methylation data obtained from 568 pregnant women, the largest cohort to date, either actively smoking during their pregnancy or formerly exposed to tobacco smoking. Results This strategy resulted in several major findings. First, among the 203 differentially methylated regions (DMRs) identified by the epigenome-wide association study, 152 showed “reversible” alterations of DNA methylation, only present in the placenta of current smokers, whereas 26 were also found altered in former smokers, whose placenta had not been exposed directly to cigarette smoking. Although the absolute methylation changes were smaller than those observed in other contexts, such as in some congenital diseases, the observed alterations were consistent within each DMR. This observation was further supported by a demethylation of LINE-1 sequences in the placentas of both current (beta-coefficient (β) (95% confidence interval (CI)), − 0.004 (− 0.008; 0.001)) and former smokers (β (95% CI), − 0.006 (− 0.011; − 0.001)) compared to nonsmokers. Second, the 203 DMRs were enriched in epigenetic marks corresponding to enhancer regions, including monomethylation of lysine 4 and acetylation of lysine 27 of histone H3 (respectively H3K4me1 and H3K27ac). Third, smoking-associated DMRs were also found near and/or overlapping 10 imprinted genes containing regions (corresponding to 16 genes), notably including the NNAT, SGCE/PEG10, and H19/MIR675 loci. Conclusions Our results pointing towards genomic regions containing the imprinted genes as well as enhancers as preferential targets suggest mechanisms by which tobacco could directly impact the fetus and future child. The persistence of significant DNA methylation changes in the placenta of former smokers supports the hypothesis of an “epigenetic memory” of exposure to cigarette smoking before pregnancy. This observation not only is conceptually revolutionary, but these results also bring crucial information in terms of public health concerning potential long-term detrimental effects of smoking in women.


2020 ◽  
pp. 004723792098048
Author(s):  
Lawrence M. Scheier ◽  
Martin Komarc

We used data from the 2014 National Youth Tobacco Survey to examine patterns of cigarette smoking behavior and tobacco use. In light of the recent upsurge in e-cigarette use, we modeled current use and future intentions to use vape products along with combustible cigarette smoking and other tobacco products (i.e., cigars, cigarillos, chew, snuff, and dip). Latent class analyses indicated four discrete classes of smokers including a nominally involved class with very modest levels of tobacco product use, a class blending e-cigarette and cigars, a class of youth who predominantly use combustible cigarettes, and a group reporting indiscriminate use of almost all tobacco products excluding chew. Tests of invariance in item response probabilities and latent class proportions showed little variation across race and gender, albeit a new class of combustible cigarette and e-cigarette users emerged when examined by grade. Members of the heavy smoking and tobacco use class were more likely to be male, White, and older. Predictors of class membership included expectancies (perceived benefits of use), perceived harm (risk), media exposure, tobacco dependence, and the desire to quit. Findings are discussed in terms of characterizing risk among already smoking youth and how actionable prevention measures can be incorporated into existing universal and indicated programs that target reducing tobacco use and smoking behaviors.


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