Smoking rates in the Middle-East and North Africa: Interim results of the BREATHE study

Abstract

Background: Smoking is the main risk factor for the development of COPD.

Objectives: This epidemiological study aimed to assess the prevalence and burden of COPD, chronic bronchitis and smoking in 11 countries in the Middle East and North Africa (Algeria, Morocco, Tunisia, Egypt, Jordan, Lebanon, Saudi Arabia, Syria, UAE, Pakistan and Turkey).

Methods: A general population sample of 10 000 subjects ≥ 40yrs in each country was generated from random phone numbers. A structured interview was proposed to all subjects by telephone. Screening questions was used to identify potential subjects with COPD. Individuals who have a life time of smoking ≥ 10 pack-yrs and who either had a diagnosis of COPD or symptoms of chronic bronchitis were considered to have possible COPD. This interim analysis assesses smoking habits of the study population.

Results: 44892 subjects were interviewed and 14034 subjects were smokers. This reflects a prevalence of smoking of 31.4% [95%CI: 31.0-31.8%], ranging from 14.9% [95%CI: 13.5-16.5%] in Pakistan to 48.8% [95%CI: 47.1-50.4%] in Lebanon. The rate of smoking ≥10 pack-yrs was 22.8% [95%CI: 22.4-23.2%]. Smoking was more frequent in men (50.9%; 95%CI: 50.2-51.6%) than in women (15.6%;95%CI: 15.1-16.0%). No relevant differences in smoking rates were found between age groups: 31.6% in subjects aged 40-49yrs, 32.2% in those aged 50-59yrs and 29.4% in those aged ≥60yrs. The use of water-pipes alone was reported by 605 smokers (4.3%), and 442 (3.1%) used both water-pipes and cigarettes.

Conclusion: Smoking is more frequent in men than in women, but rates vary considerably between different countries in the Middle East and North Africa. This may have an impact on health status.