Al Sabbah Haleama, Assaf Enas A, Taha Zainab, Qasrawi Radwan, Ismail Leila Cheikh, Al Dhaheri Ayesha S, Hoteit Maha, Al-Jawaldeh Ayoub, Tayyem Reema, Bawadi Hiba, AlKhalaf Majid, Bookari Khlood, Kamel Iman, Dashti Somaia, Allehdan Sabika, Waly Mostafa, Al-Halawa Diala Abu, Mansour Rania, Ibrahim Mohammed, Al-Mannai Mariam
Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates.
Faculty of Nursing, Applied Science Private University, Amman, Jordan.
Tob Induc Dis. 2022 Nov 11;20:98. doi: 10.18332/tid/155007. eCollection 2022.
Tobacco smokers are at high risk of developing severe COVID-19. Lockdown was a chosen strategy to deal with the spread of infectious diseases; nonetheless, it influenced people's eating and smoking behaviors. The main objective of this study is to determine the impact of the COVID-19 lockdown on smoking (waterpipe and cigarette) behavior and its associations with sociodemographic characteristics and body mass index.
The data were derived from a large-scale retrospective cross-sectional study using a validated online international survey from 38 countries (n=37207) conducted between 17 April and 25 June 2020. The Eastern Mediterranean Region (WHO-EMR countries) data related to 10 Arabic countries that participated in this survey have been selected for analysis in this study. A total of 12433 participants were included in the analysis of this study, reporting their smoking behavior and their BMI before and during the COVID-19 lockdown. Descriptive and regression analyses were conducted to examine the association between smoking practices and the participant's country of origin, sociodemographic characteristics, and BMI (kg/m).
Overall, the prevalence rate of smoking decreased significantly during the lockdown from 29.8% to 23.5% (p<0.05). The percentage of females who smoke was higher than males among the studied population. The highest smoking prevalence was found in Lebanon (33.2%), and the lowest was in Oman (7.9%). In Egypt, Kuwait, Lebanon, and Saudi Arabia, the data showed a significant difference in the education level of smokers before and during the lockdown (p<0.05). Smokers in Lebanon had lower education levels than those in other countries, where the majority of smokers had a Bachelor's degree. The findings show that the BMI rates in Jordan, Lebanon, Oman, and Saudi Arabia significantly increased during the lockdown (p<0.05). The highest percentages of obesity among smokers before the lockdown were in Oman (33.3%), followed by Bahrain (28.4%) and Qatar (26.4%), whereas, during the lockdown, the percentage of obese smokers was highest in Bahrain (32.1%) followed by Qatar (31.3%) and Oman (25%). According to the logistic regression model, the odds ratio of smoking increased during the pandemic, whereas the odds ratio of TV watching decreased. This finding was statistically significant by age, gender, education level, country of residence, and work status.
Although the overall rates of smoking among the studied countries decreased during the lockdown period, we cannot attribute this change in smoking behavior to the lockdown. Smoking cessation services need to anticipate that unexpected disruptions, such as pandemic lockdowns, may be associated with changes in daily tobacco consumption. Public health authorities should promote the adoption of healthy lifestyles to reduce the long-term negative effects of the lockdown.
吸烟者感染重症 COVID-19 的风险很高。封锁是应对传染病传播的一项既定策略；尽管如此，它还是影响了人们的饮食和吸烟行为。本研究的主要目的是确定 COVID-19 封锁对吸烟（水烟和香烟）行为的影响及其与社会人口学特征和体重指数的关联。
数据来自一项大规模回顾性横断面研究，该研究使用了 2020 年 4 月 17 日至 6 月 25 日期间在 38 个国家（n = 37207）进行的经过验证的在线国际调查。本研究选取了与参与该调查的 10 个阿拉伯国家相关的东地中海区域（世卫组织东地中海区域国家）数据进行分析。本研究分析共纳入 12433 名参与者，他们报告了 COVID-19 封锁之前和期间的吸烟行为及体重指数。进行描述性和回归分析以检验吸烟习惯与参与者的原籍国、社会人口学特征和体重指数（kg/m）之间的关联。
总体而言，封锁期间吸烟患病率从 29.8%显著降至 23.5%（p<0.05）。在研究人群中，吸烟女性的比例高于男性。吸烟患病率最高的是黎巴嫩（33.2%），最低的是阿曼（7.9%）。在埃及、科威特、黎巴嫩和沙特阿拉伯，数据显示封锁之前和期间吸烟者的教育水平存在显著差异（p<0.05）。黎巴嫩吸烟者的教育水平低于其他国家，其他国家的大多数吸烟者拥有学士学位。研究结果表明，约旦、黎巴嫩、阿曼和沙特阿拉伯的体重指数在封锁期间显著上升（p<0.05）。封锁之前吸烟者中肥胖比例最高的是阿曼（33.3%），其次是巴林（28.4%）和卡塔尔（26.4%），而在封锁期间，肥胖吸烟者比例最高的是巴林（32.1%），其次是卡塔尔（31.3%）和阿曼（25%）。根据逻辑回归模型，疫情期间吸烟的比值比上升，而看电视的比值比下降。这一发现按年龄、性别、教育水平、居住国和工作状态具有统计学意义。
尽管在封锁期间所研究国家的总体吸烟率有所下降，但我们不能将吸烟行为的这种变化归因于封锁。戒烟服务需要预计到意外干扰，如疫情封锁，可能与日常烟草消费的变化有关。公共卫生当局应促进采用健康的生活方式，以减少封锁带来的长期负面影响。
