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

Substance use among Lebanese university students: prevalence and associated factors

Scientific research on use and misuse of substances in Lebanon is scarce. This study aimed to evaluate the rate of use and abuse of substances among Lebanese youth and identify the determinants and risk factors behind these behaviours. An observational survey was conducted on 1945 university students selected from the different faculties of the Lebanese University and other private universities. A self-administered questionnaire based on ASSIST [Alcohol, Smoking and Substance Involvement Screening Test] was administered. The prevalence of ever consuming alcohol was 20.9%. Cannabis [12.3%] and tranquilizers [11%] had the highest rates of ever use among the drugs, whereas cocaine [3.3%] and hallucinogens [3.6%] had the lowest rates. Smoking cigarettes and waterpipes, going out at night, peer pressure and having no specific leisure time activity were associated with problematic substance use, while a better relationship with parents, reading and working were inversely associated with use. There is a high prevalence of substance use among university students in Lebanon. Multidisciplinary support for addicted students is needed to meet their diverse needs

Do personal beliefs and peers affect the practice of alcohol consumption in university students in Lebanon?

Alcohol consumption is frequent among university students in Lebanon as elsewhere in the world. A cross- sectional study was conducted in Lebanon's public and private universities between October 2009 and September 2010 using a standardized questionnaire to assess personal beliefs about alcohol consumption, peers' behaviours and opinions and history of and current drinking practices. Of 1235 students, 199 [16.1%] had an AUDIT score >/=. Older age, male sex, Christian religion, attending a private university, studying a non-health specialty and residing in Beirut or Mount Lebanon were associated with a higher risk of harmful drinking. Beliefs concerning alcohol consumption and peers' opinions and behaviours were factors significantly associated with harmful drinking, especially: ignoring the dangers of alcohol consumption; higher frequency of consumption with friends; and a higher proportion of friends who drank regularly. University students'alcohol drinking behaviour was mostly influenced by peers' behaviour, and a peer education programme is recommended to decrease the risk of harmful drinking

Current status of nosocomial infections in the Lebanese Hospital Center, Beirut

Nosocomial infections are a significant problem and hospitals need to be aware of their nosocomial infection status. This retrospective study aimed to identify nosocomial bacterial infections in patients admitted to the Lebanese Hospital Center from January 2006 to January 2008 and determine the causative micro-organisms, the antibiotic sensitivity of the micro-organisms and evaluate the hospital treatment. In total 96 patients with nosocomial infection were included. Urinary infections were the commonest nosocomial infections [42%] followed by pulmonary infections [28%]. Gram-negative bacteria were responsible for 89% of nosocomial infections and staphylococci for 7%, with Esherichia coli and Pseudomonos alrogenosa being the most common [46% and 26% respectively] The organisms were resistant to multiples antibiotics and 18% of the patients were treated with imipenem, 7% with vancomycin, 42% with third-generation cephalosporins and 24% with amikacin. Hospital hygiene measures and antibiotic prescription policies are required to fight nosocomial infections and reduce antibiotic resistance among organisms

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

Pattern of obesity and associated diabetes in Lebanese adolescents: a pilot study

Obesity-associated diabetes in adolescents is increasing throughout the world. In this study, body mass index and capillary blood glucose were measured in a randomly selected sample of adolescents from 3 Lebanese private schools. Obesity was evaluated according to international Obesity Task Force cut-offs. Out of 300 students, 18.7% were at risk of obesity 3.0% were obese. Random glycaemia level was >/= 140 mg/dL in 10.3% of students. In those fasting, 10.5% had glucose intolerance and 3.5% had diabetes. Glucose levels were significantly higher in overweight versus normal weight individuals: 86 [SD 13] versus 96 [SD 16] mg/dL. Among the normal weight group 8.6% had abnormal glycaemia while among those who were overweight 37.0% had abnormal glycaemia. Lebanese school students have high rates of overweight and of obesity-associated diabetes and glucose intolerance

Obesity-associated distress in Lebanese adolescents: an exploratory look at a large cohort of students

Childhood obesity has become an international concern. Our objective was to construct a scale for assessing obesity-related distress among Lebanese boys and girls and to study the relationship between obesity-associated behaviours and distress. Across-sectional study was conducted in 2009 on a sample of 1933 adolescents aged 12-18 years. Questions were asked about personal and family characteristics, satisfaction with weight, frequency of consumption of selected food groups, eating and dieting habits, physical activity behaviour [current and during childhood], attitudes towards obesity, and obesity-related distress. In the factor analysis, all 8 items of the obesity distress scale loaded onto 1 factor. Boys were significantly less likely than girls to be distressed by their obesity. Obesity-related distress, particularly when related to family and media pressure to lose weight; increased the risk of using weight-loss diets and drugs but was not associated with healthy dietary habits or participation in physical activity

[Maternity leave and experience of working mothers in Lebanon]

We conducted a cross-sectional study of 802 Lebanese mothers to evaluate the effect of rapid return to work on their health and that of their child. Breastfeeding practices were also assessed. The duration of maternity leave was insufficient for 72.8% of the women. Rapid return to work could cause physical and psychological problems depending on the type of work. The average length of breastfeeding was 4.7 months and while the average desired length was 10.9 months. Breastfeeding depended on the duration of the maternity leave, the possibility of breaks for breastfeeding and the presence of nurseries at work. Urgent interventions are necessary to prolong maternity leave and promote breastfeeding among working women

Knowledge and practice of university students in Lebanon regarding contraception

We evaluated knowledge and practice of Lebanese university students regarding contraception in a cross-sectional, comparative study on students in public and private universities using an Arabic language self-administered questionnaire. We found low levels of knowledge of contraception. The majority of males [73.3%] and a few females [21.8%] declared previous sexual relations: the majority of males had used a condom [86.1%], but females had generally not used contraceptives [75.6%]

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

[Satisfaction of pharmacists in Lebanon and the prospect for clinical pharmacy]

We conducted a questionnaire survey among community and pharmaceutical company pharmacists in Lebanon to evaluate their satisfaction with their professional status and their willingness to work as clinical pharmacists. The majority of community pharmacists were satisfied with their professional situation [> 50%], except for the financial aspect [40%]. For pharmaceutical company pharmacists, only 33% thought that their profession had a positive image. However, > 65% were satisfied with social and financial standing. About 25% of pharmacists in pharmaceutical companies were ready to switch to clinical pharmacy with less income. Over 75% of the community pharmacists were prepared to apply clinical pharmacy in their practice and would be ready to attend courses for this purpose

Hair lead concentration in the Lebanese population: phase 1 results

Phase 1 of this cross-sectional study aimed to compare hair lead concentrations and establish the determinants of hair lead levels in 149 occupationally exposed individuals versus 177 non-occupationally exposed controls in the Lebanese population. In addition to a standardized questionnaire, lead concentration was measured by atomic spectrophotometry. A 5-6-fold difference in hair lead concentration was found between occupationally exposed and non-exposed individuals [23.60 ppm versus 4.33 ppm]. Professional exposure, particularly working in petrol refining and gasoline stations, had the highest correlation with lead exposure. In non-exposed individuals, male sex, non-Lebanese nationality and urban worksite correlated with higher hair lead concentration

Environmental noise in Beirut, smoking and age are combined risk factors for hearing impairment

Effect of smoking and environmental noise on hearing impairment was investigated in 440 people aged 21-50 years living in Beirut. Participants were divided into 4 groups: nonsmokers and smokers living in noisy areas [70-90 dBA] and non-smokers and smokers living in quiet areas [45-55 dBA]. Smoking was associated with hearing loss at 8000 Hz, in both bivariate and multivariate analysis. An additive interaction at high frequencies [mostly at 8000 Hz] between smoking and noise appeared after age 40 years. At age 21-39 years, neither smoking nor environmental noise had a significant adverse effect on hearing capacity at low frequencies

[Smoking among Lebanese mothers: knowledge, attitudes and practices]

Smoking among women is increasing, especially in women of reproductive age. In a cross-sectional study of 1000 Lebanese mothers, we evaluated their knowledge, attitude and practice regarding cigarette smoking. We found that the amount of tobacco smoked by Lebanese mothers was related to age, educational level, profession and knowledge regarding smoking. A woman was more likely to stop or decrease smoking during pregnancy if she were more knowledgeable about the effects of smoking on the baby, if she smoked less, and if she had a higher degree of education. Knowledge about the effects of smoking on the smoker did not seem to affect this practice

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