Smoking Habits and the Influence of War on Cigarette and Shisha Smoking in Syria

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.

Smoking Patterns Among Third Level Students: A latent class analysis

Introduction: The psychosocial framework of adolescent transformation period is characterised by risk-taking behaviours such as the use of psychoactive substances like tobacco. Smoking initiated at this stage may lead to a lifetime nicotine-addiction. This study aims to identify and describe a typology of smoking among third level student smokers according to their pattern of smoking and to inform the designing of effective interventions in tobacco use among studentsMethods: Latent class analysis was used to characterise different smoking pattern among 361 third level students in an Irish university. The participants were enrolled in this cross-sectional study by inviting them to complete an online survey.Results: Three groups were identified: (1) Late-onset, Social smokers (n=88, 41.3%). (2) late-onset, light smokers (n = 74, 34.4%). (3) Early-onset, Nicotine addicts (n = 52, 24.3%). The predominantly female Late-onset, Social smokers has a low probability of regular use of tobacco, a low number of lifetime cigarettes smoked and a high probability (83.0%) of initiating smoking in their adulthood. Nearly 100% of them had neither of the parents as smokers. The predominantly male late-onset, light smokers exhibits similar characteristics with the female-dominated class 1 but has consumed more of cigarettes in the lifetime relative to class 1. 33.8% of class 2 smokers had both parents as smokers; 42.0% had mothers and 33.8% reported their father was a smoker. 64.6% of this class reported their parents to smoke in the home and 54.3% initiated smoking in adulthood. Class 3 (Early-onset, Nicotine addicts) dominated by males has a higher probability of regular tobacco use and has smoked the largest number of cigarette in their lifetime compared to classes 1 and 2. The majority (60.0%) of those in this group had initiated smoking as a teenager. 14.9% had both parents as smokers; 10.6% had mothers who smoke and 20.6% reported their father was a smoker. 23.7% of this class reported their parents to smoke in the home.Conclusion: This study reveals the cigarette smoking behaviours among students and can further inform interventions and strategies to achieving a tobacco-free Ireland.

Smoking habits in Syria and the influence of war on cigarette and shisha smoking.

Backgrounds: Shisha smoking has become an epidemic since the nineties and it adds an additional burden over cigarette smoking as it is more harmful, smoked socially and is widely accepted in many countries. We aim to discuss shisha and cigarette smoking prevalence in the Syrian community and university students with their associated risk factors and the relationship with many war factors.Methods: Online surveys were used that contained demographic and war-related questions along with cigarette and shisha smoking pattern questions.Results: The sample contained 987 responders with a mean age of 24.69, 25.7% being males, 16.4% smoking cigarettes, and 29.3% smoking shisha. Cigarette and shisha smoking was more common in males with P<0.0001 (OR, 4.762; 95% CI 3.333-6.757) and P=0.047 (OR, 1.364; 95% CI 1.003-1.855) for cigarettes and shisha respectively. Males also smoked daily, for longer years, more packs and more shisha every week than females P<0.05. However, females were more social smokers. While cigarette smoking was more prevalent in older ages, shisha was so in younger ages. Having a job, certain types of work and students at certain faculties were correlated with smoking more P<0.05. Losing someone due to the war and being distressed from war noises were also correlated with smoking. Field of education affected smoking patters as medical field students smoked fewer cigarettes and shisha while social studies students smoked more. Being a labourer, working as a clerk or in a restaurant, or as a technician was more frequently associated with smoking. However, no associations were found with SES, marital status and changing place of living due to war.Conclusions: Males tend to smoke more, heavier, more consistent, and for longer periods than females while women smoked shisha more socially. War increases smoking patterns while SES did not affect smoking in Syria. Shisha smoking increased and cigarette smoking decreased compared to previous studies and cigarette smoking remains lower than other regional countries, but shisha smoking is higher when compared to many other countries.

The Effects of Transcranial Direct Current Stimulation of Dorsolateral Prefrontal Cortex on Reduction of Craving in Daily and Social Smokers

Objective: Tobacco smoking is an addictive behavior with many psychological side effects, and many smokers are unable to quit it. Despite various treatments for smoking cessation, there is an urgent need to develop and utilize a noninvasive technique with high efficacy. This study aimed to determine the effects of transcranial direct current stimulation (tDCS) of dorsolateral prefrontal cortex (DLPFC) on reduction of craving in daily and social smokers. Method: This pretest-posttest quasi-experimental study, in which the participants were randomly assigned into sham and active groups, was performed on 40 daily and social smokers. Stimulation was delivered over the left DLPFC at a 2 m/A during 10 twenty-minute sessions for 5 weeks. The participants filled out the Desire for Drug questionnaire (DDQ) before and after intervention. Analysis of covariance was used for data analysis. Results: A significant decrease was found in the number of cigarette smoking in both daily and social smokers compared to the sham group. Moreover, the results indicated that anodal tDCS on F3 and Cathodal tDCS on F4 has significant effects on nicotine craving (P < 0/000). Conclusion: The results of the present study showed that the current tDCS of DLPFC decreases the craving of smoking. This noninvasive brain stimulation technique targeted at DLPFC area may be a promising method for reducing and treating smoking craving.

An Epidemiological Study of Population Health Reveals Social Smoking as a Major Cardiovascular Risk Factor

Purpose: To present nationally representative data on the prevalence of “social” smoking and its relationship to cardiovascular health. Design: A population-based, cross-sectional survey on cardiovascular health and its risk factors across the United States. Setting: Million Hearts® cardiovascular screenings that took place in community settings. Participants: De-identified data were collected on a convenient sample of 39, 555 participants. Measures: Reported smoking status, blood pressure, and total cholesterol. Analysis: The prevalence of current smoking, social smoking, and non-smoking were cross-tabulated and stratified by sample characteristics. The adjusted estimates were derived from multiple logistic regression models, adjusting for demographics and other biometric measures. Results: Ten percent identified as social smokers. Social smokers were more likely to be aged between 21 and 40, male, and Hispanic. Social smokers had significantly higher risks of having hypertension (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.80-2.41) and elevated cholesterol (OR: 1.53, 95% CI: 1.33-1.75) than non-smokers. There was no significant difference between social smokers and current smokers (OR = 0.94, 95% CI = 0.80-1.14 for hypertension and OR = 0.95, 95% CI = 0.81-1.11 for elevated cholesterol). Conclusion: This is the first population health study to compare the blood pressure and cholesterol levels of people who self-identify as current verses social smokers. Although previous smoking behavior was not controlled for in the analysis, this study demonstrates there is no significant difference in the prevalence of elevated blood pressure or cholesterol among the 2 smoking groups.

Phantom smoking among young adult bar patrons

ObjectiveTo explore the prevalence and sociodemographic makeup of smokers who do not self-identify as smokers (ie, phantom smokers) compared with self-identifying smokers in a sample of bar-going young adults aged 18–30 years to more accurately assess young adult prevalence of smoking and inform cessation message targeting.MethodsCross-sectional surveys of smokers (n=3089) were conducted in randomly selected bars/nightclubs in seven US cities. Logistic regression models assessed associations between phantom smoking (past 30-day smoking and denial of being a smoker), tobacco and alcohol use behaviours (eg, social smoking, nicotine dependence, smoking while drinking, past 30-day alcohol use) and demographics.ResultsCompared with smokers, phantom smokers were more likely to be college graduates (OR=1.43, 95% CI 1.03 to 1.98) and to identify themselves as social smokers (OR=1.60, 95% CI 1.27 to 2.12). Phantom smokers had lower odds of smoking while drinking (OR=0.28, 95% CI 0.25 to 0.32), being nicotine dependent (OR=0.36, 95% CI 0.22 to 0.76) and having quit for at least 1 day in the last year (OR=0.46, 95% CI 0.36 to 0.69) compared with smokers.ConclusionsThis research extends phantom smoking literature on college students to provide a broader picture of phantom smoking among young adults in high-risk contexts and of varying levels of educational attainment. Phantom smokers may be particularly sensitive to social pressures against smoking, suggesting the importance of identifying smoking as a behaviour (rather than identity) in cessation messaging to ensure that phantom smokers are reached.

Social Smoking and Mental Health Among Chinese Male College Students

Purpose. China has a high prevalence of smoking, but the characteristics of social smoking in Chinese college students have not been investigated. We examined the pattern of social smoking and explored the association between social smoking and personal cessation efforts and mental health factors among Chinese male college students. Design. Study design was a cross-sectional survey. Setting. P. R. China was the setting of the study. Subjects. Participants were a random sample of 1327 male college students. Measures. All participants completed a self-administered questionnaire that examined their smoking behaviors and a group of specific mental health factors (loneliness, self-harm, suicide, depression, and anxiety). Analysis. Analysis was conducted using descriptive statistics, χ2 analysis, and multivariate logistic regression. Results. Of a total of 207 current smokers, 102 (49.3%) were identified as social smokers. Compared with nonsmokers, social smokers had increased risks for depression (odds ratio, 1.74; 95% confidence interval, 1.15–2.65). Among daily smokers, social smokers were less likely to have an intention to quit smoking than nonsocial smokers (odds ratio, .08; 95% confidence interval, .01–.57). Conclusion. This study reveals unique psychologic characteristics related to social smoking. College students are a particular group of interest because unhealthy behaviors initiated during adolescence may continue through adulthood. Our findings provide evidence for future tobacco control intervention among this population.