RESEARCH PAPER

The tobacco epidemic in Syria

K D Ward^1,*, T Eissenberg^1,, S Rastam¹, T Asfar¹, F Mzayek^1,, M F Fouad¹, F Hammal¹, J Mock², W Maziak^1,

¹ Syrian Center for Tobacco Studies, Aleppo, Syria
² Department of Psychiatry, University of California San Francisco, California, USA

Correspondence to:
Correspondence to:
Dr Wasim Maziak
PO Box 16542, Aleppo, Syria; maziak{at}scts-sy.org

Background: The Syrian Center for Tobacco Studies (SCTS) was established in response to the smoking epidemic in Syria and lack of local knowledge and expertise to confront it.

Objectives: To (1) study tobacco use and local smoking practices using both qualitative and quantitative research methods; (2) develop and test an effective smoking cessation intervention for the Syrian environment; and (3) train Syrian researchers.

Methods and results: The Aleppo Household Survey involved a representative sample of adults in Aleppo (2038 subjects, 45.2% men, mean age 35.3 years, response rate 86%). The prevalence of cigarette smoking was 56.9% among men and 17.0% among women, while the prevalence of waterpipe smoking was 20.2% among men and 4.8% among women. Daily use predominated for cigarettes (29.0%), while the opposite was seen in waterpipe use with 10.6% smoking occasionally. Interest in quitting was greater for cigarette than waterpipe smokers (74.0% v 48.6%), while quit rates were higher for waterpipe compared to cigarettes (28.2% v 16.5%). In-depth ethnographic interviews with smokers show that smoking waterpipe is often viewed as an aesthetic enjoyable experience, while smoking cigarettes is viewed as a mundane anxiety-relieving addiction. Clinical laboratory studies reveal that both waterpipe and cigarette smokers in Syria are exposed to smoke toxicants and exhibit dependence symptoms.

Conclusions: All these data have been used iteratively to adapt smoking cessation interventions from developed countries to suit the local Syrian environment. Research conducted in the SCTS to date has provided a fertile training ground for Syrian researchers, as well as for the building of regional collaborations.

Abbreviations: AHS, Aleppo Household Survey; EMR, Eastern Mediterranean Region; NRT, nicotine replacement therapy; PPS, probability proportional to size; QSU, Tiffany-Drobes Questionnaire of Smoking Urges; RAM, Research Assistance Matching Project; SCTS, Syrian Center for Tobacco Studies; SES, socioeconomic status

Keywords: capacity building; smoking; Syria; Syrian Center for Tobacco Studies; waterpipe

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This article has been cited by other articles:

• Hammal, F, Mock, J, Ward, K D, Eissenberg, T, Maziak, W (2008). A pleasure among friends: how narghile (waterpipe) smoking differs from cigarette smoking in Syria. Tobacco Control 17: e3-e3 [Abstract] [Full Text]  

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