Burden of smoking and its association with hospitalization in a large nationally representative sample of the Lebanese adult population

Abstract

Background: The international literature has consistently shown a relationship between smoking and increased hospitalization. This facet of smoking research contributes to the widely debated costs of smoking on healthcare systems. Studies originating from Lebanon have revealed that smoking prevalence rates are as high as one-third of the population, which means that this relationship might represent a substantial burden on the Lebanese healthcare system. The purpose of this study is to examine the prevalence of smoking in Lebanon and its association with hospitalization.Methods: Secondary data analysis of the Nutrition and Non-Communicable Disease Risk Factor (NNCD-RF) survey conducted in Lebanon between 2008 and 2009. A nationally representative sample of Lebanese adults aged 18 years and above of 1,332 men and 1,504 women was drawn from randomly selected households based on area probability multi-stage sampling: the strata were the Lebanese Governorates and the clusters were selected at the level of districts, urban and rural areas. Housing units constituted the primary sampling units in the different districts. Using WHO-stepwise approach where the first step consisted of interviews conducted using a comprehensive questionnaire, the study covered information on socio-demographic characteristics, tobacco and alcohol use, dietary intake, physical activity patterns, general health status and health seeking behavior, including hospitalization use. The survey team then measured participants blood pressure and anthropometric measurements (weight and height,) using standardized techniques and calibrated equipment. The study’s main outcome was hospitalization status reported as ever been hospitalized. Descriptive statistics and regression analysis were used to evaluate prevalence of smoking and its association hospitalization.Results: The overall prevalence rate of smoking was around 34percent, where males' prevalence rate was around 42percent compared to 27percent of females. Nearly 60percent of the study subjects were non-smokers an