PM2.5 as a marker of exposure to tobacco smoke and other sources of particulate matter in Cairo, Egypt.

SETTING: Cairo and Giza governorates of Egypt. BACKGROUND: Particulate matter under 2.5 µm in diameter (PM2.5) arises from diverse sources, including tobacco smoke from cigarettes and waterpipes, and is recognized as a cause of acute and chronic morbidity and mortality. OBJECTIVE: To measure PM2.5 in workplaces with different intensities of smoking and varying levels of smoking restrictions. DESIGN: We conducted an air sampling study to measure PM2.5 levels in a convenience sample of indoor and outdoor venues in 2005-2006. RESULTS: Using a calibrated SidePak instrument, 3295 individual measurements were collected at 96 venues. Compared to indoor venues where tobacco smoking was banned (PM2.5 levels 72-81 µg/m(3)), places offering waterpipes to patrons of cafes (478 µg/m(3)) and Ramadan tents (612 µg/m(3)) had much higher concentrations, as did venues such as public buildings with poor enforcement of smoking restrictions (range 171-704 µg/m(3)). Both the number of waterpipe smokers and the number of cigarette smokers observed at each venue contributed significantly to the overall burden of PM2.5. CONCLUSION: Such data will support smoke-free policies and programs aimed specifically at reducing environmental tobacco exposure and improving air quality in general, and will provide a baseline for monitoring the impact of tobacco control policies.

Public opinion on smoke-free policies among Egyptians.

SETTING: A smoke-free law was passed in Egypt in 2007. In 2010 a bylaw was issued, leading to a drive by the Ministry of Health and Population (MOHP) to launch a smoke-free initiative in Alexandria, the second largest city. OBJECTIVE: To assess public opinion with regard to 100% smoke-free legislation and its implementation in the Alexandria governorate. DESIGN: The Union Middle-East Office, in collaboration with the Central Agency for Public Mobilization and Statistics and the MOHP, conducted a cross-sectional survey among 427 randomly selected adults (206 males and 221 females), covering the seven major districts of the Alexandria governorate. RESULTS: The majority of the interviewed subjects (98%) expressed support of the government in enacting 100% smoke-free indoor legislation in all public places and public transport. Respondents endorsed the government plan to implement legislation imposing 100% smoke-free public places. More than one third (33.5%) of all respondents indicated that they would increase visits to restaurants if they were smoke-free, and 63% indicated no impact at all. CONCLUSION: The results of the poll clearly support results from different countries worldwide that smoke-free policies are popular and supported by the public.

Assessment of tobacco dependence in waterpipe smokers in Egypt.

SETTING: Waterpipe smoking is increasing worldwide. Nevertheless, little is known about nicotine dependence in tobacco smokers who use waterpipes. OBJECTIVE: To assess evidence of dependence among non-cigarette smoking waterpipe smokers in Egypt. METHODS: A total of 154 male exclusive current waterpipe smokers were enrolled for the present study. We adapted the Fagerström test for nicotine dependence and the Reasons for Smoking (RFS) scales and related these to smoking behavior. RESULTS: The mean age of the subjects was 47 ± 14 years, the mean age at smoking initiation was 22 ± 9 years, and average daily consumption was 4 ± 8 hagars (tobacco units). The time to the first smoke of the day (P < 0.001), smoking even when ill (P = 0.003), time to tobacco craving (P < 0.001), and hating to give up the first smoke of the day (P = 0.033) were each significantly associated with the number of hagars smoked per day. The RFS subscales of addictive smoking, smoking to relieve negative affect, and smoking for stimulation were also associated with these variables. CONCLUSION: The overall findings suggest that waterpipe smokers exhibit many of the same features of nicotine dependency attributed to cigarette smokers.