Prevalence and personal attitudes towards tobacco smoking among Palestinian healthcare professionals: a cross-sectional study

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Abstract

Background

Little is known about tobacco smoking behaviors of healthcare professionals in the Middle East where stress conditions are high and tobacco smoking regulations are either absent or loose. The objective of this study was to identify the prevalence of and attitudes toward tobacco smoking among healthcare professionals.

Methods

Trained senior medical students conducted a cross–sectional survey study in all governmental and non-governmental hospitals in Nablus city (Palestine) using a self-administered questionnaire containing both open-and closed-ended questions.

Results

In total, 708 healthcare professionals participated in the study. The mean age of the participants was 31.4 ± 9.6 years. Forty-five (6.4%) participants were ex-smokers, 419 (59.2%) were never smokers, and 244 (34.5%) were current tobacco smokers. One hundred and forty-two (58.2%) tobacco smokers reported that they smoke inside the hospital and 119 (48.8%) reported that they think of quitting smoking. Univariate analysis indicated that age, gender, marital status, family history of tobacco smoking, country of graduation, and night shifts were significantly associated with tobacco smoking status. No significant difference ( p = 0.156) in prevalence of tobacco smoking was found between physicians and other healthcare professionals. Binary logistic regression indicated that older age, male gender, and having a positive family history of smoking were significant predictors of being a current tobacco smoker. Non-smokers had significantly higher frequency of patient counseling than current smokers.

Conclusion

Palestinian healthcare professionals have relatively higher prevalence of tobacco smoking compared to the general population. Urgent national intervention and strict implementation of “No Smoking Law” in health institutions and in public places are needed to root out this negative behavior.

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Most cited references 30

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Global trends of lung cancer mortality and smoking prevalence.

Farhad Islami, Lindsey A Torre, Ahmedin Jemal (2015)

Lung cancer killed approximately 1,590,000 persons in 2012 and currently is the leading cause of cancer death worldwide. There is large variation in mortality rates across the world in both males and females. This variation follows trend of smoking, as tobacco smoking is responsible for the majority of lung cancer cases. In this article, we present estimated worldwide lung cancer mortality rates in 2012 using the World Health Organization (WHO) GLOBOCAN 2012 and changes in the rates during recent decades in select countries using WHO Mortality Database. We also show smoking prevalence and trends globally and at the regional level. By region, the highest lung cancer mortality rates (per 100,000) in 2012 were in Central and Eastern Europe (47.6) and Eastern Asia (44.8) among males and in Northern America (23.5) and Northern Europe (19.1) among females; the lowest rates were in sub-Saharan Africa in both males (4.4) and females (2.2). The highest smoking prevalence among males is generally in Eastern and South-Eastern Asia and Eastern Europe, and among females is in European countries, followed by Oceania and Northern and Southern America. Many countries, notably high-income countries, have seen a considerable decrease in smoking prevalence in both males and females, but in many other countries there has been little decrease or even an increase in smoking prevalence. Consequently, depending on whether or when smoking prevalence has started to decline, the lung cancer mortality trend is a mixture of decreasing, stable, or increasing. Despite major achievements in tobacco control, with current smoking patterns lung cancer will remain a major cause of death worldwide for several decades. The main priority to reduce the burden of lung cancer is to implement or enforce effective tobacco control policies in order to reduce smoking prevalence in all countries and prevent an increase in smoking in sub-Saharan Africa and women in low- and middle-income countries (LMICs).

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Waterpipe and cigarette tobacco smoking among Palestinian university students: a cross-sectional study

Marina Tucktuck, Rula Ghandour, Niveen M E Abu-Rmeileh (2017)

Background During the last two decades, waterpipe tobacco smoking (WTS), also known as hookah, witnessed a global increase in use, especially among youth. Little information is known about the burden of WTS among Palestinian youth. A cross-sectional study was conducted to estimate the prevalence of WTS and cigarette smoking and explore the associated factors among a sample of Palestinian university students. Methods 1891 students, from five Palestinian universities in the West Bank and Gaza Strip, completed a self-administered, web-based survey in 2014–2015. The questionnaire, which was based on the Global Adults Tobacco Survey (GATS), had questions on WTS and cigarette smoking patterns and socio-demographic and university-related characteristics. Binary logistic regression analyses were computed to investigate associated factors with WTS and cigarette smoking. Results 50.9% of the sample was women. The mean age was 20.1 ± 2.0. Overall, 30.0% of participants were current tobacco smokers and 33.4% reported ever smoking tobacco through a waterpipe. The prevalence of current WTS (24.4%) surpassed the prevalence of current cigarette smoking (18.0%), with a significantly higher prevalence among men compared to women. The gender gap for WTS (36.4% vs. 12.9%) was smaller than that for cigarette smoking (32.8% vs. 3.6%). Binary logistic regression models for the total sample (men and women) revealed that men were more likely to be current waterpipe and cigarette tobacco smokers compared to women (AOR = 4.20, 95% CI = 3.22–5.48, and AOR = 10.91, 95% CI = 7.25–16.42, respectively). Geographic area of residence, faculty of study and self-reported academic achievement were also associated with the likelihood of being current waterpipe and cigarette tobacco smokers. Conclusion A high prevalence of WTS was reported among our study sample, and it surpassed the prevalence of cigarette smoking. Interventions to curb the practice of tobacco smoking among Palestinian youth should be tailored differently to WTS and cigarette smoking, be gender-sensitive and specific and target the regional variation in the smoking behavior. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4524-0) contains supplementary material, which is available to authorized users.

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Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review

Elie A. Akl, Mohammed Jawad, Wai Yim Lam … (2013)

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.

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Author and article information

Contributors

Isra Y. Mizher: isra.mizher@gmail.com

Shahd I. Fawaqa: fawaqashahd@yahoo.com

Waleed M. Sweileh: 00-970-599-225906 , waleedsweileh@yahoo.com

Journal

Journal ID (nlm-ta): Addict Sci Clin Pract

Journal ID (iso-abbrev): Addict Sci Clin Pract

Title: Addiction Science & Clinical Practice

Publisher: BioMed Central (London )

ISSN (Print): 1940-0632

ISSN (Electronic): 1940-0640

Publication date (Electronic): 27 July 2018

Publication date PMC-release: 27 July 2018

Publication date (Print): 2018

Volume: 13

Electronic Location Identifier: 17

Affiliations

[1 ]ISNI 0000 0004 0631 5695, GRID grid.11942.3f, College of Medicine and Health Sciences, , An-Najah National University, ; Nablus, 44839 Palestine

[2 ]ISNI 0000 0004 0631 5695, GRID grid.11942.3f, Department of Physiology, Pharmacology, and Toxicology, College of Medicine and Health Sciences, , An-Najah National University, ; Nablus, 44839 Palestine

Article

Publisher ID: 119

DOI: 10.1186/s13722-018-0119-z

PMC ID: 6063017

PubMed ID: 30053911

SO-VID: 654de22d-e584-46d0-9177-a5a2d06ce5de

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 24 April 2018

Date accepted : 19 July 2018

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Prevalence and personal attitudes towards tobacco smoking among Palestinian healthcare professionals: a cross-sectional study

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Tobacco Prevention & Cessation

Most cited references 30

Global trends of lung cancer mortality and smoking prevalence.

Waterpipe and cigarette tobacco smoking among Palestinian university students: a cross-sectional study

Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review

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