Rationale: The Global Burden of Disease program identified smoking and ambient and household air pollution as the main drivers of death and disability from chronic obstructive pulmonary disease (COPD).Objectives: To estimate the attributable risk of chronic airflow obstruction (CAO), a quantifiable characteristic of COPD, due to several risk factors.Methods: The Burden of Obstructive Lung Disease study is a crosssectional study of adults, aged $40, in a globally distributed sample of 41 urban and rural sites. Based on data from 28,459 participants, we estimated the prevalence of CAO, defined as a postbronchodilator FEV 1 -to-FVC ratio less than the lower limit of normal, and the relative risks associated with different risk factors. Local relative risks were estimated using a Bayesian hierarchical model borrowing information from across sites.From these relative risks and the prevalence of risk factors, we estimated local population attributable risks. Measurements and Main Results:The mean prevalence of CAO was 11.2% in men and 8.6% in women. The mean population attributable risk for smoking was 5.1% in men and 2.2% in women. The next most influential risk factors were poor education levels, working in a dusty job for $10 years, low body mass index, and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites.Conclusions: Although smoking remains the most important risk factor for CAO, in some areas, poor education, low body mass index, and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites.

Objective: To identify the prevalence and predictors of the water-pipe (WP) smoking epidemic in the Kingdom of Saudi Arabia (KSA). Methods: A cross-sectional study conducted with 16-18 year-old high school students in Riyadh, Saudi Arabia. Results: Of the 1272 participants, 414 (33.0%) reported having tried WP smoking. Of this group, 141 (34.1%) were female and 273 (65.9%) were male. Further, 129 (10.2%) students were current WP smokers who had used at least one rock in the past month; 20 were female (1.6%) and 120 were male (8.6%). Regarding age, 276 (68.1%) students who tried WP smoking at least once began when they were over 11 years of age, whereas 129 (31.9%) began WP smoking at or before 11 years of age. Adjusted odds ratios showed that trying WP smoking at least once was associated with smoking after the age of 11 (p = 0.021, OR 7.7; CI: 1.4-43.6) and accepting water-pipes from a friend (p = 0.024, OR 10.6; CI: 1.4-83.4). Conclusion: A high prevalence of WP smoking exists among male and female high schools students in Riyadh, KSA. WP smoking was reported to begin in early adulthood.

BackgroundTo estimate the lifetime prevalence and address the attitudes and knowledge of using prohibited substances (doping) among sport players in Saudi Arabia.MethodsA cross-sectional survey carried out using systematic random sampling technique among Saudi players of variable sports attending the sport clubs, stadiums, and sport fields (70 sport clubs, 22 types of sports belong to 22 Saudi sport federations were visted in 18 cities from all regions of Saudi Arabia).ResultsA total of 1142 male sport players were interviewed with main age of 24. The prevalence of using prohibited substances (doping) was 4.3 %. The main reason for using prohibited substances was to improve performance (69 %). The prevalence of using food supplements (not prohibited) was 38.4 %. Among the players, 30 % of them believe that such behavior is against the spirit of sport while 70 % of the players are aware of punishment against doping. 65 % of players admitted that they received advice on prohibited substances. Higher rate of using prohibited substances (doping) among Saudi players was associated with low education, age below 20 years, previous use of food supplements and lack of punishment awareness.ConclusionUsing prohibited substances (doping) among Saudi sport players is common. Players believe that such use is against the spirit of the sport and they are aware about its punishment, despite this, they are still using prohibited substances.