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Health issues of males and females due to smoking in the U.A.E. (For the age group 18 to 25 years)

Introduction 

1.1 Background and Context

Tobacco use is the single most significant avoidable risk factor for mortality today, accounting for more than 6 million deaths per year. Over 5 million of all these fatalities are necessarily connected to smoking tobacco, and the number of fatalities can rise to 10 million each year by 2030 unless adequate and enhanced precautionary measures are employed. Additionally, 70% of all these predicted fatalities will occur in lower-income nations (Chung Hall et al., 2019). Tobacco use not only causes cancer (of the lung, stomach, tongue, and mouth) but also damages nearly all of the other organs and is directly related to dementia, respiratory illnesses, heart disease and stroke (CHD) and other major lung diseases such as globe-wide respiratory infections both in UAE and other parts of the world. Consequently, to combat the harmful effects of smoking, The U.A.E.’s national health strategy has specified ten specific objectives to be attained by 2021, five of which have been associated with non-communicable diseases: combating heart disease, cancer, asthma, diabetes, obesity, and smoking (Razzak et al., 2020). Evidence that tobacco smoking contributes to disease and death has become undeniable. Despite the initiatives taken by the government, smoking is still regarded as a prominent public health concern contributing to significant health diseases in U.A.E. Thus, this study attempts to study male and female health issues due to smoking in the U.A.E., especially amongst adolescents.

1.2 Rationale of the Study

In the United Arab Emirates (U.A.E.), a high-income Arab country, non-communicable diseases (N.C.D.s) accounts for 77% of all deaths. N.C.D.s (diabetes, tumors, chronic respiratory illnesses, and heart disease) are becoming more prevalent in Arab countries, including the U.A.E. Physical inactivity, bad diets, cigarette use, and obesity are prevalent among adults and children in the Sadc countries. According to the World Health Organization (WHO), “alcohol use, eating habits, substance use, hygiene, mental health, moderate exercise, cardiovascular diseases, sexual behaviors, tobacco use, aggression, and mental illness” are the leading cause of mortality and morbidity in adults and children worldwide (Pengpid and Peltzer, 2020). Children who develop a habit of smoking at an early age are more prone to the risk of CVD diseases and other respiratory-related illnesses. According to the estimates, tobacco smoking is comparatively more amongst males than females in the U.A.E. (Barakat et al., 2021). To identify proper intervention strategies, it is critical to assess the health issues that males and females face due to smoking in U.A.E., especially between 18 to 25 years). An improved understanding of smoking use patterns would enable the government to formulate appropriate legislative measures and health-related policies for reducing and controlling tobacco use patterns.

1.3 Research Questions and Objectives  

The study primarily intends to find the answer to the following questions:

  • What are the health-related challenges that males and females of the age group 18-25 years in the U.A.E. face?
  • What is the trend of smoking consumption patterns in the U.A.E. over the years?

The existing study’s research objectives are as follows

  • To ascertain and expand the smoking patterns amongst males and females in U.A.E.
  • To ascertain the health-related challenges faced by smokers in U.A.E.

2. Literature Review

Empirical evidence related to the prevalence of smoking: Six U.A.E. prevalent studies were performed: two in Dubai, one in Ajman and three in Abu Dhabi. Five of the six systematic reviews on tobacco cigarette smoking were cross-sectional, whereas the sixth was cohort longitudinal (Obaid et al., 2014). Men consumed tobacco more than women surveyed. A cross-sectional research of Abu Dhabi exhibited the highest smoking rate among Arab expatriates (31.9%), preceded by other nations (21.6%) and ex-pats (22.6 percent). Men smoked cigarettes higher (19.2%) than women (3.5 percent). Women from Arab expatriates showed higher cigarette smoking prevalence (31.4%) than women from other nations (0.7percent). In Abu Dhabi, a cohort study identified essential characteristics related to substance use,’ including marital status and smoking. More comprehensive perspective research conducted in Abu Dhabi documented the U.A.E.’s modes of tobacco consumption and frequency (Crookes and Wolff, 2014). Males smoked at a rate of 24.3 percent, while females smoked at a rate of 0.8 percent.  Males aged 20–39 years had the highest incidence.  Cigarette smoking was the most prevalent form of tobacco use (77.4 percent), followed by 6.8 percent water-pipe use and 0.66 percent cigar use (Al-Houqani et al., 2012). 14.6 percent of participants with 2457 children aged 10 to 20 years were tobacco smokers, with 2.2 percent using water pipes and 11.2 percent smoking tobacco. Peer pressure (21.9 percent), stress alleviation (22.5 percent), and pleasure were the top reasons for smoking (29.4 percent).

Empirical evidence related to Health risks of smoking in U.A.E.:  Tobacco use in Geographical locations such as the Middle East has been ingrained in society for centuries and has recently seen an upsurge, particularly among adolescents. Even though the legal smoking age is 18, one of most latest available statistics shows that 13% of males and 2% of females aged 13–15 years are more addicted to cigarette smokers. Tobacco’s addiction promotes cardiac contractility and vasoconstriction, resulting in an acute transitory increase in heart rate and systemic vascular resistance during a 30-minute smoking session that returns to normal within 20 minutes of cigarette withdrawal. Prolonged usage of excessive parasympathetic results in continual increases in heart rate and cardiac output, which might cause damage to the vascular wall. Nicotine stimulation of the parasympathetic ganglia in the lungs can result in airway contraction, manifesting as breathing difficulties and tachypnoea. No study has been conducted to identify the acute consequences of smoking, especially in the U.A.E. (Shaikh et al., 2012).

Empirical evidence related to Interventions in U.A.E.: Tobacco use is the most common risk factor for premature death and sickness in the world. The invasion practice study looks at the most efficient, brief therapies and tobacco addiction therapy, or the most beneficial and quick advice. Finally, smoking prevention therapy in Abu Dhabi is a cost-effective technique of curing illness and lengthening life in the city. Several types of treatment were investigated in the interventional study, including brief initiatives awareness on quitting smoking, 18–20 counseling sessions, group behavioral management programs, and individual ’s behavioral counselling services (Asfour et al., 2015). A dearth of health informative materials, a lack of time, and a shortage of communal programs made it difficult to provide counseling (Rahman et al., 2016). Another cross-sectional survey was done to document smoking cessation counseling processes amongst that random selection of healthcare professionals (G.P.s) in Sharjah, Dubai, and Abu Dhabi, and the results were published in the journal Addiction. Despite positive views and thoughts about smoking cessation counseling, just 47 percent of physicians believe they have the requisite skills to aid and support patients who are trying to quit cigarettes (Awad et al., 2016).

Although several types of research on tobacco consumption are already conducted in U.A.E., an additional extensive review was required to build the most effective smoking mitigation strategies.

3. Research Methodology

The current study has utilized an Interpretivism research approach for accurately representing the project’s central theme. Moreover, the study has utilized a qualitative approach to systematically identify and represent the data from the secondary resources (journals, articles, newspapers, books, literature, publications) that best answer the research questions stated in the previous section. Moreover, some data has been collected from WorldBank to showcase the prevalence of Tobacco use amongst males and females in the U.A.E. The research will identify and record the most recent information available restricting the research to the U.A.E. region. To acquire a deeper understanding of the subject matter, the data collected are presented in graphs and figures wherever possible. The following search strings have been used to find relevant information, including; smoking, prevention, prevalence, health-risk, tobacco-use, interventions, counseling, cigarette, etc. Additionally, the search was limited to the English language only because it was not feasibly possible to convert the articles to other languages. Due to the limited time and cost of the study, the investigation was confined to study objectives (Razzak et al., 2020).

4. Data Analysis

4.1 Comparison of Prevalence of tobacco use amongst adults, males and females in U.A.E.

In order to draw a comparative analysis of smoking consumption patterns amongst males and females, a statistical analysis was performed on the data sourced from World Bank (2021), and the results depicted that the average tobacco consumption patterns amongst adults, as well as males and females in U.A.E. between the year 2007 and 2018, has decreased significantly. But, the situation was still worrisome as the drop rate has declined to a minor extent but still not as significant as was expected. However, the tobacco consumption for both males (35.6) and females (0.8) were least in 2018 for U.A.E. Moreover, the results depicted a significant difference in the consumption patterns of males and females in U.A.E. for all the years; 2007 to 2018.  Moreover, the study was undertaken by has shown a positive correlation between age and smoking consumption patterns signifying the fact that cigarettes consumption increases with age in U.A.E. (Siddiquia et al., 2018)

4.2 Health issues smoking in U.A.E.

In order to analyze the impact of smoking on males and females, a systematic review of the literature was performed. Smoking wreaks havoc on the lungs’ airways and little air sacs. This damage begins shortly when someone begins smoking and continues to worsen as long as the person smokes. Nonetheless, it may take several years for the condition to manifest itself so that lung illness can be diagnosed. Smoke-induced lung damage can result in long-term severe lung disorders such as congestive heart failure (C.O.P.D.).

Additionally, smoking can lead to lung cancer and other infections like bacterial pneumonia and tuberculosis and exacerbate some pre-existing lung disorders such as asthma. Chronic bronchitis is a typical complication of long-term smokers. In this disease, the airways produce an abnormal amount of mucus, requiring the patient to cough it out. Inflammation (swelling) of the airways occurs, and the cough becomes persistent (long-lasting). Emphysema occurs when the walls between the small air sacs in the lungs deteriorate, resulting in larger but fewer sacs. This decreases the amount of oxygen delivered to the circulation. These sacs can degrade with time, to the point where an individual with emphysema may fail to provide enough air even when at rest. Tobacco use has a detrimental effect on the heart and blood arteries (cardiovascular system), boosting the risk of cardiovascular disease. Smoking is a leading cause of coronary heart disease (CHD), a condition in which the heart’s arteries cannot send enough oxygen-rich blood to the heart muscle. Smoking raises blood pressure, impairs your ability to exercise, and increases the likelihood of your blood clotting.

Additionally, it depletes the blood of HDL (good) cholesterol. All of these factors contribute to the risk of heart attacks and strokes. Emphysema patients are also at risk for a variety of additional complications associated with impaired lung function, including pneumonia. Tobacco use is a significant risk factor for peripheral arterial disease (P.A.D.). Plaque accumulates in the arteries that provide blood to the brain, organs, and limbs in P.A.D. This raises the risk of developing heart disease, having a heart attack, or having a stroke.  Smoking significantly causes aortic aneurysm. This is a balloon-like dilation of the aorta, the primary artery that connects the heart to the rest of the body (Zaabi et al., 2016).

5. Findings and Conclusions

Our study results have shown that smoking consumption patterns estimation is critically essential to introduce counter-attack measures and combat the resultant effects of smoking in the U.A.E. The results have clearly shown a significant decline in the smoking consumption patterns in U.A.E. from 2007, both in males and females. Moreover, the study has indicated a positive correlation between age and smoking consumption patterns. Also, the study has revealed numerous health-related ill effects of smoking in the U.A.E. that call for the government to impose strict legislative measures for discouraging and controlling tobacco use, especially amongst adolescents in the U.A.E. Moreover, results have clearly shown that the prevalence of smoking was higher amongst males than females.

References

Aden, B., Karrar, S., Shafey, O. and Al Hosni, F., 2013. Cigarette, water-pipe, and medwakh smoking prevalence among applicants to Abu Dhabi’s Pre-Marital Screening Program, 2011. International journal of preventive medicine4(11), p.1290.

Al-Houqani, M., Ali, R. and Hajat, C., 2012. Tobacco smoking using Midwakh is an emerging health problem–evidence from a large cross-sectional survey in the United Arab Emirates. PloS one7(6), p.e39189.

Asfour, L.W., Stanley, Z.D., Weitzman, M. and Sherman, S.E., 2015. Uncovering risky behaviors of expatriate teenagers in the United Arab Emirates: A survey of tobacco use, nutrition and physical activity habits. B.M.C. public health15(1), pp.1-8.

Awad MA, O’Loughlin J. Physician delivery of smoking prevention counseling to young patients in the United Arab Emirates. Patient Educ Couns 2007 Jul;67(1-2):151- 156.

Awad, M.A., El Kouatly, M. and Fakhry, R., 2010. Smoking counseling practices of physicians in the United Arab Emirates. Global health promotion17(4), pp.05-14.

Barakat, M., Jirjees, F., Ala’a, B., Alfoteih, Y., Kharaba, Z. and Al-Obaidi, H., 2021. The Era of E-Cigarettes: A Cross-Sectional Study of Vaping Preferences, Reasons for Use and Withdrawal Symptoms Among Current E-Cigarette Users in the United Arab Emirates. Journal of Community Health, pp.1-11.

Chung-Hall, J., Craig, L., Gravely, S., Sansone, N. and Fong, G.T., 2019. Impact of the WHO FCTC over the first decade: a global evidence review prepared for the Impact Assessment Expert Group. Tobacco control28(Suppl 2), pp.s119-s128.

Crookes, A. and Wolff, K., 2014. Prevalence of the tobacco product dokha among high school students in Dubai. Substance use & misuse49(10), pp.1349-1352.

Obaid, H.A., Hassan, M.A., Mahdy, N.H., El Disouky, M.I., Alzarba, F.E., Alnayeemi, S.R., Rillera, M.C. and Al Mazrooei, B.S., 2014. Tobacco use and associated factors among school students in Dubai, 2010: intervention study. EMHJ-Eastern Mediterranean Health Journal20(12), pp.765-773.

Pengpid, S. and Peltzer, K., 2020. Trends in the prevalence of twenty health indicators among adolescents in United Arab Emirates: cross-sectional national school surveys from 2005, 2010 and 2016. B.M.C. pediatrics20(1), pp.1-11.

Rahman, B., Hawas, N. and Rahman, M.M., 2016. Opinions of dental students toward tobacco cessation intervention in the United Arab Emirates. International dental journal66(5), pp.304-310.

Razzak, H.A., Harbi, A. and Ahli, S., 2020. Tobacco Smoking Prevalence, Health Risk, and Cessation in the U.A.E. Oman Medical Journal35(4), p.e165.

Razzak, H.A., Harbi, A. and Ahli, S., 2020. Tobacco Smoking Prevalence, Health Risk, and Cessation in the U.A.E. Oman Medical Journal35(4), p.e165.

Shaikh, R.B., Haque, N.M.A., Al Mohsen, H.A.H.K., Al Mohsen, A.A.H.K., Humadi, M.H.K., Al Mubarak, Z.Z., Mathew, E. and Al Sharbatti, S., 2012. Acute effects of dokha smoking on the cardiovascular and respiratory systems among U.A.E. male university students. Asian Pacific Journal of Cancer Prevention13(5), pp.1819-1822.

Siddiqua, A., Dghaim, R. and Barakat-Haddad, C., 2018. Sociodemographic predictors of tobacco smoking among expatriate and national adolescents in the United Arab Emirates. Eastern Mediterranean Health Journal24(3).

WorldBank, 2021. Prevalence of current tobacco use (% of adults) – United Arab Emirates. Available from <https://data.worldbank.org/indicator/SH.PRV.SMOK?locations=AE [Retrived on 10 June 2021]. 

Worldbank, 2021a. Prevalence of current tobacco use, males (% of male adults) – United Arab Emirates. Available from <https://data.worldbank.org/indicator/SH.PRV.SMOK?locations=AE>. [Retrived on 10 June 2021]. 

Worldbank, 2021b. Prevalence of current tobacco use, females (% of female adults) – United Arab Emirates. Available from <https://data.worldbank.org/indicator/SH.PRV.SMOK.FE?locations=AE [Retrived on 10 June 2021]. 

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