Academic journal article Central European Journal of Public Health

Smoking, Awareness of Smoking-Associated Health Risks, and Knowledge of National Tobacco Legislation in Gaza, Palestine

Academic journal article Central European Journal of Public Health

Smoking, Awareness of Smoking-Associated Health Risks, and Knowledge of National Tobacco Legislation in Gaza, Palestine

Article excerpt


Aims: To assess university students' extent of smoking, knowledge of smoking health risks, and awareness of existing national anti-smoking laws.

Methods: Self-administered questionnaire was employed across 7 universities (1,104 students, equal proportions of males and females) located in Gaza Strip, Palestine.

Results: About 55% of participants reported ever smoking, 31% were current cigarette smokers, and 36% were 'strictly' (only) narghile (water pipe) smokers. Mean age of smoking initiation was 17 ± 3.15 years. Smokers had less knowledge of smoking associated health risks than non-smokers. Students' knowledge of existing anti-smoking laws was generally low (11.3-25.5%), and significantly more smokers had knowledge about existing laws (ban of advertisement of smoking, ban of smoking in public places, and ban of selling cigarettes to minors) than non-smokers. About 81% of current smokers tried to quit smoking at least once during their life, 53% felt ready to quit smoking if cessation assistance was provided, 17% were not ready to quit, and 30% were reluctant/felt unsure if they were ready to quit. Most students (94.3%) reported that there were no smoking cessation centres in Palestine, or did not know if such centres existed. Males were associated with almost all categories of smoking (e.g. smoking both cigarettes and narghile, or smoking narghile only).

Conclusions: There is a lack of knowledge about the existing national anti-smoking legislation among university students in Gaza, Palestine. Smoking cessation centres also seem non-existent in Gaza. Multi-level interventions and actions are required by policy makers, educators and non-governmental agencies to prevent smoking among university students in Gaza, and to educate them on tobacco cessation counselling, on the dangers of tobacco use, and about effective stress management strategies to help them to cope with stressors. Smoking cessation interventions are required to address both cigarette and narghile use. Efforts need to be invested in ensuring compliance with legislation and for follow-up activities to enforce the anti-smoking laws through coordinated actions across ministries and departments.

Key words: smoking, university, students, narghile, water pipe, anti-smoking laws


Tobacco use is a risk factor shared by four major non-communicable conditions, it is an important cause of preventable death and without urgent actions to alleviate such burden, one billion people will die from tobacco in the 21st century (1). In addition, passive smoking (second-hand smoke) causes disease, disability, and death in people who do not smoke (2). Tobacco smoking and passive smoking are global public health challenges.

Tobacco use and the treatment/management of tobacco-related diseases incur financial burdens, particularly for low-income countries with already stretched health budgets. Deaths attributable to cigarette smoking are expected to double in developing countries, as they are now targeted by the tobacco industry (3). Many college students start smoking (4), being easy targets for the tobacco industry and young people are bombarded with protobacco messages and sometimes offered free cigarettes. Such actions violate the claimed responsibility of the tobacco industry for protecting young people from smoking (5).

Tobacco use is risky behaviour among youth that extends into adulthood (6). Quitting smoking is beneficial to health at any age, and smokers who quit before 35 years of age have mortality rates similar to those who never smoked (7). The WHO Framework Convention on Tobacco Control (WHO FCTC) provided basis for countries to implement/manage tobacco control programmes, and the MPOWER package comprises multiple evidence-based tobacco control measures : offering help/assistance to quit tobacco use (smoking cessation services); warning about dangers of tobacco (provision ofknowledge/information); and enforcing bans on tobacco advertising, promotion and sponsorship (law enforcement) (8). …

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