The rise in narghile (shisha, hookah) waterpipe tobacco smoking: A qualitative study of perceptions of smokers and non smokers

<p>Abstract</p> <p>Background</p> <p>The prevalence of waterpipe tobacco smoking (WTS) in the Middle East region and worldwide is increasing. There is evidence to indicate both short term and long term health effects of WTS, resulting in the issuance of an advisory note by the World Health Organization.</p> <p>Methods</p> <p>This research aimed at gaining an in-depth understanding of the factors contributing to the rise in WTS in Lebanon. Qualitative focus groups (25) and in-depth interviews (9) were conducted with adults in Lebanon in 2007. Participants were recruited to represent diversity in smoking status, gender, age groups and urban/rural residence. The interviews and focus groups were thematically analyzed, and recurrent themes noted and summarized.</p> <p>Results</p> <p>The main themes identified were availability, affordability, innovation, influence of media, lack of a policy framework, and the sensory characteristics evoked from WTS. Men and women, smokers and non-smokers, and younger and older participants differed in their emphases on the above themes. These themes, though specific to waterpipe, are similar to themes manipulated by the cigarette industry, and eventually controlled through tobacco control policies.</p> <p>Conclusions</p> <p>Understanding reasons behind the rise in waterpipe tobacco use is important if appropriate prevention, cessation, and policy interventions are to be formulated. Strict adherence to the FCTC is warranted, with careful and vigilant attention that all tobacco products are covered by laws in both high as well as middle to lower income countries.</p

Burden of waterpipe smoking and chewing tobacco use among women of reproductive age group using data from the 2012-13 Pakistan Demographic and Health Survey

Background: Despite the general decline in cigarette smoking, use of alternative forms of tobacco has increased particularly in developing countries. Waterpipe (WP) and Chewing Tobacco (CT) are two such alternative forms, finding their way into many populations. However, the burden of these alternative forms of tobacco and their socio demographic determinants are still unclear. We assessed the prevalence of WP and CT use among women of reproductive age group in Pakistan. Methods: Data from the most recent Pakistan Demographic and Health Survey 2012–13 (n = 13,558) was used for this analysis. Information obtained from ever married women, aged between 15 and 49 years were analyzed using two separate data subgroups; exclusive WP smokers (total n = 12,995) and exclusive CT users (total n = 12,771). Univariate and Multivariate logistic regression analyses were conducted and results were reported as crude and adjusted Odds Ratio with 95 % confidence intervals. Results: Prevalence of WP smoking and CT were 4 % and 2 %, respectively. After multivariate adjustments, ever married women who were: older than 35 years (OR; 4.68 95 % CI, 2.62–8.37), were poorest (OR = 4.03, 95 % CI 2.08–7.81), and had no education (OR = 9.19, 95 % CI 5.10–16.54), were more likely to be WP smokers. Similarly, ever married women who were: older than 35 years (OR = 3.19, 95 % CI 1.69–6.00), had no education (OR = 4.94, 95 % CI 2.62–9.33), were poor (OR = 1.64, 95 % CI 1.07–2.48) and had visited health facility in last 12 months (OR = 1.81, 95 % CI 1.22–2.70) were more likely to be CT users as well. Conclusion: Older women with lower socio-economic profile were more likely to use WP and CT. Focused policies aiming towards reducing the burden of alternate forms of tobacco use among women is urgently needed to control the tobacco epidemic in the country

A study of social and economic implications of mobile sources on air quality in Lebanon

The work presented in this paper is aimed at investigating the economic effects of air pollution from mobile sources on public health in Lebanon. It is part of the effort to implement MedPolicies Initiative of the Mediterranean Environmental Technical Assistance Program (METAP III whose objective is to encourage sustainable economic growth through the integration of environmental concerns in economic and fiscal policy-making in 13 Mediterranean countries. In each of these countries, the most significant sector is investigated. The transport sector in Lebanon is the predominant sector in terms of energy consumption and its associated air pollution impacts. A multidisciplinary effort is carried out for this purpose in which measurement and modeling of air pollution caused by motor vehicles, determination of the quantitative relationship between pollutants and public health, and an estimation of the effects of air pollution on public health have been carried out. This study is concluded by highlighting the mitigation options applicable for the country and for similar developing nations from social and economic points of view.PublishedN/

Determinants of the willingness-to-participate in an environmental intervention in a Beirut neighborhood

Participatory environmental management can empower communities and enhance the sustainability of environmental interventions. However, existing power structures and inequalities along class, gender, or ethnic lines could prevent part of the community from accessing the full benefits of the intervention. An analysis of determinants of the willingness-to-participate in an environmental intervention in a Beirut neighborhood is conducted. Socioeconomic, health-risk distribution, and perception of community efficacy are used as predictors. A randomly selected sample of residents was surveyed. Respondents were asked to specify the frequency with which they were willing to be involved in an intervention to address priority environmental problems in the neighborhood. Bivariate and multivariate ordinal regression analyses were conducted. Tests of significance were based on the 95percent confidence intervals (CI) of the odds ratio (OR). Males versus females (OR = 4.89, P 0.001), respiratory patients versus nonsufferers (OR = 5.65, P 0.001), tenants versus house owners (OR = 2.98, P 0.01), and the less educated versus the more educated (OR = 2.42, P 0.05) were significantly more likely to be willing to participate. The reluctance of female community members to participate might be a major hindrance to community-based environmental protection and special strategies must be devised to overcome it. On the other hand, respondents suffering from an illness perceived to be related to environmental toxins are likely to be strong participants in environmental conservation efforts. Finally, the study yielded no evidence that belief or lack of it in the efficacy of community action is a good predictor of the willingness-to-participate in such action. © 2006 Springer Science+Business Media, Inc.Agarwal B, 2000, CAMBRIDGE J ECON, V24, P283, DOI 10.1093-cje-24.3.283; Ahmed M. R., 2003, Forests, Trees and Livelihoods, V13, P79; Beck U., 1992, RISK SOC NEW MODERNI; DESAI V, 1996, 3 WORLD PLANNING REV, V18, P217; Edwards SD, 1997, OCEAN COAST MANAGE, V36, P143, DOI 10.1016-S0964-5691(97)00011-2; ELZEIN A, 2005, UNPUB RISK ANAL INT; Etzioni A, 1996, DEV CHANGE, V27, P301, DOI 10.1111-j.1467-7660.1996.tb00591.x; FALSBORDA O, 1981, INTERMEDIATE TECHNOL; Gupte M, 2004, HUM ECOL, V32, P365, DOI 10.1023-B:HUEC.0000028086.63366.3d; JACKSON C, 1993, DEV CHANGE, V24, P649, DOI 10.1111-j.1467-7660.1993.tb00500.x; Kapoor I, 2001, J ENVIRON MANAGE, V63, P269, DOI 10.1006-jema.2001.0478; KONGOLO M, 2002, J INT WOMENS STUDIES, V4, P79; Lahiri-Dutt K., 2004, COMMUNITY DEV J, V39, P13, DOI 10.1093-cdj-39.1.13; Lall SV, 2004, J DEV STUD, V40, P1, DOI 10.1080-002203802000213184; Laurian L, 2004, J AM PLANN ASSOC, V70, P53, DOI 10.1080-01944360408976338; Lubell M, 2002, ENVIRON BEHAV, V34, P431, DOI 10.1177-00116502034004002; Mansuri G, 2004, WORLD BANK RES OBSER, V19, P1, DOI 10.1093-wbro-lkh012; Marjolein BAV, 2002, GLOBAL ENVIRON CHANG, V12, P167; MCBETH M, 1992, EC DEV REV, V10, P41; *MIN ENV REP LEB, 2001, STAT ENV REP; MOHAI P, 1992, SOC NATUR RESOUR, V5, P1, DOI 10.1080-08941929209380772; MORRISON WR, 1994, J CEREAL SCI, V20, P69, DOI 10.1006-jcrs.1994.1046; Mukhopadhyay L, 2004, ECOL ECON, V49, P215, DOI 10.1016-j.ecolecon.2004.03.020; Paraskevopoulos S, 2003, SOC NATUR RESOUR, V16, P759, DOI 10.1080-08941920390227167; Parisi D, 2004, SOC NATUR RESOUR, V17, P97, DOI 10.1080-08941920490261212; Polk M, 2003, TRANSPORT RES D-TR E, V8, P75, DOI 10.1016-S1361-9209(02)00034-2; Putnam R. D., 2000, BOWLING ALONE COLLAP; Snary C., 2002, J ENVIRON PLANN MAN, V45, P267, DOI 10.1080-09640560220116332; Soderqvist T, 2003, ECOL ECON, V47, P105, DOI 10.1016-j.ecoleon.2002.09.004; Tesh SN, 1999, POLICY SCI, V32, P39, DOI 10.1023-A:1004398228075; Vanslembrouck I, 2002, J AGR ECON, V53, P489, DOI 10.1111-j.1477-9552.2002.tb00034.x; Williams B. L., 2001, J ENVIRON PLANN MAN, V44, P41; Woolcock M., 2001, ISUMA CANADIAN J POL, V2, P11; Zanetell BA, 2004, WORLD DEV, V32, P793, DOI 10.1016-j.worlddev.2004.01.002; ZURAYK R, 2003, ARIDLANDS NEWSLETTER, V53; Zurayk R, 2001, AGR ECOSYST ENVIRON, V86, P247, DOI 10.1016-S0167-8809(00)00287-521

The challenges of sustainable access to safe drinking water in rural areas of developing countries: Case of zawtar el-charkieh, Southern Lebanon

Adequate and safe water is important for human health and well-being, economic production, and sustainable development. Failure to ensure the safety of drinking water may expose the community to the risk of outbreaks of waterborne and infectious diseases. Although drinking water is a basic human right, many people do not have access to safe and adequate drinking water or proper sanitation facilities. The authors conducted a study to assess the quantity, cost, continuity, coverage, and quality of drinking water in the village of Zawtar El-Charkieh, Lebanon. Their aim was to identify the challenges of sustainable access to safe drinking water in order to determine the short-term management actions and long-term strategies to improve water quality. Results revealed that contamination of the source, absence of any disinfection method or insufficient dose, poor maintenance operations, and aging of the networks are significant factors contributing to water contamination during the storage and distribution process. Establishing a comprehensive drinking water system that integrates water supply, quality, and management as well as associated educational programs in order to ensure the safety and sustainability of drinking water supplies is essential.

Interdisciplinary approach to environmental education

This paper examines the need for an interdisciplinary educational approach in environmental engineering and science, discusses the constituents of interdisciplinary environmental education, and addresses its advantages. A case of interdisciplinary environmental education within the Interfaculty Graduate Environmental Sciences Program at the American University of Beiurt is then presented. Specifically, this newly created program is introduced with a description of its structure, content, and performance in terms of mission accomplishment, student enrollment, and marketability of its graduates. Future curriculum development and constraints are also examine

The effect of different ventilation modes on in-vehicle carbon monoxide exposure

In-vehicle carbon monoxide (CO) concentration profiles were monitored in a passenger vehicle driven along a heavily traveled route of a commercial/residential area of Beirut, Lebanon, under several ventilation modes. Trips were conducted during morning rush hours in spring and summer time. Concomitant monitoring of car-exterior CO level, ambient CO level and wind speed was also undertaken. The highest mean CO exposure was experienced for the “windows closed, vents closed” and “windows closed, AC on recirculation” ventilation settings, with mean CO levels of 37.4 and 30.8 ppm, respectively, exceeding the 1-h air quality guidelines. The exposure was less significant for other ventilation modes with respective mean values of 10.8 - 19ppm. Mean car-exterior CO levels were lower than the 1-h air quality guidelines, but exceeded the 8-h CO exposure guidelines. Ambient CO levels were low and non-representative of the personal exposure of individuals neither inside nor in the vicinity of road vehicles. In-vehicle CO levels revealed moderate to good correlations to out-vehicle CO levels for ventilation modes allowing for outdoor air intake, and no correlation to ambient CO levels and wind speed. Infiltration as a result of indoor–outdoor air exchange and intrusion from engine combustion/exhaust infiltration constituted the main sources of observed in-vehicle CO levels.<br/