Smoking and associated factors in the Occupied Palestinian Territory : an analysis of three demographic and health surveys (1995, 2000, and 2004)

Abstract

Smoking is one of the major preventable causes of disease, death, and disability in the world, yet data on prevalence and trends is limited especially in developing countries. In the Occupied Palestinian Territory the data available on smoking and factors associated with initiating and maintaining smoking are limited. This report presents an analysis of data collected from the Demographic Health Survey (DHS) by the Palestinian Central Bureau of Statistics (PCBS). Data was collected in 1995, 2000, and 2004 by conducting interviews with an eligible female in each household, information on selection of the female is provided elsewhere (PCBS 2006). The prevalence of smoking in the general population is presented along with the different factors associated with smoking behavior. Results from this report will be used for development of further studies aiming to provide empirical evidence for the development of health policies and community based interventions aiming to reduce the burden of smoking among youth especially those living in stressful environments. Results from the 2004 survey indicate that 17.4% of the population aged 10 and above were smokers. There was no specific trend in smoking prevalence across the three years; where for individuals 14 years and above the prevalence was 21.1%, 23.6%, and 20.9% in 1996, 2000, and 2004, respectively. A Similar trend was observed in adolescents, 4.9% of individuals between the ages of 12-18 years old reported smoking in 2000, which dropped to 2.7% in 2004. From the variables assessed in this study it appears that gender, education, whether parents are still alive, and area of residence are statistically significantly related to smoking status in the Occupied Palestinian Territory. More in depth analysis of smoking trends was not feasible due to some limitations in the data present. Information in each questionnaire was collected from the female head of household; these results might not be reliable especially when information is collected for young individuals and especially when such information is collected on smoking behavior. Time comparisons were an objective of this study yet because the three surveys were modified, this was not possible. Further studies should be developed and conducted in order to start a database on smoking trends over the years so that interventions can be her variables should also be investigated in so that their relationship to initiating smoking can be assessed. This preliminary analysis indicates that individuals living in more violent areas such as the north of the West Bank have a higher prevalence of smoking compared to those living in South and Central of the West Bank and thus variables measuring exposure to violence may be related to smoking behavior. Future studies should investigate in such non-classical factors that are specific to the Occupied Palestinian Territory including violence and violence related events.