Predictors of past quit attempts and duration of abstinence among cigarette smokers

Objective: Despite the widespread awareness of the harms of smoking, millions continue to smoke around the world partly due to the difficulty it takes to quit smoking. Identifying the factors associated with making quit attempts is an essential pillar to reach successful quitting. The purpose of this study is to assess the factors associated with the past quit attempts and their past length of abstinence in a Lebanese sample of cigarette smokers

Methods: This study was conducted between March 2014 and March 2015, involving 382 patients randomly chosen from 5 outpatient clinics in 5 hospitals in Lebanon. A standardized questionnaire was completed including socio-demographic characteristics, smoking behavior, chronic respiratory symptoms, Fagerstrom scale, Mondor scale, packaging perception, quitting behavior and readiness to quit ladder. Results: Smokers who have chronic allergies [ORa = 2.45, p = 0.03], those who have ever stopped smoking for at least one month due to the warnings implemented on the packages [ORa = 4.6, p< 0.0001] and smokers with an intention to quit in 2 months [ORa = 2.49, p < 0.0001] had significantly more past quit attempts

Results: Furthermore, longer quit attempts duration [more than 1 month] were significantly associated with low-nicotine dependent smokers [ORa = 0.56, p = 0.02], higher-motivated smokers [ORa = 1.85, p = 0.01], people with chronic allergies [ORa = 2.07, p = 0.02], smokers who have ever stopped smoking for at least one month due to the warnings [ORa = 3.72, p < 0.0001] and those with an intention to quit in 2 months [ORa = 1.98, p = 0.05]

Conclusion: The promoters of smoking cessation services should consider these factors when designing comprehensive tobacco control initiatives and in service planning

Clinical and parasitological studies on pulmonary and hepatic hydatid cysts in hospitalized children and adults

A cross sectional study compared the clinical features of the pulmonary and hepatic hydatid cysts in children and adults and evaluated IHAT and ELISA techniques in diagnosis. The results showed that the patients ages were 5-14 years [10.6+/-3.7] in children and 16-75 years [32.2+/-14] in adults, patients 34 [75.5%] had liver cysts, 25 [55.5%] had pulmonary cysts and 7 [15.5%] had both liver and lung cysts. In hepatic hydatidosis, 7/34 [20.5%] cases were asymptomatic while others showed variable clinical manifestations. The commonest symptom was localized right hypochondrial pain in 13 [38.2%] and the least one was jaundice in 4 [11.7%]. The commonest sign was abdominal masses on the right hypochondrium in 88.2% and the least one was ascites in 5.8%.The commonest symptom of pulmonary hydatidosis was chest pain in 8 [34.7%] followed by cough and hemoptysis on 4 [17.3%] and the least one was cough and fever [8.6%]. Pulmonary hydatid cysts in children were significantly higher in males [17.3%] than females [4.3%], but without significance in adults [26% in male vs. 21.7% in females]. Sex difference in hydatid cyst frequencies between adults and children was significant [P <0.05]. Mixed hepatic and pulmonary cysts were less in children than in adults [14.3%vs 85.7%], with huge pulmonary cysts of 20 cm were more common in children [37.7%] than in adults [17.7%]. The high sensitivity [95.5%] of ELISA-IgG recommended this test showed a dependable sero-diagnosing one

Waterpipe smoking and dependence are associated with chronic bronchitis: a case-control study in Lebanon

Waterpipe smoking and its association with chronic bronchitis has not been assessed in Lebanon. This case-control study in Beirut in 2009/2010 evaluated this relationship: 274 cases of chronic bronchitis and 559 controls without the condition aged >/=40 years were enrolled. Data were collected by questionnaire on: sociodemographic characteristics, respiratory symptoms, smoking [waterpipe and cigarette] and nicotine dependence. ANOVA, Student, Kruskal-Wallis, chi-squared and Fisher exact tests were used when applicable and logistic regression analysis was carried out. Previous waterpipe smoking [OR = 6.4], previous mixed smoking [OR = 38.03] and current mixed smoking [OR = 7.68] were significantly associated with chronic bronchitis [P < 0.001 for all] but current exclusive waterpipe smoking was not [OR = 1.87, 95% CI: 0.74-4.72]. Current waterpipe dependence was significantly associated with chronic bronchitis [OR = 3.74, P < 0.001]. After adjustment for covariates/confounders, ever waterpipe smoking > 20 WP-years [P < 0.001] was significantly associated with chronic bronchitis

Exposure to outdoor air pollution and chronic bronchitis in adults: a case-control study

Although Lebanon is a highly polluted country, so far no study has specifically been designed to assess the association between outdoor air pollution and chronic bronchitis in this country. To assess the association between exposure to outdoor air pollution and chronic bronchitis in Lebanon. A pilot case-control study was conducted in two tertiary care hospitals. Cases consisted of patients diagnosed with chronic bronchitis by a pulmonologist and those epidemiologically confirmed. Controls included individuals free of any respiratory signs or symptoms. After obtaining informed consent, a standardized questionnaire was administered. Bivariate, stratified [over smoking status and gender] and multivariate analyses revealed that passive smoking at home [ORa: 2.56, 95% CI: 1.73-3.80] and at work [ORa: 1.89, 95% CI: 1.13-3.17]; older age [ORa: 1.75, 95% CI: 1.55-2.39]; lower education [ORa: 1.44, 95% CI: 1.21-1.72]; living close to a busy road [ORa: 1.95, 95% CI: 1.31-2.89] and to a local power plant [ORa: 1.62, 95% CI: 1.07-2.45]; and heating home by hot air conditioning [ORa: 1.85, 95% CI: 1.00-3.43] were moderately associated with chronic bronchitis; an inverse association was found with heating home electrically [ORa: 0.58, 95% CI: 0.39-0.85]. A positive dose-effect relationship was observed in those living close to a busy road and to a local diesel exhaust source. Chronic bronchitis is associated with outdoor air pollution

Water-pipe [narguile] smokers in Lebanon: a pilot study

We carried out a comparative study to assess the demographic and social characteristics of water pipe [WP] smokers, the association with cigarette smoking and chronic respiratory diseases and the dependence profile on 4 groups: exclusive WP smokers, exclusive cigarette smokers, mixed smokers and absolute non-smokers. Cigarette smoking was statistically significantly higher in WP smokers than non-WP smokers; 36.5% of exclusive WP smokers smoked >/= 7 WPs/week. Chronic respiratory disease and chronic bronchitis were reported more frequently in exclusive WP smokers than absolute non-smokers. WP smoking seems to be as great a risk factor as cigarette smoking for chronic respiratory disease

Spirometric changes following the use of pesticides

We compared the respiratory function of 19 pesticide factory workers and a control group of 43 other factory workers in Lebanon. The groups had no difference in smoking status. Baseline measurements of respiratory function showed significantly lower forced expiratory volume and flow rates [FEV1, FEF[25-75%], and FEV1/FVC ratio] among subjects working with pesticides, i.e. obstruction may be linked to chronic exposure to pesticides. After 4 hours of work, all respiratory variables were still significantly lower in pesticide-exposed subjects, but no acute changes in respiratory function were seen. Pesticide-exposed workers had 5.6 times higher risk of abnormal FEV1/FVC ratio and 16.5 higher risk for abnormal FEF[25-75%]. Duration of occupation in the pesticide factory was significantly correlated with abnormal respiratory measures