Determinants and sequelae of smoking: prevalence, incidence, and cessation among male adults in Abu dhabi, United Arab Emirates - a retrospective cohort study.

BACKGROUND

Smoking represents a significant public health challenge and remains one of the leading causes of preventable morbidity and mortality worldwide. This study aimed to determine the prevalence and cumulative risk of smoking among adult males in Abu Dhabi, and to assess the factors influencing the initiation, cessation, and maintenance of smoking, as well as the association of smoking status with other health conditions.

METHODS

This retrospective cohort study included a total of 4361 male subjects aged 18 to 93 years who participated in a comprehensive screening program (Weqaya) conducted in Abu Dhabi ambulatory healthcare services between 2011 and 2013. Of those participants, 3865 had a documented smoking status at baseline (2011-2013) and were followed up for an average of 8.9 years (range: 0-12 years). Data were initially collected from the electronic medical records (EMR), and follow-up data were collected again from their medical records in the Cerner system in 2023. At the end of the follow-up in 2023, the smoking status was documented in 3360 participants, based on their last encounter documented in the EMR. Statistical analysis included descriptive statistics, Chi-square tests, and logistic regression.

RESULTS

The baseline prevalence of smoking among male adults was 24.5%, whereas the prevalence at the end of the follow-up period was 21%. The cumulative risk of smoking, which is the reporting of smoking at any point in time, was 45%, with the highest risk observed in adults aged 30-39. Young age and lower cholesterol level were the main determinants of starting smoking. The predictors of quitting smoking were younger age, lower systolic blood pressure, higher cholesterol, lower high-density lipoprotein (HDL), lower glomerular filtration rate (GFR), and lower vitamin D levels. The history of acute coronary syndrome (ACS) was a determinant for maintaining smoking cessation. Continuing smoking is associated with a higher risk of developing diabetes mellitus (DM), stroke, acute coronary syndrome (ACS), psychiatric illness, non-alcoholic fatty liver disease (NAFLD), and peripheral artery disease (PAD), while smoking cessation is associated with a reduced risk of those conditions.

CONCLUSIONS

The study confirms smoking's health burden in Abu Dhabi and its association with various health risks.