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Health Policy Plan. 2014 Sep;29(6):784-94. doi: 10.1093/heapol/czt055. Epub 2013 Aug 19.

Tobacco in the Arab world: old and new epidemics amidst policy paralysis.

Author information

1
Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 St, Miami, 33199 FL, USA, Syrian Center for Tobacco Studies, Sheehan St, Aleppo, Syria, Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Riad El Solh St, 1107 2020 Beirut, Lebanon, Department of Social Medicine and Public Health, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen, Institute of Community and Public Health, Birzeit University, PO Box 14 Birzeit, Occupied Palestinian Territory and Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 1112 East Clay St, Richmond, 23298 VA, USA Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 St, Miami, 33199 FL, USA, Syrian Center for Tobacco Studies, Sheehan St, Aleppo, Syria, Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Riad El Solh St, 1107 2020 Beirut, Lebanon, Department of Social Medicine and Public Health, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen, Institute of Community and Public Health, Birzeit University, PO Box 14 Birzeit, Occupied Palestinian Territory and Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 1112 East Clay St, Richmond, 23298 VA, USA wmaziak@fiu.edu.
2
Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 St, Miami, 33199 FL, USA, Syrian Center for Tobacco Studies, Sheehan St, Aleppo, Syria, Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Riad El Solh St, 1107 2020 Beirut, Lebanon, Department of Social Medicine and Public Health, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen, Institute of Community and Public Health, Birzeit University, PO Box 14 Birzeit, Occupied Palestinian Territory and Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 1112 East Clay St, Richmond, 23298 VA, USA.
3
Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 St, Miami, 33199 FL, USA, Syrian Center for Tobacco Studies, Sheehan St, Aleppo, Syria, Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Riad El Solh St, 1107 2020 Beirut, Lebanon, Department of Social Medicine and Public Health, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen, Institute of Community and Public Health, Birzeit University, PO Box 14 Birzeit, Occupied Palestinian Territory and Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 1112 East Clay St, Richmond, 23298 VA, USA Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 St, Miami, 33199 FL, USA, Syrian Center for Tobacco Studies, Sheehan St, Aleppo, Syria, Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Riad El Solh St, 1107 2020 Beirut, Lebanon, Department of Social Medicine and Public Health, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen, Institute of Community and Public Health, Birzeit University, PO Box 14 Birzeit, Occupied Palestinian Territory and Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 1112 East Clay St, Richmond, 23298 VA, USA.

Abstract

The Arab world is comprised of 22 countries with a combined population of ∼360 million. The region is still at the initial stages of the tobacco epidemic, where it is expected to witness an increase in smoking levels and mounting tobacco-related morbidity and mortality in the future. Still, the bleak outlook of the tobacco epidemic in the Arab world continues to be faced with complacency in the form of underutilization of surveillance systems to monitor the tobacco epidemic and prioritize action, and failure to implement and enforce effective policies to curb the tobacco epidemic. Understandably, the focus on the Arab world carries the risk of trying to generalize to such a diverse group of countries at different level of economic and political development. Yet, tobacco control in the Arab world faces some shared patterns and common challenges that need to be addressed to advance its cause in this region. In addition, forces that promote tobacco use, such as the tobacco industry, and trends in tobacco use, such as the emerging waterpipe epidemic tend to coalesce around some shared cultural and socio-political features of this region. Generally, available data from Arab countries point at three major trends in the tobacco epidemic: (1) high prevalence of cigarette smoking among Arab men compared with women; (2) the re-emergence of waterpipe (also known as hookah, narghile, shisha, arghile) smoking as a major tobacco use method, especially among youth and (3) the failure of policy to provide an adequate response to the tobacco epidemic. In this review, we will discuss these trends, factors contributing to them, and the way forward for tobacco control in this unstable region.

KEYWORDS:

Arab world; hookah; policy; tobacco industry; waterpipe

PMID:
23958628
PMCID:
PMC4153301
DOI:
10.1093/heapol/czt055
[Indexed for MEDLINE]
Free PMC Article
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