# Unveiling Smoking Behavior Amid the COVID-19 Pandemic: A Cross-Sectional Study in the United Arab Emirates

## TL;DR

This study found that 28% of UAE adults smoked during the pandemic, with significant predictors like gender, occupation, and obesity, and many smokers attempted to quit.

## Contribution

The study identifies key predictors of smoking behavior and changes during the pandemic in the UAE, offering insights for targeted cessation strategies.

## Key findings

- Smoking prevalence among UAE adults during the pandemic was 28.3%.
- 79.4% of smokers reported changes in smoking behavior during the pandemic.
- Smokers had a higher prevalence of prior COVID-19 infection compared to non-smokers.

## Abstract

Objectives

This study aimed to assess the prevalence of smoking among adults residing in the United Arab Emirates (UAE) during the COVID-19 pandemic. Secondary objectives were to identify self-reported changes in smoking behavior, assess associations between smoking and selected epidemiological factors, and determine key predictors for smoking during this period.

Methods

The research team designed and distributed a meticulous questionnaire covering sociodemographic characteristics, lung health, medical and family history, and factors associated with smoking. The instrument was validated by two specialist physicians and a faculty member specializing in behavioral science. The questionnaire gathered information on smoking status, changes in smoking habits during the COVID-19 pandemic, and related factors.

Results

The analysis of 463 participants revealed a smoking prevalence of 28.3% (n = 129/453). During the COVID-19 pandemic, 79.4% (n = 85/107) of smokers who responded to this question reported altering their behavior. Among those who changed their smoking method (n = 11), the primary switch was to vaping. The prevalence of smoking among participants who had contracted COVID-19 was 20% (n = 26/129). Significant age-related differences were observed, with the highest smoking rates found in individuals aged 35 and older at 50.0% (n = 29/58). Prevalence was slightly higher among individuals from non-Eastern Mediterranean regions at 29.1% (n = 39/134) compared to 27.4% (n = 90/329) for those from the Eastern Mediterranean. A high body mass index (BMI) was common among smokers, with 52.5% (n = 31/59) having a BMI over 30. Cigarette smoking was the most common method, preferred by 69.8% (n = 90/129) of smokers. Notably, 74% (n = 94/127) of smokers reported having attempted to quit. The smoking rate among non-healthcare professionals was 54.0% (n = 34/63), significantly higher than the 25.8% (n = 8/31) among healthcare professionals.

Significant associations were found between smoking and age (p < 0.0001), gender (p < 0.0001), occupation (p < 0.0001), living situation (p < 0.0001), family history of smoking (p < 0.0001), chronic disease status (p < 0.0001), and BMI (p < 0.0001). Logistic regression identified gender (adjusted odds ratio (AOR): 3.781, p < 0.0001), being a non-health science student (AOR: 3.717, p < 0.0001), living alone (AOR: 4.948, p < 0.0001), having a family history of smoking (AOR: 3.613, p < 0.0001), and obesity (AOR: 2.692, p = 0.008) as significant predictors of smoking. Smokers also reported a significantly higher prevalence of prior COVID-19 infection compared to non-smokers (20.5% vs 12.0%, p < 0.05).

Conclusion

The smoking prevalence of 28.3% among adults in the UAE during the pandemic represents a significant public health concern. Key predictors for smoking included gender, occupation, living alone, family history, and obesity. The finding that a majority of smokers have attempted to quit presents a crucial "window of opportunity" for implementing effective, behavior-directed strategies to support smoking cessation.