Predictors of Nicotine Dependence Among Adult Male Midwakh and Cigarette Smokers.

Objectives: Midwakh is a popular form of smoking in the Middle East. This study aimed to assess the predictors of nicotine dependence among cigarette or midwakh smokers in the United Arab Emirates (UAE). Methods: This cross-sectional study was conducted from September to December 2015 in Ajman, UAE. A convenience sampling strategy was implemented to recruit adult male smokers aged ≥18 years who exclusively smoked either cigarettes or midwakh. A validated self-administered questionnaire was used to collect data from the participants, with nicotine dependence assessed using the Modified Fagerström Test for Nicotine Dependence. In addition, the levels of salivary cotinine and exhaled breath carbon monoxide (CO) were measured. Results: Of the 88 adult male smokers included in the study, 40 (45.5%) were cigarette smokers and 48 (54.5%) smoked midwakh. The majority of participants were 26-35 years of age (48.9%), followed by 18-25 years (30.7%) and >35 years (20.5%). Midwakh use was associated with more than a three-fold increase in the risk of moderate-to-high nicotine dependence compared to cigarette smoking. Moreover, for each unit increase in CO level, there was a 10% increase in the risk of nicotine dependency. There was also a significant association between nicotine dependence level and depth of inhalation (P = 0.023). Conclusion: Type of smoking and CO level were found to be significant predictors of nicotine dependence among adult male smokers. In particular, greater dependency was observed among midwakh smokers than cigarette smokers.

Salivary cotinine concentration and carbon monoxide levels in young adults smoking midwakh in comparison with cigarette smokers.

OBJECTIVES: To estimate and compare the salivary cotinine levels using a semiquantitative method, called NicAlert, between three groups: non-smokers, daily smokers of cigarettes and daily smokers of midwakh, and to compare the carbon monoxide (CO) levels among these groups. MATERIALS AND METHODS: A total of 159 adult male volunteers aged 20 and above were included, with 54 current cigarette smokers, 52 current midwakh smokers and 53 non-smokers. Estimate of breath carbon monoxide and salivary cotinine were collected, as well as sociodemographic characteristics and details of smoking habits and second-hand smoke exposure among participants. Institutional review board approval was obtained and data were analysed using SPSS V.21 with the Kruskal-Wallis test used to obtain differences in the distribution. RESULTS: There was no significant difference in the median breath CO and salivary cotinine levels between cigarette and midwakh smokers. Levels of breath CO were significantly higher in cigarette and midwakh smokers as compared with non-smokers (19.5, 17.5 and 6.0, respectively, p<0.05); the same relationship was observed for cotinine levels among cigarette and midwakh smokers as compared with non-smokers (4.0, 3.0 and 0.0, respectively, p≤0.05). Additionally, the values of both salivary cotinine and breath CO increased with the frequency of tobacco use. CONCLUSION: These are the first data that we are aware of that demonstrate that in terms of at least two key biomarkers of tobacco use, there are comparable levels of exposure between cigarettes and midwakh users, demonstrating a need for intensified attention to the use of midwakh.

Predictors of Colorectal Cancer Knowledge among Adults in the United Arab Emirates

Objective: To assess knowledge regarding colorectal cancer (CRC) and to identify its predictors in the UAE. Materials and Methods: A cross sectional study was conducted among subjects ≥ 50 years-old, using a validated self-administered questionnaire. Awareness of CRC risk factors, warning signs/symptoms (S/S), and screening methods was evaluated with a level of knowledge score for various areas. Low (poor) knowledge was defined as a score below the corresponding average value. The Chi-square test and logistic regression were used in the statistical analysis. Results: The percentage of respondents who had poor knowledge score concerning risk factors, warning S/S and screening were 81.7%, 84.7% and 94.1% respectively. Male and lower education level subjects had significantly higher probability of low knowledge related to risk factors and warning S/S. Also respondents without a family history of CRC or personal history of polyps had a significantly higher probability of low knowledge concerning warning S/S compared to those who had a positive history. Significantly higher probability of low knowledge concerning screening methods was noted among non-Arabs and subjects with a lower education level. Conclusion: Most of the respondents had poor knowledge. Gender, education level, family and personal history and ethnicity were found to be significant predictors of CRC knowledge.

Assessment of Breast Cancer Awareness among Female University Students in Ajman, United Arab Emirates.

OBJECTIVES: The aim of this study was to assess female university students' knowledge of breast cancer and its preventative measures and to identify their main misconceptions regarding breast cancer. METHODS: This cross-sectional study was conducted between April 2011 and June 2012 and included female students from three large universities in Ajman, United Arab Emirates (UAE). A stratified random sampling procedure was used. Data were collected through a validated, pilot-tested, self-administered questionnaire. The questionnaire included 35 questions testing knowledge of risk factors, warning signs and methods for the early detection of breast cancer. Participants' opinions regarding breast cancer misconceptions were also sought. RESULTS: The participants (n = 392) were most frequently between 18 and 22 years old (63.5%), non-Emirati (90.1%) and never married (89%). A family history of breast cancer was reported by 36 (9.2%) of the students. The percentage of participants who had low/below average knowledge scores regarding risk factors, warning signs and methods for early detection of breast cancer was 40.6%, 45.9% and 86.5%, respectively. Significantly higher knowledge scores on risk factors were noticed among participants with a family history of breast cancer (P = 0.03). The misconception most frequently identified was that "treatment for breast cancer affects a woman's femininity" (62.5%). CONCLUSION: A profound lack of knowledge about breast cancer was noted among female university students in the three UAE universities studied. The most prominent gaps in knowledge identified were those concerning breast cancer screening methods.

Breast self examination practice and breast cancer risk perception among female university students in Ajman.

Breast cancer is the top cancer in women worldwide and its incidence is increasing, particularly in developing countries. In the United Arab Emirates (UAE), many cases are first diagnosed in later stages and at younger age compared to those seen in developed countries. Early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control. Performance of breast self examination is one of the important steps for identifying breast disease at an early stage, by the woman herself. No information has hitherto been available about the frequency of this practice among female university students in UAE or about their breast cancer risk perception and therefore the present study was conducted in Ajman. It was found that 22.7% of the participants practiced BSE but only 3% of them practiced BSE monthly. Marital status but not age as significantly associated with age likelihood. The most frequent reported barriers for BSE were lack of knowledge, considering oneself not at risk and the absence of doctor advice. These factors need to be taken into account in intervention efforts.

Acute effects of dokha smoking on the cardiovascular and respiratory systems among UAE male university students.

BACKGROUND: In the United Arab Emirates (UAE) tobacco use is rampant. A less reported, yet widely used form of smoking native to UAE is midwakh or dhokha. The aim of the study is to assess the acute effects of smoking dokha (Arabian pipe) on the cardiovascular and respiratory systems among male university students in the UAE. METHOD: A quasi-experimental study was conducted among 97 male volunteers aged more than 17 years. Blood pressure, heart rate and respiratory rate of each participant, were measured before and immediately after smoking. A self administered questionnaire was used to collect personal details and data about smoking pattern. RESULTS: Mean increases in systolic blood pressures (12±1 mmHg), heart rates (20±2 bpm) and respiratory rates (4±1 breaths/min) were observed (p<0.001). A mean decrease in diastolic blood pressures (1±1 mmHg) was observed (p=0.483). CONCLUSION: Smoking dokha has a significant acute effect on systolic blood pressure, heart rate and respiratory rate. Anti smoking campaigns must address the ill effects of this form of smoking. Results from the study warrant further research into this method of smoking which is becoming more popular.

Smokers and marriage: attitude of youth in the United Arab Emirates.

INTRODUCTION: In order to control the tobacco scourge, an array of measures is required. Among them is focusing on adolescent relationships as it has been shown that being in a close relationship with a smoker or a non smoker will in the long run be a major factor in deciding whether the individual adopts smoking for initial non-smokers or ceases the habit for initial smokers. OBJECTIVES: To assess the attitude of youth towards other smokers and towards marrying a smoker. MATERIALS AND METHODS: A cross-sectional study was carried out among 415 students from five universities in the United Arab Emirates (UAE). Self-administered structured questionnaires were used for data collection. The Chi square test was used to detect significant differences between frequencies. RESULTS: Of the 415 participants who provided their gender information, 99 (24%) were males and 314 (76%) were females. Of all the participants, 83.5% were not willing to marry smokers, while 16.5% were willing. Of those whose parents smoked (106) 68% did not like it when their parents smoked, 13.6% had no opinion, 17.5% did not mind, while the other 1% had other thoughts. Of those whose close friends smoked, 43.4% did not like it, 16.2% did not have any opinion, 36.9% did not mind while 3.5% had other thoughts. CONCLUSION: Most participants, both males and females are not willing to marry smokers and prefer to have non-smokers as spouses. Also, smokers are seen as less attractive by both genders in contrast to what appears as popular beliefs amongst youngsters and what is depicted in tobacco advertisements. Tobacco control activities can be undertaken in the community and colleges by incorporating students as facilitators.