Summary of final selected studies on tobacco use
| Author | Study design and sample | Tobacco outcomes measured | Study quality* |
|---|---|---|---|
| Alajbegovic et al27 | Repeated cross-sectional study of 506 patients with acute myocardial infarction in Croatia | Prevalence of smoking (prewar): diabetic 28.7%; non-diabetic 46.4% Prevalence of smoking (war): diabetic 38.8%; non-diabetic 55.9% Prevalence of smoking (postwar): diabetic 3.7%; non-diabetic 27.5% | Weak |
| Barnes et al28 | Cross-sectional study of 591 refugees in the USA | Prevalence of smoking: 38.5% Light to moderate cigarette use (<20 cigarettes/day): 53.1% | Weak |
| Blight et al29 | Cross-sectional study of 413 Bosnian refugees in Sweden | Prevalence of daily cigarette smoking: 41% | Moderate |
| Cajdric-Vrhovac et al30 | Qualitative study (semistructured interview) of 15 Bosnian refugees in the USA | NA | Moderate |
| Chaaya et al31 | Cross-sectional study of 740 elderly in Lebanon | Prevalence of smoking (overall): 28.1%; male 41.6%; female 17.3% Prevalence of smoking (by location): refugee camp 34.3%; Nabaa 25.1%; Hay-El-Sullum 20.4% Age started smoking: 21.9. Years smoked: 40.1 | Moderate |
| Creson et al32 | Cross-sectional study of 39 health professional in Bosnia and Herzegovina | Cigarette consumption per day: prewar 17.05; war 26.07 | Weak |
| Delic-Ovcina33 | Cross-sectional study of 637 male Bosnian refugees in the USA | NA | Weak |
| Eytan and Gex-Fabry34 | Cross-sectional study of 864 conflict-affected Albanians in Kosovo | Prevalence of smoking: male 34.7%; female 11% | Moderate |
| Farhood et al35 | Cross-sectional study of 208 former prison detainees in Lebanon | Prevalence of smoking: former prisoners 58.5%; control 33.3% | Weak |
| Giuliani et al38 | Qualitative study (structured interview and focus groups) of 111 Somalis in the USA | NA | Moderate |
| Giuliani et al36 | Cross-sectional study of 302 Somali youths in the USA | Prevalence any tobacco use: ever 22.2%; current 6.3% Tobacco product use: cigarette 4.7%; waterpipe 2.3%; chewing 1.7%; cigar 2.3%; bidi 1.3%; kretek1% | Moderate |
| Giuliani et al37 | Cross-sectional study of 392 Somali adults in the USA | Prevalence of any form of tobacco use: 25.7% Prevalence of cigarette smoking: overall 24.5%: male 44.1%; female 3.7% Light cigarette use (<10 cig/day) 52.5%; moderate cigarette use (11–20 cig/day) 19.8%; heavy cigarette use (>20 cig/day): 22.8% | Moderate |
| Harel-Ftsch et al39 | Cross-sectional study of 24 935 children in Israel, West Bank, Gaza | Differences in smoking prevalence between regions, p<0.001 | Moderate |
| Harris et al41 | Cross-sectional study of 499 Bosnian refugees in the USA | Prevalence of smoking: 66.4%. Light cigarette use (<10 cigarettes/day) 37%; moderate cigarette use (11–20 cigarettes/day) 41%; heavy cigarette use (>20 cigarettes/day) 23% | Weak |
| Harris et al40 | Cross-section study of 802 secondary school students in Liberia | Prevalence of cigarette use: 6.8%; occasional cigarette use: 67.5%; at least once a month use: 32.5% | Weak |
| Helweg-Larsen and Stancioff42 | Cross-sectional study of 55 Bosnian refugees in the USA | NA | Weak |
| Isralowitz and Rawson43 | Cross-sectional study of 911 youths in Israel | Prevalence of smoking: male 69%; female 70% | Weak |
| Keinan-Boker et al44 | Cross-sectional study of 425 Israeli smokers in Gaza | Prevalence of daily smoker: 85.4%; moderate cigarette use (11–20 cigarettes/day) 55%; heavy cigarette use (>20 cigarettes/day) 14.1% | Weak |
| Khader et al45 | Cross-sectional study of 14 513 Palestinian refugee students in Gaza, Syria, Jordan, Lebanon, West Bank | Prevalence of cigarette smoking: Gaza 3.2–6.6%; Jordan 11.1–14%; Syria 11.5–13.8%; Lebanon 8.4–12.6%; West Bank 16.5–24.4% Prevalence of waterpipe: Gaza 11.7–12.6%; Jordan 14.1–25.6%; Lebanon 33.5–33.7%; Syria 24.7-33.5%; West Bank 27.8–31.2% Prevalence of smokeless tobacco: Gaza 8.9%; Jordan 7.7%; Lebanon 6.5%; Syria 5.5%; West Bank 9.1% | Moderate |
| Kopinak46 | Qualitative study (semistructured interview) of 10 Bosnian refugees in Canada | NA | Strong |
| Koupil et al47 | Cross-sectional study of 5634 adults in Russia | Prevalence of (current/past) smoking exposed to siege: male 80.8%; female 18%. Prevalence of (current/past) smoking unexposed to siege: male 78.8%; female 14% | Moderate |
| Leavey et al48 | Cross-sectional study of 329 refugee school children in the UK | Prevalence of smoking: 11% | Weak |
| Luitel et al49 | Cross-sectional study of 8021 refugees in Nepal | NA | Weak |
| Makhoul and Nakkash50 | Qualitative study (focus groups) of 41 adolescents refugees in Lebanon | NA | Strong |
| Maksimovic et al51 | Cross-sectional study of 560 IDP and host city adolescents in Serbia | Prevalence of smoking: IDPs 65.6%; host population 6.4% | Weak |
| McLeod and Reeve52 | Cross-sectional study of 2992 refugees in New Zealand | Prevalence of smoking: 20.1%; male 32.3%; female 5.6% | Weak |
| Morikawa53 | Cross-sectional study of 143 children in Kosovo | Number of smokers in household: IDP 0.7; non-IDP 0.79 | Weak |
| Mousa et al54 | Case series study of 7762 Palestinian refugees from health clinics in Jordan, Lebanon, Syria, Gaza and West Bank | Level of smoking (overall): male 50.8%; female 10.5% Level of smoking (Jordan): male 48%; female 8.4% Level of smoking (Lebanon): male 59.5%; female 39.9% Level of smoking (Syria): male 57.1%; female 15.3% Level of smoking (Gaza): male 49.5%; female 0.6% Level of smoking (West Bank): male 43.7%; female 6.1% | Weak |
| Nguyen-Van-Tam et al55 | Cross-sectional study of 135 Vietnam refugees in the UK | Prevalence of smoking: daily 21.6%; occasional 3.7%; ex-smoker 6% | Weak |
| Okello et al56 | Cross-sectional study of 551 school-going adolescents in northern Uganda | Prevalence of smoking: 2.18%; male 2.82%; female 1.5% | Weak |
| Roberts et al57 | Cross-sectional study of 3600 conflict-affected persons in Georgia | Prevalence of smoking (all conflict-affected): male 47.4%; female 1.17% Prevalence of smoking: male IDPs 51.2%; male returnees 40.4% Heavy cigarette use (>20 cigarettes/day): all conflict-affected 70.9%; male IDPs 68.9%; male returnees 75.9% High nicotine dependence: all conflict-affected 41.4%; male IDPs 47%; male returnees 39% | Moderate |
| Rudatsikira et al58 | Cross-sectional study of 2182 adolescents in the West Bank (Judea and Samaria) | Prevalence of smoking: 18.9%; male 28.7%; female 9.6% | Moderate |
| Sharon et al59 | Cross-sectional study of 298 Holocaust survivors and European-born Jews in Israel | Prevalence of smoking (Holocaust survivor): current 10%; ever 48.4% | Weak |
| Siziya et al60 | Cross-sectional study of 1989 adolescents in Iraq | Prevalence of smoking: 15.3%; male 25.1%; female 2.7% | Moderate |
| Siziya et al61 | Cross-sectional study of 1563 youths in Somaliland | Prevalence of smoking: 15.8%; male 10.3%; female 11.1% | Moderate |
| Sokolova-Djokic et al62 | Cross-sectional study of 317 conflict-affected adults in Serbia | Prevalence of smoking (prewar): male 63.5%; female 48.8% Prevalence of smoking (war): male 70.7%; female 52.2% Prevalence of smoking (postwar): male 59.2%; female 44.3% | Weak |
| Stoll63 | Mixed methods study (cross-sectional survey and focus groups) of 194 immigrants and refugees in Canada | Prevalence of smoking: all 12%; male 18%; female 6% Prevalence of smoking in parents: father 24%; mother 6% | Weak |
| Turek et al64 | Cross-sectional study of 5840 adults in Croatia | Prevalence of smoking (regular): male 34.5%; female 26.6% Prevalence of smoking (occasional): male 6.6%; female 10.1% Form of tobacco product: cigarette 98.6%; cigar 0.9%; pipe 0.5% | Moderate |
| Weaver et al65 | Cross-sectional study of 66 Bosnian refugees in the USA | Prevalence of smoking: current 59%; prewar 44% Heavy cigarette use (>20 cigarettes/day): 62% | Weak |
*Quality rating for quantitative studies based on Effective Public Health Practice Project (EPHPP) quality assessment tool.25 Quality rating for qualitative studies based on CASP tool26, with scores of 8–10 considered strong; 5–7 considered moderate; and 1–4 weaks.
CASP, Critical Appraisal Skills Programme; IDP, internally displaced person; NA, not applicable.