Insights into Cigarette and Waterpipe Use among Houston-Based Arab Immigrants and Refugees

Despite the decrease in tobacco use in the United States, it remains a public health concern among Arab Americans. Yet, limited studies have examined tobacco use among this population, especially among Arab refugees who experience significant stressors of displacement and resettlement that potentially influence the onset, maintenance, and addiction of tobacco. We conducted a cross-sectional survey to assess the prevalence of cigarette and waterpipe use (the most common forms of tobacco use among Arabs) in a sample of 250 Arab Americans, including refugees (76% female; 41.4 ± 12.4 years) residing in a large Houston metropolitan area. We observed that the prevalence of current cigarette smokers was significantly higher among males than females (45% and 3.2%, respectively; p nce of current waterpipe smokers was significantly higher among males than females (16.7% and 13.2%, respectively; p = 0.049). Unexpectedly, the prevalence of current cigarette smokers and the prevalence of waterpipe smokers were comparable between Arab American immigrants and refugees. Multivariable logistic regression analysis demonstrated that males are more likely to smoke cigarettes than females (AOR: 35.29; 95% CI: 9.56, 130.31). And 40 years and older individuals are more likely to smoke cigarettes than the younger group (AOR: 12.65; 95% CI: 1.08, 147.80). The high prevalence of cigarette and waterpipe use among Arab American immigrants and refugees is a public health concern; hence, developing evidence-based and culturally sensitive smoking cessation interventions for this understudied population is warranted.