Smoking in Syria: profile of a developing Arab country.

One of the main obstacles to tobacco control in the Middle East lies in the shortage of reliable, standardised data on the spread and patterns of tobacco use in society. In Syria, a project aiming at drawing an epidemiological map of the tobacco epidemic in this country was started 4 years ago. Overall, nine studies have resulted, with a total of 6780 participants. The crude prevalence of current smoking among adults in Syria, based on combined information from all studies, is 48% and 9% for males and females, respectively. The prevalence of current smoking among high school adolescents is 16% and 7% for boys and girls, respectively, and was strongly associated with parental and sibling smoking. High school students from families with parents and/or siblings who smoked were 4.4 times more likely to be current smokers than those from non-smoking families. The biggest influx of new smokers among males in Syria is occurring in the early twenties, but an earlier pattern can occur among youths with low academic performance or socioeconomic status. Smoking in women, evaluated by data from physicians, tends to start later than in men and continues to increase with age. Women's smoking in Syria is related to their level of social liberalisation. Data show that active smoking is associated with an increased risk of respiratory diseases among smokers, and that exposure to environmental tobacco smoke (ETS) is associated with an increased risk of respiratory symptoms in children. Knowledge about the harmful effects of smoking and the desire to quit are disproportionate to the rate of successful cessation. The evidence collected indicates possible avenues for tobacco control in Syria, including price increases, smoking cessation programmes, restriction of adolescents' access to cigarettes, and intensive prevention work among women.