Date of Completion


Embargo Period



Alcohol, Stigma, Training, Education, Stigmatized, Attitude, Behavior, Middle East, students, Physicians

Major Advisor

Thomas Babor

Associate Advisor

Stephen Schensul

Associate Advisor

Pouran Faghri

Associate Advisor

Michael Copenhaver

Field of Study

Public Health


Doctor of Philosophy

Open Access

Open Access


Background The consumption of alcohol or drugs, as well as substance dependence do exist in the Middle East despite the religious, social and cultural constraints in the region. Stigma seems to exist in every area of life for individuals with mental illness and represents a major barrier to effective rehabilitation and reintegration of these patients. Aim To better understand the reasons behind stigmatizing attitudes toward persons with alcohol dependence and to evaluate the role of stigma in medical diagnosis and care. Methods The study consisted of two phases; Phase 1 examined whether medical students demonstrate stigmatized attitudes according to the cultural background of alcohol dependent patients. Phase 2 examined whether training (intervention) on alcohol screening programs would affect and change these attitudes. Findings Medical students have stigmatized attitude towards alcohol-dependent individuals regardless of their cultural background. Training programs were able to improve the knowledge and behaviors of medical students towards addiction and substance use, but were not able to change their stigmatizing attitudes. Implications and Recommendations This is one of the first studies of alcohol stigma in the Arabian Gulf region. The study has several strengths including the use of vignettes to study stigma, its randomized design and the inclusion of advances medical students. Training programs on prevention, screening and brief intervention of substance use, specifically nicotine and alcohol dependence should be introduced and conducted with physicians, medical students and healthcare providers in the Middle East earlier in their careers.