title: Self-reported substance use in Iraq: findings from the Iraqi National Household Survey of Alcohol and Drug Use, 2014.
abstract: OBJECTIVE
  To estimate the prevalence of tobacco, alcohol and drug use in Iraq using data from the Iraqi National Household Survey of Alcohol and Drug Use (INHSAD).
  
  
  METHODS
  A cross-sectional survey was conducted using a multi-stage cluster sampling method. Trained surveyors conducted face-to-face household interviews.
  
  
  METHODS
  Iraq, from April 2014 to December 2014.
  
  
  METHODS
  A total of 3200 adult, non-institutionalized Iraqi citizens residing across all 18 governorates of Iraq.
  
  
  METHODS
  We estimated weighted prevalence and 95% confidence intervals (CIs) for life-time, past-year and past-month use of a variety of substances (tobacco, alcohol, prescription drugs and illicit drugs). For each substance, we also estimated whether individuals knew people who currently use the substance.
  
  
  RESULTS
  Self-reported past-month tobacco use was 23.2% (95% CI = 21.40, 25.19). Past-month alcohol use was 3.2% (95% CI = 2.58, 3.93). Women reported significantly lower prevalence for both tobacco and alcohol use compared with men (P-value < 0.01 for both). Only 1.4% (95% CI = 0.67, 3.02) reported past-month non-medical use of any prescription drugs. None of the women reported using any illicit drugs, and only 0.2% (95% CI = 0.07, 0.49) of men reported using any illicit drugs in the past month. Approximately 90.5% (95% CI = 88.58, 92.11) knew someone who uses tobacco, 42.4% (95% CI = 39.53, 45.24) knew someone who drinks alcohol, 27.9% (95% CI = 25.53, 30.45) knew someone who uses medication outside a doctor's instructions and 9.2% (95% CI = 7.87, 10.75) knew someone who uses an illicit drug.
  
  
  CONCLUSIONS
  Psychoactive drug use is generally low in Iraq, tobacco being highest at an estimated 23.2%. Iraqi women report significantly less substance use than Iraqi men, which may be related to cultural gender norms. Discrepancy between self-report and 'knowing someone who uses a substance' suggests under-reporting in this population.
authors.affiliation: Psychiatry Division, Department of Medicine, College of Medicine, University of Baghdad, Iraq.
authors.forename: Nesif
authors.initials: N
authors.lastname: Al-Hemiery
authors.affiliation: Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.|Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA.
authors.forename: Rufaidah
authors.identifier: http://orcid.org/0000-0002-6136-6810
authors.initials: R
authors.lastname: Dabbagh
authors.affiliation: Psychiatry Division, Department of Medicine, College of Medicine, University of Baghdad, Iraq.
authors.forename: Mushtaq T
authors.initials: MT
authors.lastname: Hashim
authors.affiliation: Republic of Iraq Council of Representatives, Baghdad, Iraq.
authors.forename: Salih
authors.initials: S
authors.lastname: Al-Hasnawi
authors.affiliation: Department of Family and Community, Medicine College of Medicine, Kerbala University, Iraq.
authors.forename: Ali
authors.initials: A
authors.lastname: Abutiheen
authors.affiliation: Republic of Iraq Ministry of Health, Baghdad, Iraq.
authors.forename: Emad A
authors.initials: EA
authors.lastname: Abdulghani
authors.affiliation: Department of Community Medicine, College of Medicine, University of Baghdad, Iraq.
authors.forename: Jawad K
authors.initials: JK
authors.lastname: Al-Diwan
authors.affiliation: University Research Co. LLC, Center for Human Services, Bethesda, ND, USA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Kak
authors.affiliation: University Research Co. LLC, Center for Human Services, Bethesda, ND, USA.
authors.forename: Hala
authors.initials: H
authors.lastname: Al Mossawi
authors.affiliation: School of Social Work, University of Texas at Austin, Austin, TX, USA.
authors.forename: Jane Carlisle
authors.initials: JC
authors.lastname: Maxwell
authors.affiliation: Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA.
authors.forename: Mary-Lynn
authors.initials: ML
authors.lastname: Brecht
authors.affiliation: Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Antonini
authors.affiliation: Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Hasson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Rawson
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D013287:Illicit Drugs; D007407:Interviews as Topic; D007493:Iraq / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D057566:Self Report; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000453:epidemiology*; D064424:Tobacco Use / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D013287:Illicit Drugs
keywords: Alcohol; Iraq; drug; hookah; illicit; prescription; prevalence; smoking; substance abuse; tobacco