What is already known on this subject?
-
Important sociodemographic disparities exist in tobacco smoking prevalence
What important gaps in knowledge exist on this topic?
-
The relationship between tobacco use and refugee status is understudied and unclear
What this study adds?
-
Refugees have a higher tobacco smoking prevalence in Syria, and smoke tobacco more frequently in Lebanon, Syria and the West Bank
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Assessment of disparities in tobacco smoking should extend beyond simple prevalence measures and include measures of smoking frequency
Background
Methods
Sample and data
Measures
Statistical analysis
Results
Sample characteristics
Jordan | Lebanon | Syria | West Bank | |||||
---|---|---|---|---|---|---|---|---|
Refugee | Non-refugee | Refugee | Non-refugee | Refugee | Non-refugee | Refugee | Non-refugee | |
Age in years, % (n) | ||||||||
<12 |
5.0 (69)
|
6.4 (114)
|
2.1 (34)
|
2.1 (51)
|
3.0 (48)
|
4.4 (72)
|
7.3 (107)
|
3.6 (75)
|
12 |
8.6 (123)
|
18.3 (322)
|
6.6 (107)
|
11.0 (264)
|
9.8 (153)
|
12.1 (228)
|
11.5 (180)
|
16.5 (368)
|
13 |
26.2 (370)
|
31.8 (568)
|
24.5 (384)
|
24.8 (571)
|
30.5 (479)
|
29.0 (547)
|
26.1 (389)
|
22.4 (443)
|
14 |
31.1 (477)
|
27.9 (570)
|
29.6 (425)
|
28.7 (592)
|
30.8 (495)
|
32.5 (391)
|
33.1 (447)
|
23.9 (439)
|
15 |
23.1 (375)
|
13.9 (283)
|
22.3 (368)
|
21.4 (408)
|
20.0 (330)
|
13.0 (211)
|
19.0 (277)
|
21.9 (391)
|
16 |
5.3 (82)
|
1.5 (28)
|
11.9 (204)
|
8.4 (189)
|
5.3 (87)
|
6.4 (172)
|
2.3 (33)
|
10.4 (192)
|
>16 |
0.7 (11)
|
0.3 (6)
|
3.1 (54)
|
3.5 (81)
|
0.7 (11)
|
2.4 (10.4)
|
0.7 (11)
|
1.3 (24)
|
Sex, % (n) | ||||||||
Female |
49.4 (54.6)
|
59.7 (1094)
|
54.1 (48.5)
|
52.6 (1129)
|
49.8 (811)
|
51.4 (973)
|
59.7 (860)
|
52.9 (1022)
|
Male |
50.6 (45.4)
|
40.3 (750)
|
45.9 (51.5)
|
47.4 (1074)
|
50.2 (769)
|
48.7 (640)
|
40.4 (515)
|
47.1 (931)
|
Year of survey | ||||||||
2008
|
2009
|
2008
|
2011
|
2008
|
2010
|
2008
|
2009
|
Prevalence of current tobacco use
Jordan | Lebanon | Syria | West Bank | |||||
---|---|---|---|---|---|---|---|---|
Non-refugee | Refugee | Non-refugee | Refugee | Non-refugee | Refugee | Non-refugee | Refugee | |
Current tobacco smoking | ||||||||
Prevalence, % (95 % CI) |
24.0 (19.3, 29.6)
|
26.7 (19.9, 34.9)
|
38.5 (33.4, 43.3)
|
39.4 (32.1, 47.1)
|
23.2 (18.5, 28.7)
|
36.6 (31.4, 42.3)
|
38.4 (29.5, 48.2)
|
39.5 (31.3, 48.2)
|
Cigarettes per month, median (IQR) |
4.0 (0.8, 50.8)
|
4.0 (0.8, 26.3)
|
1.5 (0.8, 14.8)
|
5.3 (0.8, 55.4)
|
1.5 (0.8, 14.5)
|
4.0 (0.8, 14.5)
|
4.0 (0.8, 50.8)
|
4.0 (1.5, 50.8)
|
Waterpipes per month, median (IQR) |
1.5 (0.8, 4.0)
|
1.5 (0.8, 7.3)
|
2.0 (0.8, 14.0)
|
2.0 (0.8, 14.0)
|
0.8 (0.8, 3.8)
|
1.5 (0.8, 7.5)
|
1.5 (0.8, 7.5)
|
2.0 (0.8, 14.0)
|
Current cigarette-only smoking | ||||||||
Prevalence, % (95 % CI) |
4.4 (3.0, 6.2)
|
5.9 (4.1, 8.5)
|
1.7 (1.1, 2.6)
|
2.9 (1.9, 4.4)
|
2.8 (1.6, 4.8)
|
5.4 (3.7, 7.8)
|
5.6 (4.1, 7.6)
|
7.8 (6.1, 10.0)
|
Cigarettes per month, median (IQR) |
1.8 (0.8, 26.3)
|
2.0 (0.8, 15.0)
|
0.8 (0.8, 2.0)
|
3.9 (0.8, 24.8)
|
1.5 (0.8, 7.5)
|
2.0 (0.8, 7.5)
|
1.5 (0.8, 7.5)
|
1.5 (0.8, 14.0)
|
Current waterpipe-only smoking | ||||||||
Prevalence, % (95 % CI) |
12.3 (10.2, 14.8)
|
12.5 (10.9, 14.2)
|
24.9 (20.4, 30.0)
|
26.8 (21.4, 32.9)
|
15.1 (12.4, 18.3)
|
22.7 (19.9, 25.8)
|
16.9 (14.0, 20.1)
|
16.4 (14.4, 18.6)
|
Waterpipes per month, median (IQR) |
0.8 (0.8, 1.5)
|
0.8 (0.8, 4.0)
|
0.8 (0.8, 4.0)
|
1.5 (0.8, 5.3)
|
0.8 (0.8, 2.0)
|
1.5 (0.8, 4.0)
|
0.8 (0.8, 2.0)
|
1.5 (0.8, 5.3)
|
Current dual smoking | ||||||||
Prevalence, % (95 % CI) |
7.3 (5.2, 10.1)
|
8.4 (4.9, 14.0)
|
11.9 (10.4, 13.6)
|
9.7 (6.2, 15.0)
|
5.3 (3.8, 7.4)
|
8.5 (6.2, 11.7)
|
15.9 (10.4, 23.6)
|
15.2 (10.0, 22.6)
|
Cigarettes per month, median (IQR) |
4.0 (0.8, 85.8)
|
4.0 (0.8, 26.3)
|
1.5 (0.8, 30.0)
|
7.4 (1.5, 73.9)
|
2.0 (0.8, 26.3)
|
4.0 (0.8, 26.3)
|
5.3 (1.5, 60.0)
|
7.3 (1.5, 72.9)
|
Waterpipes per month, median (IQR) |
3.8 (0.8, 14.0)
|
3.8 (0.8, 7.5)
|
7.3 (1.5, 50.8)
|
7.5 (1.5, 30.0)
|
1.8 (0.8, 4.0)
|
3.8 (0.8, 14.5)
|
3.8 (0.8, 14.5)
|
7.3 (1.5, 24.5)
|
Association between refugee status and current tobacco use and frequency
Jordan | Lebanon | Syria | West Bank | |||||
---|---|---|---|---|---|---|---|---|
Non-refugee | Refugee | Non-refugee | Refugee | Non-refugee | Refugee | Non-refugee | Refugee | |
Current tobacco smoking | ||||||||
Prevalence, AOR (95 % CI) |
1.00
|
0.91 (0.67, 1.24)
|
1.00
|
1.00 (0.76, 1.31)
|
1.00
|
1.96 (1.46, 2.62)
+
|
1.00
|
1.04 (0.82, 1.32)
|
Cigarettes per month, β (95 % CI) |
0.00
|
−0.35 (−0.77, 0.07)
|
0.00
|
0.57 (0.17, 0.97)^
|
0.00
|
−0.01 (−0.43, 0.41)
|
0.00
|
0.22 (−0.10, 0.54)
|
Waterpipes per month, β (95 % CI) |
0.00
|
0.06 (−0.17, 0.29)
|
0.00
|
−0.03 (−0.22, 0.15)
|
0.00
|
0.40 (0.19, 0.61)
+
|
0.00
|
0.42 (0.21, 0.64)
+
|
Current cigarette-only smoking | ||||||||
Prevalence, AOR (95 % CI) |
1.00
|
1.06
(0.70, 1.59)
|
1.00
|
1.65 (0.92, 2.96)
|
1.00
|
2.16 (1.10, 4.24)*
|
1.00
|
1.53 (1.10, 2.14)*
|
Cigarettes per month, β (95 % CI) |
0.00
|
−0.29
(−0.95, 0.38)
|
0.00
|
1.07 (0.19, 1.96)*
|
0.00
|
0.21 (−0.39, 0.81)
|
0.00
|
0.36 (−0.16, 0.88)
|
Current waterpipe-only smoking | ||||||||
Prevalence, AOR (95 % CI) |
1.00
|
0.88 (0.71, 1.10)
|
1.00
|
1.07 (0.74, 1.53)
|
1.00
|
1.62 (1.23, 2.14)^
|
1.00
|
0.93 (0.69, 1.24)
|
Waterpipes per month, β (95 % CI) |
0.00
|
0.11 (0.86, 4.23)
|
0.00
|
0.09 (−0.11, 0.28)
|
0.00
|
0.35 (0.13, 0.58)^
|
0.00
|
0.37 (0.14, 0.61)^
|
Current dual smoking | ||||||||
Prevalence, AOR (95 % CI) |
1.00
|
0.91 (0.59, 1.40)
|
1.00
|
0.76 (0.52, 1.12)
|
1.00
|
1.64 (1.11, 2.41)*
|
1.00
|
0.94 (0.68, 1.30)
|
Cigarettes per month, β (95 % CI) |
0.00
|
−0.37 (−0.92, 0.18)
|
0.00
|
0.53 (0.08, 0.98)*
|
0.00
|
−0.04 (−0.60, 0.53)
|
0.00
|
0.22 (−0.17, 0.62)
|
Waterpipes per month, β (95 % CI) |
0.00
|
−0.15 (−0.56, 0.27)
|
0.00
|
−0.09 (−0.46, 0.28)
|
0.00
|
0.54 (0.06, 1.01)*
|
0.00
|
0.46 (0.12, 0.81)^
|