Smoke and Mirrors

Study shows more women in the UAE are smoking than previously reported but not all will admit it

Are you likely to admit being a cigarette smoker in a society where it is considered unfavorable, especially if you’re a woman?

Results from a pilot study involving 399 UAE nationals show that while most participants are likely to identify themselves as smokers, some still won’t admit to using tobacco.

Overall, self-reported tobacco use by Emiratis was 36 percent among men and 3 percent among women. This kind of self-report data is the highest in the region but that doesn’t mean everyone was being truthful. The numbers are actually much higher and indicate a worrying trend — especially among women.

Here is where science steps in. The validity of their answers was tested by analyzing the urine samples of the people surveyed to look for cotinine — a metabolite substance that shows up in your body when it has to process the nicotine present in tobacco, and which can be detected even two or three days after tobacco use. The results revealed that 42 percent men and 9 percent of women tested positive for cotinine, which indicates possible recent tobacco use.

This is the first study in the region to biochemically verify tobacco use against self-report data, and it also showed that smokers were using multiple tobacco products such as cigarettes, dokha, and shisha.

While the number of women who reported being smokers were higher than previously reported, researchers surmise that others denied being smokers because of the stigma attached — it is frowned upon in local culture for women to smoke.

Cotinine can also be detected in the urine if the person has been exposed to secondhand smoke, so it’s possible the participants could have been exposed to second-hand smoke in the days leading up to the collection of urine sample or they were bending the truth quite a bit, the researchers concluded.

Among people who identified themselves as smokers, 15 percent had a negative cotinine test, which could simply mean they hadn’t used tobacco recently but smoke periodically — still a cause for concern for researchers, while nearly 14 percent of self-reported non-smokers tested positive for cotinine.

Data for the pilot study comes from the UAE Healthy Futures Study, which was launched in 2015, and which aims to recruit 20,000 UAE nationals between the ages of 18-40  to investigate the causes for highly prevalent health conditions such as obesity, diabetes, and cardiovascular diseases.

The pilot study was done to help determine the feasibility of the larger prospective cohort of 20,000. The paper, Patterns of Tobacco use in the United Arab Emirates Healthy Future (UAEHFS) pilot study, was recently published by PLOS One, a peer-reviewed open access scientific journal published by the Public Library of Science.