Publications
115 results found
Dogar O, Zahid R, Mansoor S, et al., 2018, Varenicline versus placebo for waterpipe smoking cessation: a double-blind randomized controlled trial, ADDICTION, Vol: 113, Pages: 2290-2299, ISSN: 0965-2140
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- Citations: 8
Basu S, Yudkin JS, Berkowitz SA, et al., 2018, Reducing chronic disease through changes in food aid: A microsimulation of nutrition and cardiometabolic disease among Palestinian refugees in the Middle East, PLOS Medicine, Vol: 15
BackgroundType 2 diabetes mellitus and cardiovascular disease and have become leading causes of morbidity and mortality among Palestinian refugees in the Middle East, many of whom live in long-term settlements and receive grain-based food aid. The objective of this study was to estimate changes in type 2 diabetes and cardiovascular disease morbidity and mortality attributable to a transition from traditional food aid to either (i) a debit card restricted to food purchases, (ii) cash, or (iii) an alternative food parcel with less grain and more fruits and vegetables, each valued at $30/person/month.Methods and findingsAn individual-level microsimulation was created to estimate relationships between food aid delivery method, food consumption, type 2 diabetes, and cardiovascular disease morbidity and mortality using demographic data from the United Nations (UN; 2017) on 5,340,443 registered Palestinian refugees in Syria, Jordan, Lebanon, Gaza, and the West Bank, food consumption data (2011–2017) from households receiving traditional food parcel delivery of food aid (n = 1,507 households) and electronic debit card delivery of food aid (n = 1,047 households), and health data from a random 10% sample of refugees receiving medical care through the UN (2012–2015; n = 516,386). Outcome metrics included incidence per 1,000 person-years of hypertension, type 2 diabetes, atherosclerotic cardiovascular disease events, microvascular events (end-stage renal disease, diabetic neuropathy, and proliferative diabetic retinopathy), and all-cause mortality. The model estimated changes in total calories, sodium and potassium intake, fatty acid intake, and overall dietary quality (Mediterranean Dietary Score [MDS]) as mediators to each outcome metric. We did not observe that a change from food parcel to electronic debit card delivery of food aid or to cash aid led to a meaningful change in consumption, biomarkers, or disease outcomes. By contrast, a shift to an alternative foo
Jawad M, Lee JT, Glantz S, et al., 2018, Price elasticity of demand of non-cigarette tobacco products: a systematic review and meta-analysis, Tobacco Control, Vol: 27, Pages: 689-695, ISSN: 0964-4563
OBJECTIVE: To systematically review the price elasticity of demand of non-cigarette tobacco products. DATA SOURCES: Medline, Embase, EconLit and the Web of Science without language or time restrictions. STUDY SELECTION: Two reviewers screened title and abstracts, then full texts, independently and in duplicate. We based eligibility criteria on study design (interventional or observational), population (individuals or communities without geographic restrictions), intervention (price change) and outcome (change in demand). DATA EXTRACTION: We abstracted data on study features, outcome measures, statistical approach, and single best own- and cross-price elasticity estimates with respect to cigarettes. We conducted a random effects meta-analysis for estimates of similar product, outcome and country income level. For other studies we reported median elasticities by product and country income level. DATA SYNTHESIS: We analysed 36 studies from 15 countries yielding 125 elasticity estimates. A 10% price increase would reduce demand by: 8.3% for cigars (95% CI 2.9 to 13.8), 6.4% for roll your owns (95% CI 4.3 to 8.4), 5.7% for bidis (95% CI 4.3 to 7.1) and 2.1% for smokeless tobacco (95% CI -0.6 to 4.8). Median price elasticities for all ten products were also negative. Results from few studies that examined cross-price elasticity suggested a positive substitution effect between cigarette and non-cigarette tobacco products. CONCLUSIONS: There is sufficient evidence in support of the effectiveness of price increases to reduce consumption of non-cigarette tobacco products as it is for cigarettes. Positive substitutability between cigarette and non-cigarette tobacco products suggest that tax and price increases need to be simultaneous and comparable across all tobacco products.
Cornes MR, Danks G, Elgaddal S, et al., 2018, Early availability of laboratory results increases same day ward discharge rates, CLINICAL CHEMISTRY AND LABORATORY MEDICINE, Vol: 56, Pages: 1864-1869, ISSN: 1434-6621
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- Citations: 4
Mughal F, Rashid A, Jawad M, 2018, Tobacco and electronic cigarette products: awareness, cessation attitudes, and behaviours among general practitioners, PRIMARY HEALTH CARE RESEARCH AND DEVELOPMENT, Vol: 19, Pages: 605-609, ISSN: 1463-4236
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- Citations: 7
Singh N, Jawad M, Darzi A, et al., 2018, Features of the waterpipe tobacco industry: A qualitative study of the third International Hookah Fair [version 2; referees: 1 approved, 1 approved with reservations], F1000Research, Vol: 7, ISSN: 2046-1402
Background: Little research has been done to uncover the features of the waterpipe tobacco industry, which makes designing effective interventions and policies to counter this growing trend challenging. The objective of this study is to describe the features of the waterpipe industry. Methods: In 2015, we randomly sampled and conducted semi-structured interviews with 20 representatives of waterpipe companies participating in a trade exhibition in Germany. We used an inductive approach to identify emerging themes. Results: We interviewed representatives and four themes emerged: industry globalisation, cross-industry overlap, customer-product relationship, and attitude towards policy. The industry was described as transnational, generally decentralized, non-cartelized, with ad hoc relationships between suppliers, distributors and retailers. Ties with the cigarette industry were apparent. The waterpipe industry appeared to be in an early growth phase, encroaching on new markets, and comprising of mainly small family-run businesses. Customer loyalty appears stronger towards the waterpipe apparatus than tobacco. There was a notable absence of trade unionism and evidence of deliberate breaches of tobacco control laws. Conclusion: The waterpipe industry appears fragmented but is slowly growing into a mature, globalized, and customer-focused industry with ties to the cigarette industry. Now is an ideal window of opportunity to strengthen public health policy towards the waterpipe industry, which should include a specific legislative waterpipe framework.
Jawad M, Cheeseman H, Brose LS, 2018, Waterpipe tobacco smoking prevalence among young people in Great Britain, 2013-2016, European Journal of Public Health, Vol: 28, Pages: 548-552, ISSN: 1101-1262
Background: One percent of adults in Great Britain use waterpipe tobacco at least monthly, however national epidemiological evidence among young people is absent. This study aims to assess waterpipe tobacco prevalence and correlates among young people in Great Britain. Methods: Data were analyzed from online surveys conducted annually from 2013 to 2016 with weighted national samples of 11 to 18-year olds in Great Britain (annual n = 1936-2059). Primary outcome measures were at least monthly waterpipe tobacco use and lifetime waterpipe tobacco use. Binary logistic regression models tested the association between these outcomes and age, sex, country of residence and other tobacco consumption. Results: Between 2013 and 2016, 1.7% (95% CI 1.5-2.1%) used waterpipe tobacco at least monthly and 9.9% (95% CI 9.2-10.7%) used waterpipe in their lifetime. There were no changes in prevalence over time. At least monthly use was associated with older age groups [16-18 years vs. 11-15 years, adjusted odds ratio (AOR) 2.63, 95% CI 1.55-4.46], male sex (AOR 1.82, 95% CI 1.23-2.71) and other tobacco consumption (e.g. lifetime cigarette use AOR 10.30, 95% CI 5.22-20.29). Lifetime use had similar correlates, but was not associated with male sex (AOR 0.97, 95% CI 0.80-1.17). Conclusions: One in 10 young people in Great Britain have tried waterpipe tobacco, though more frequent use appears low. We found no evidence of increasing or decreasing prevalence of waterpipe use between 2013 and 2016. Being male, older and a concurrent user of other tobacco products were correlated with waterpipe tobacco use.
El-Shahawy O, Nicksic NE, Ramôa C, et al., 2018, Linking Global Youth Tobacco Survey Data to the WHO Framework Convention on Tobacco Control: the Case for Egypt, Current Addiction Reports, Vol: 5, Pages: 54-64
Purpose: Limited publications from Egypt have focused on prevalence of tobacco use and tobacco control policy. We used four waves of the Egypt Global Youth Tobacco Survey (GYTS) between 2001 and 2014 and a cigarette affordability measure, to evaluate the implementation of the World Health Organization’s MPOWER recommendations. Findings: Despite Egypt’s implementation of several MPOWER recommendations, the enforcement of laws and regulations may be limited, and therefore had little to no impact on youth current smoking prevalence through 2014. Notably, experimentation with cigarette smoking has significantly increased between waves 2001 and 2014. Summary: There is a missed opportunity for implementing evidence-based interventions for youth tobacco control in Egypt. There is a strong need for initiatives aiming at meaningful taxation, enforcement of smoking bans in public places, promoting smoke-free homes, appropriate mass media counter-advertising, and effective cessation activities.
Yang Y, Jawad M, Filippidis F, 2018, Prevalence and correlates of waterpipe use among adolescents in 60 countries, 17th World Conference on Tobacco or Health, Publisher: International Society for the Prevention of Tobacco Induced Diseases, Pages: 309-309, ISSN: 1617-9625
Singh N, Jawad M, Darzi A, et al., 2018, Features of the waterpipe tobacco industry: A qualitative study of the third International Hookah Fair [version 1; referees: 1 approved, 1 approved with reservations], F1000Research, Vol: 7, ISSN: 2046-1402
Background: Little research has been done to uncover the features of the waterpipe tobacco industry, which makes designing effective interventions and policies to counter this growing trend challenging. The objective of this study is to describe the features of the waterpipe industry.Methods: In 2015, we randomly sampled and conducted semi-structured interviews with representatives of waterpipe companies participating in a trade exhibition in Germany. We used an inductive approach to identify emerging themes.Results: We interviewed 20 representatives and four themes emerged: industry growth, cross-industry overlap, customer-product relationship, and attitude towards policy. The industry was described as transnational, generally decentralized, non-cartelized, with ad hoc relationships between suppliers, distributors and retailers. Ties with the cigarette industry were apparent. The waterpipe industry appeared to be in an early growth phase, encroaching on new markets, and comprising of mainly small family-run businesses. Customer loyalty appears stronger towards the waterpipe apparatus than tobacco. There was a notable absence of trade unionism and evidence of deliberate breaches of tobacco control laws.Conclusion: The waterpipe industry appears fragmented but is slowly growing into a mature, globalized, and customer-focused industry with ties to the cigarette industry. Now is an ideal window of opportunity to strengthen public health policy towards the waterpipe industry, which should include a specific legislative waterpipe framework.
Jawad M, Charide R, Waziry R, et al., 2018, The prevalence and trends of waterpipe tobacco smoking: A systematic review, PLoS ONE, Vol: 13, ISSN: 1932-6203
IntroductionWaterpipe tobacco smoking is harmful to health however its prevalence estimates remain uncertain. We aimed to systematically review the medical literature on waterpipe tobacco prevalence and trends.MethodsWe searched Medline, Embase and ISI Web of Science for ‘waterpipe’ and its synonyms, without using language or date restrictions. We included any measure of waterpipe tobacco smoking prevalence in jurisdictionally representative populations. We stratified findings by prevalence measure (past 30 day, ever, regular or occasional, daily, other or unspecified) and age (adults or youth).ResultsWe included 129 studies reporting 355 estimates for 68 countries. In general, prevalence estimates among adults were highest in the Eastern Mediterranean, and among youth were about equal between Eastern Mediterranean and European regions. Past 30 day use was highest among Lebanese youth (37.2% in 2008), ever use was highest among Lebanese youth in 2002 and Lebanese university students in 2005 (both 65.3%), regular or occasional use was highest in among Iranian university students (16.3% in 2005), and daily use was highest among Egyptian youth (10.4% in 2005). Trend data were limited but most studies reported increased use over time, ranging from 0.3–1.0% per year among youth in the US to 2.9% per year among youth in Jordan (both for past 30 day use). Results were similar for ever use trends. Turkey (2.3% in 2008 to 0.8% in 2010) and Iraq (6.3% in 2008 and 4.8% in 2012) both witnessed decreased waterpipe use.ConclusionWaterpipe tobacco smoking is most prevalent in Eastern Mediterranean and European countries, and appears higher among youth than adults. Continued surveillance will be important to assess and inform policy measures to control waterpipe tobacco use.
O'Neill N, Dogar O, Jawad M, et al., 2018, Which Behavior Change Techniques May Help Waterpipe Smokers to Quit? An Expert Consensus Using a Modified Delphi Technique, NICOTINE & TOBACCO RESEARCH, Vol: 20, Pages: 154-160, ISSN: 1462-2203
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- Citations: 9
Abdulrahim S, Jawad M, 2018, Socioeconomic differences in smoking in Jordan, Lebanon, Syria, and Palestine: A cross-sectional analysis of national surveys, PLOS ONE, Vol: 13, ISSN: 1932-6203
IntroductionThe association between education and wealth, as fundamental determinants of health, and smoking is well-established. Yet, social inequalities have received little attention in the expanding field of tobacco research in the Arab region. In this study, we examine inequalities in cigarette smoking by education and wealth in four Arab countries.MethodsUtilizing the most recently available population-level data sets (Syria 2009 PAPFAM, Jordan 2012 DHS, Palestine 2010 Family Health Survey, and Lebanon 2004 PAPFAM), we tested the association between cigarette smoking and education and wealth–controlling for age, marital status, and region of residence–for each country, and among men and women depending on data availability.ResultsCigarette smoking prevalence among Arab men is high– 51.3% in Syria, 39.7% in Palestine, and 42.1% in Lebanon; among women, prevalence is 8.4% in Syria, 10.9% in Jordan, and 24.3% Lebanon. Cigarette smoking shows the expected patterns inequalities by education among men in Syria, Palestine, and Lebanon, and among women in Jordan and Lebanon. On the other hand, wealth does not show a clear pattern in its association with cigarette smoking and, in some cases (men in Palestine and women in Syria) the behavioral risk is higher among the wealthiest.ConclusionsAvailable data from 2004–2012 show that cigarette smoking among men and women in the four Arab countries is predominant among those with limited access to education as a fundamental cause. The weak or absent negative association between wealth and cigarette smoking suggests that access to material resources does not precipitate a reduction in the consumption of tobacco.
Jawad M, Lotfi T, Darzi A, et al., 2018, Towards understanding the features of the waterpipe tobacco industry: findings from two consecutive visits to the International Hookah Fair, World Conference on Tobacco or Health, Publisher: EUROPEAN PUBLISHING, Pages: 174-174, ISSN: 1617-9625
Dogar O, Kanaan M, Zahid R, et al., 2018, A double-blind, placebo-controlled, randomized trial of varenicline in hookah tobacco smokers in Pakistan, World Conference on Tobacco or Health, Publisher: EUROPEAN PUBLISHING, Pages: 341-341, ISSN: 1617-9625
Kanaan M, Dogar O, Zahid R, et al., 2018, Dependence and withdrawal symptoms among waterpipe tobacco smokers enrolled in a double-blind, placebo-controlled, randomised trial, World Conference on Tobacco or Health, Publisher: EUROPEAN PUBLISHING, Pages: 341-341, ISSN: 1617-9625
El Kadi L, Jawad M, Nakkash R, 2018, Global reporting of waterpipe tobacco policy in online news articles in 2015: a cross-sectional analysis, World Conference on Tobacco or Health, Publisher: EUROPEAN PUBLISHING, Pages: 321-321, ISSN: 1617-9625
Fouad FM, Sparrow A, Tarakji A, et al., 2017, Health workers and the weaponisation of health care in Syria: a preliminary inquiry for <i>The Lancet</i>-American University of Beirut Commission on Syria, LANCET, Vol: 390, Pages: 2516-2526, ISSN: 0140-6736
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- Citations: 129
Schayck OCPV, Williams S, Barchilon V, et al., 2017, Erratum: Treating tobacco dependence: guidance for primary care on life-saving interventions. Position statement of the IPCRG., npj Primary Care Respiratory Medicine, Vol: 27, ISSN: 2055-1010
A correction to this article has been published and is linked from the HTML version of this article.
Van Schayck OCP, Williams S, Barchilon V, et al., 2017, Treating tobacco dependence: guidance for primary care on life-saving interventions. Position statement of the IPCRG (vol 27, 52, 2017), npj Primary Care Respiratory Medicine, Vol: 27, ISSN: 2055-1010
Jawad M, 2017, Health promotion in the poly-tobacco market, JOURNAL OF BEHAVIORAL MEDICINE, Vol: 40, Pages: 682-683, ISSN: 0160-7715
Jawad M, Darzi A, Lotfi T, et al., 2017, Waterpipe product packaging and labelling at the 3rd international Hookah Fair; does it comply with Article 11 of the Framework Convention on Tobacco Control?, Journal of Public Health Policy, Vol: 38, Pages: 303-313, ISSN: 0197-5897
We assessed compliance of waterpipe product packaging and labelling with the Framework Convention on Tobacco Control’s Article 11. We evaluated samples collected at a trade fair against ten domains: health warning location, size, use of pictorials, use of colour, and packaging information on constituents and emissions. We also evaluated waterpipe accessories (e.g., charcoal) for misleading claims. Ten of 15 tobacco products had health warnings on their principal display areas, covering a median of 22.4 per cent (interquartile range 19.4–27.4 per cent) of those areas. Three had pictorial, in-colour health warnings. We judged all packaging information on constituents and emissions to be misleading. Eight of 13 charcoal products displayed environmentally friendly descriptors and/or claims of reduced harm that we judged to be misleading. Increased compliance with waterpipe tobacco regulation is warranted. An improved policy framework for waterpipe tobacco should also consider regulation of accessories such as charcoal products.
Jawad M, Roderick P, 2017, Integrating the impact of cigarette and waterpipe tobacco use among adolescents in the Eastern Mediterranean Region: a cross-sectional, population-level model of toxicant exposure, Tobacco Control, Vol: 26, Pages: 323-329, ISSN: 0964-4563
BACKGROUND: Waterpipe smoking is more prevalent than cigarette smoking among adolescents in the Eastern Mediterranean Region (EMR); however, simple prevalence masks complex waterpipe smoking patterns and makes uncertain its contribution to risk of tobacco-related harm. This study aimed to integrate the impact of cigarette and waterpipe tobacco use on toxicant exposure among EMR adolescents. METHODS: A cross-sectional model made equivalent individual-level toxicant exposure data for cigarettes and waterpipes, and aggregated it to 23 countries in the EMR using the Global Youth Tobacco Survey. The waterpipe model adjusted for estimated frequency of use, session duration and sharing behaviours. The final model included 60 306 12-17-year olds, and modelled as outcomes nicotine, carbon monoxide (CO) and 14 carcinogens. Sensitivity analyses substantially reduced session duration and proportion of solo use. RESULTS: Our model suggests waterpipe use may contribute a median of 36.4% (IQR 26.7-46.8%, n=16) of the total toxicant exposure from tobacco, and may reach up to 73.5% and 71.9% of total CO and benzene exposure, respectively. Sensitivity analyses reduced all values by 4.3-21.0%, but even the most conservative scenarios suggested over 50% of benzene and CO exposure was from waterpipe use. Between 69.2% and 73.5% of total toxicant exposure derived from dual cigarette and waterpipe users, who smoked cigarettes and waterpipe more frequently and intensely than single users. CONCLUSIONS: More research is warranted to refine our model's parameters. Tobacco control researchers should consider a move towards a single unit of measure for cigarette and waterpipe tobacco exposure in order to better inform health policy.
Ali M, Jawad M, 2017, Health Effects of Waterpipe Tobacco Use: Getting the Public Health Message Just Right, Tobacco Use Insights, Vol: 10, ISSN: 1179-173X
Many public health messages benchmark the harms of waterpipe tobacco against those of cigarettes, usually using numericalmagnitudes of risk. This approach, although well intentioned, could be perceived as alarmist, damaging scientific credibility, and giving anunintended impression that one tobacco product is less harmful than the other. This commentary makes clear the harm waterpipe tobaccosmoking poses to public health by describing its mechanism of use, consumption uptake, toxicologic profile, and documented health outcomes,as well as challenge existing thinking that toxicologic assessments are the most appropriate way to frame waterpipe tobacco health promotionmessages. How can we describe the health effects of waterpipe tobacco without undermining its toxicity nor falling into the temptation ofalarmist messaging? Several recommendations are provided.
Matharoo J, Arshad A, Sadhra S, et al., 2017, S126 How does knowledge, perceptions and attitudes towards shisha pipe smoking vary amongst university students? (vol 71, pg A74, 2016), THORAX, Vol: 72, ISSN: 0040-6376
Jawad M, McIver C, 2017, Waterpipe tobacco smoking prevalence and illegal underage use in waterpipe-serving premises: a cross-sectional analysis among schoolchildren in Stoke-on-Trent, Public Health, Vol: 146, Pages: 32-38, ISSN: 0033-3506
ObjectivesWaterpipe tobacco smoking has received little epidemiological and policy attention in the UK despite reports of increasing prevalence alongside an anecdotally non-compliant industry. This study aimed to determine how waterpipe tobacco smoking is changing among young people in the UK, both in terms of prevalence and sociodemographic correlates of use, and to quantify the extent of illegal underage use in waterpipe-serving premises in the UK.Study designRepeat cross-sectional.MethodsA secondary analysis of two cross-sectional surveys (total N = 3376), conducted in 2013 and 2015 among secondary school students aged 11–16 years in Stoke-on-Trent, measured lifetime (both surveys) and regular (at least monthly; 2015 survey only) waterpipe tobacco prevalence and location of usual use. Logistic regression models measured the association between independent variables (age, sex, ethnicity, presence of free school meals, cigarette smoking status) with lifetime and regular waterpipe tobacco use, and with illegal underage use; the latter defined as usually smoking waterpipe tobacco in a waterpipe-serving premise.ResultsLifetime waterpipe tobacco prevalence remained similar in 2013 (13.7%, 95% confidence interval [CI] 12.0–15.4%) and 2015 (14.6%, 95% CI 12.8–16.4%), whereas regular use was measured at 2.9% (95% CI 2.1–3.8%) in 2015. Older, non-white, males who concurrently used cigarettes had higher odds of lifetime waterpipe tobacco use. Illegal underage use was reported among 27.1% of all regular users, correlates of which included increasing age and South Asian ethnicity. The presence of free school meals was not associated with lifetime or regular waterpipe tobacco prevalence, nor illegal underage use.ConclusionsIncreased monitoring of waterpipe tobacco prevalence and patterns, including the underage policy compliance of waterpipe-serving premises, is needed to help inform policy decisions to control waterpipe tobacco use.
Jawad M, Laverty AA, Millett C, 2017, Pokémon GO: are limited physical activity benefits undermined by McFlurries consumed?, BMJ, Vol: 356, ISSN: 0959-8138
Zahid R, Dogar O, Mansoor S, et al., 2017, The efficacy of varenicline in achieving abstinence among waterpipe tobacco smokers - study protocol for a randomized controlled trial, Trials, Vol: 18, ISSN: 1745-6215
Background:Waterpipe tobacco smoking has increased among youth across the globe including in the US, and it continues as a common and traditional form of smoking tobacco in Pakistan. A range of behavioral and pharmacological therapies are available to support people in quitting cigarette smoking; however, little evidence exists for the efficacy of these therapies in achieving abstinence among waterpipe tobacco smokers. The objective of this study is to assess the efficacy of varenicline when added to behavioral support for waterpipe tobacco smoking cessation, by measuring biochemically validated continuous abstinence in waterpipe tobacco smokers.Methods/design:This is a two-arm, double-blind, placebo-controlled randomized trial conducted in four districts in Punjab, Pakistan. Study participants include adults using a waterpipe (with or without concomitant cigarette, bidi or other forms of tobacco smoking) on a daily basis for at least 6 months and who are willing to quit. We will individually randomize 510 participants to one of the two arms of the trial. Participants in the intervention arm will receive varenicline and behavioral support and those in the control arm will receive placebo and behavioral support. The primary outcome will be continuous abstinence for at least 6 months (week 25) which is biochemically verified by a carbon monoxide level of <10 ppm. Secondary outcomes will include biochemically verified 7-day point abstinence at 5, 12 and 25 weeks and any lapses and relapses between the different assessment points. Tertiary outcomes will include assessment of withdrawal symptoms using the Mood and Physical Symptoms Scale (MPSS), smoking dependency using the Lebanon Waterpipe Dependency Scale (LWDS-11) and monitoring adverse outcomes.Discussion:This is an efficacy trial and would require a subsequent effectiveness trial for a definitive evaluation of the intervention.
Matharoo J, Arshad A, Sadhra S, et al., 2016, HOW DOES KNOWLEDGE, PERCEPTIONS AND ATTITUDES TOWARDS SHISHA PIPE SMOKING VARY AMONGST UNIVERSITY STUDENTS?, THORAX, Vol: 71, Pages: A74-A74, ISSN: 0040-6376
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