Prevalence of Strox Smoking Among University Students in Cairo, Egypt

Background: In Egypt, the prevalence rate of New Psychoactive Substances (NPSs) use is severely underestimated. In the last 5 years, several non-scientific reports have demonstrated the presence of an emergent, cheap NPSs that has taken the name of “Strox” or “Egyptian Spice”. The objective of this study was to estimate the prevalence rate of Strox smoking among undergraduate students attending Ain Shams University (ASU), Cairo (Egypt). Methods: A cross-sectional study was conducted in five non-medical colleges of ASU, namely, Law, Commerce, Computer Science, Engineering, and Literature. Participants were recruited using a convenient sampling method and were asked about NPSs use. Data were collected using the Marijuana Smoking History Questionnaire (MSHQ) developed by Bonn-Miller and Zvolensky (2009). The questionnaire was translated and modified to reflect Egyptian slang and culture. Results: This study included 558 students, 422 (75.6%) males and 136 (24.4%) females. The results showed that 189 (33.9%) were current tobacco smokers, 51 (9.1%) were smokers of substances other than tobacco, 45 (8.1%) were cannabis smokers, 38 (6.8%) were Strox smokers, and 3 (0.5%) were Voodoo smokers. When students were asked about their reasons for smoking Strox, they cited the following motivations: to achieve a feeling of euphoria(28.9%), depression (23.7%), experimentation (23.7%), peer pressure (21.1%), and having excess money (2.6%). The results showed a clear association between tobacco and cannabis smoking and consumption of Strox. Conclusion: Although the prevalence rates of NPSs usage as observed in this study were not high, higher rates could be expected in other communities outside of the university. Community-based studies are needed to estimate the magnitude of NPSs use in Egypt and the associated risk factors.