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Dadipoor S, Alavi A, Eshaghi Sani Kakhaki H, Shahabi N, Kader Z. A qualitative exploration of experts' views about multi-dimensional aspects of hookah smoking control in Iran. BMC Public Health 2024; 24:1665. [PMID: 38909209 PMCID: PMC11193193 DOI: 10.1186/s12889-024-19139-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 06/13/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND The related literature has primarily addressed cigarette smoking control. It seems that researchers have failed to explore the determinants of hookah smoking (HS) control. In an attempt to fill this gap, the present study explores experts' views about aspects of HS control in Bandar Abbas, a city in the south of Iran. METHODS The present qualitative study, conducted in 2022 and 2023, used a content analysis. To this aim, 30 experts in tobacco prevention and control were invited to participate in the research. Twenty seven accepted the invitation. In-depth, semi-structured, and face-to-face interviews were held with the experts. A purposive sampling was used and the data collection continued until data saturation. The interviews lasted between 18 and 65 min. MAXQDA 10.0 was used for data management and analysis. RESULTS The expert interviewees had a mean age of 44.77 ± 6.57 years and a mean work experience of 18.6 ± 6.8 years. A total number of six main categories were extracted from the data, including usin influential figures to control HS, controlling HS by alternative activities, changing beliefs and attitudes toward HS, taking administrative and regulatory measures, and facilitating HS cessation. CONCLUSION This qualitative study explored the multifaceted ways people adopt to quit HS. Using influential figures to control hookah smoking, promoting alternative activities as a means of control, changing beliefs and attitudes, enforcing administrative regulations, and facilitating quit attempts all play an important role in tackling the prevalence of hookah smoking. These findings emphasize the importance of a comprehensive and multifaceted approach to integrate various interventions to effectively address hookah smoking behavior.
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Affiliation(s)
- Sara Dadipoor
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran
| | - Azin Alavi
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadi Eshaghi Sani Kakhaki
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran.
| | - Nahid Shahabi
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran.
| | - Zainab Kader
- The Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Bellville, South Africa
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Tamim H, Beyhum A, Alzaghoul A, Kesibi D, Alghalyini B, Yunis K. Prevalence and characteristics of smoking cigarette and narghile among Syrian refugee parents in Ontario, Canada. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003176. [PMID: 38701042 PMCID: PMC11068169 DOI: 10.1371/journal.pgph.0003176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
This study aimed to explore the prevalence and associated sociodemographic, migration, and health-related factors of smoking cigarettes and narghile among Syrian refugee parents resettled in Ontario, Canada since 2015. A total of 540 Syrian refugee parents, with at least one child less than 18 years of age, were interviewed. Multivariate logistic regression analysis was performed to assess the independent relationship between each of the associated sociodemographic, migration, and health-related factors and smoking cigarettes and narghile. The overall prevalence of smoking was 43% (cigarette = 22%, narghile = 25.6%). The average number of cigarettes smoked per day was 15.4 (SD = 10.1). With regard to smoking narghile, 18.2% of the sample smoked daily, while 35.5% and 52.9% smoked at least once weekly and occasionally, respectively. Results from multivariate logistic regression analysis showed that more fathers were at increased odds of smoking cigarettes than mothers OR (95% CI) = 6.6 (3.7-11.9), while no such difference was found for narghile smokers OR (95% CI) = 1.5 (0.9-2.6). Results showed that smoking cigarettes was associated with lower education levels and being Muslim, whereas smoking narghile was associated with younger age and alcohol use. Poor perceived mental health was significant/approached significance for both types of smoking. Greater understanding of smoking patterns of resettled refugees is needed to direct healthcare providers to offer targeted interventions for those who are most at risk.
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Affiliation(s)
- Hala Tamim
- Department of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Aliya Beyhum
- Department of Archeology, University of Cambridge, Cambridge, United Kingdom
| | - Aseel Alzaghoul
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Durmalouk Kesibi
- Department of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | | | - Khalid Yunis
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Dadipoor S, Hemayatkhah M, Eshaghi Sani Kakhaki H, Mohseni S, Fattahi E, Shahabi N, El-Shahawy O. The role of intrapersonal and interpersonal factors in waterpipe cessation: a case-control study. BMC Public Health 2023; 23:1705. [PMID: 37667194 PMCID: PMC10476390 DOI: 10.1186/s12889-023-16597-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The prevalence of waterpipe smoking among women in southern Iran is significantly higher than women in other regions of Iran. We aimed to explore the effect of several demographic factors, knowledge, attitude, self-efficacy and social norms on a successful cessation of waterpipe smoking in the marginalized women of Bandar Abbas city, in the south of Iran. METHODS This case-control study was conducted in 2022 among 731 women (246 subjects who successfully quit waterpipe smoking in the case group and 485 who smoked waterpipe in the control group). A cluster sampling method was used to collect the required data through face-to-face interviews and a researcher-made questionnaire. The questionnaire consisted of demographic information, behavioral information about waterpipe smoking and knowledge, attitude, self-efficacy and social norms. The data were analyzed in STATA 14 using univariate and multivariate regression analyses. RESULTS The mean and standard deviation of age was 39.24 ± 11.93 and 37.18 ± 13.57 in the control and case groups, respectively. With an increase of one score in social norm (OR: 1.046), the odds of cessation were increased for 4%. With an increase of one score in self-efficacy (OR: 1.152), the odds of cessation were increased for 15%. With an increase of one score in knowledge (OR: 1.064), the odds of cessation were increased for 6%. With an increase of one score in attitude (OR: 1.215) the odds of cessation were increased for 21%. CONCLUSION The present findings revealed personal and interpersonal influential factors in successful waterpipe cessation. Women's knowledge can be increased and their attitude can be changed. Important people in women's lives can be influenced to, consequently, affect women positively and improve their self-esteem.
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Affiliation(s)
- Sara Dadipoor
- Tobacco and Health Research Centre, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran
| | | | - Hadi Eshaghi Sani Kakhaki
- Tobacco and Health Research Centre, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran
| | - Shokrollah Mohseni
- Determinants in Health Promotion Research Centre, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Esmaeil Fattahi
- Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Nahid Shahabi
- Tobacco and Health Research Centre, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran.
| | - Omar El-Shahawy
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Dadipoor S, Heydari G, Abu-Rmeileh NM, Mohseni S, Kakhaki HES, Aghamolaei T, Shahabi N. A predictive model of waterpipe smoking cessation among women in southern Iran: application of the theory of planned behavior. BMC Public Health 2023; 23:1151. [PMID: 37316841 DOI: 10.1186/s12889-023-16053-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Today, waterpipe (WT) smoking is a rising issue worldwide, and has taken a significant and growing share of tobacco consumption in the world. Present study aimed to explore the predictors of WT cessation in the light of the theory of planned behavior (TPB). METHODS This cross-sectional analytical study was conducted in 2021-2022 using a multi-stratified cluster sampling on 1,764 women in Bandar Abbas, southern Iran. Data were collected through a reliable and valid questionnaire. The three-part questionnaire includes demographic information, behavioral information of WT smoking, and the constructs of the TPB along with an additional habit construct. Multivariate logistic regression analysis was run to model the predictor constructs of WT smoking. The data were analyzed statistically in STATA14.2. RESULTS With an increase in one attitude score, the odds of cessation increased by 31% (p < 0.001). Also, with an increase of one score in knowledge, the odds of cessation are increased by 0.05% (0.008). With an increase of one score for intention, the odds of cessation are 26% (0.000). in social norms, the odds of cessation are 0.02% (0.001). With an increase of one score in perceived control, the odds of cessation increased by 16% (0.000) and inhabit score, the odds of cessation decrease by 37% (0.000). In the model where the habit construct was present, the accuracy, sensitivity, and pseudo R2 indices were 95.69%, 77.31%, and 65%, respectively and after removing the habit construct, the so-called indices changed to 90.7%, 50.38% and 0.44%, respectively. CONCLUSIONS The present research confirmed the effectiveness of the TPB model in predicting waterpipe cessation behavior. The knowledge obtained from this research can help develop a systematic and effective intervention to facilitate waterpipe cessation. Focusing on the habit variable can play a critical role in waterpipe cessation in women.
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Affiliation(s)
- Sara Dadipoor
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Gholamreza Heydari
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadi Eshaghi Sani Kakhaki
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nahid Shahabi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Al Sabbah H, Assaf EA, Dabeet E. Prevalence of smoking (cigarette and waterpipe) and its association with obesity/overweight in UAE and Palestine. Front Public Health 2022; 10:963760. [PMID: 36339216 PMCID: PMC9633859 DOI: 10.3389/fpubh.2022.963760] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/06/2022] [Indexed: 01/24/2023] Open
Abstract
Aim This study aimed to assess the prevalence rate of smoking behavior (cigarette and waterpipe) and its association with obesity/ overweight among university students in the United Arab Emirates (UAE) and Palestine. Methods A cross-sectional study was conducted at a convenient sample of 10 largest universities in the West Bank- Palestine and Dubai- UAE. In total, 3800 students were randomly selected from the universities, with an 87.6% response rate. A self-administered questionnaire was used to collect the data. The key measures were: waterpipe smoking, weight, height, cigarette smoking, dieting to reduce weight, and perception and knowledge related to tobacco waterpipe smoking (TWP). Body Mass Index (BMI) was calculated using the WHO cutoffs. Results The analysis included 3,327 students (54% from the West Bank and 46% from Dubai). About 16% of students in Dubai and 18% of students in the West Bank smoke cigarettes. Quarter (26%) of the students in Dubai and 32% of the students in West Bank smoke water pipes. 17% of students in Dubai and 18% of students in the West Bank reported that they smoke waterpipes to reduce their weight. Waterpipe smoking was found to have a significant positive association with obesity/overweight (p < 0.001). Conclusions Smoking is very common among university students. Waterpipe smoking was associated with obesity. More research is still needed in this field to better understand the relationship between cigarette smoking and obesity.
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Affiliation(s)
- Haleama Al Sabbah
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates,*Correspondence: Haleama Al Sabbah
| | - Enas A. Assaf
- Community Health Department, Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Elias Dabeet
- Science Department, Eastern Iowa College, Davenport, IA, United States
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Dadipoor S, Heyrani A, Mirzaei-Alavijeh M, Aghamolaei T, Ghaffari M, Ghanbarnejad A. Using intervention mapping for hookah smoking cessation: a quasi-experimental evaluation. Addict Sci Clin Pract 2022; 17:18. [PMID: 35287728 PMCID: PMC8919552 DOI: 10.1186/s13722-022-00287-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 01/12/2022] [Indexed: 11/18/2022] Open
Abstract
Background The present study aimed to evaluate the results of a theory-based and systematic intervention on Hookah Tobacco Smoking (HTS) cessation in women local to Bandar Abbas, Iran. Methods In the present quasi-experimental research, we used an intervention mapping approach to develop, implement, and evaluate an education and training course as our intervention. Applying the results of a systematic review and two prior local qualitative studies, we identified six HTS determinants and set goals for the intervention. We selected 212 eligible women through systematic stratified random sampling and enrolled them in control and intervention groups. The course was presented to the intervention group in 17 sessions for four months. The educational material was developed to address the goals of the intervention, improve HTS determinants, and change the HTS behavior. We used a questionnaire to collect data on participants’ characteristics, HTS behavior, and detailed determinants of HTS in the control and intervention groups at the beginning of the study, at the end of the intervention, and at three- and six- months follow-up. All work done in the study was guided by ethical considerations. Results The results showed no significant difference between women enrolled in control and intervention groups regarding participants’ characteristics and HTS behavior. At baseline, there were no differences between groups for six determinants of HTS (knowledge, attitude, social norms, self-efficacy, habit, and intention). At the end of the intervention and at three and six months follow-up, the women in the intervention group had significantly better results in all six domains, compared with those in the control group. The rate of HTS abstinence at the end of the intervention and at the three- and six-month follow-ups was 61.3%, 48.5%, and 45.5% for the intervention and 16%, 14.4%, and 10% for the control groups, respectively. Conclusions HTS is a complicated behavior, and its cessation is hard. However, Intervention Mapping (IM) can be a powerful integrative, purposeful, theory-based, and participation-based method to reduce or cease HTS. This method should be tested in other settings. Trial registration: IRCT20190126042494N1, Registered 3.3.2019. https://en.irct.ir/trial/37129 Supplementary Information The online version contains supplementary material available at 10.1186/s13722-022-00287-5.
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Affiliation(s)
- Sakineh Dadipoor
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ali Heyrani
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Amin Ghanbarnejad
- Department of Epidemiology And Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Shahsavari S, Alavi A, Razmjoue P, Mohseni S, Ranae V, Hosseini Z, Dadipoor S. A predictive model of genital warts preventive behaviors among women in the south of Iran: application of health belief model. BMC Womens Health 2022; 22:63. [PMID: 35260143 PMCID: PMC8903721 DOI: 10.1186/s12905-022-01649-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Genital wart (GW) is known as an infectious disease. Besides the infection, it is associated with a higher risk of cervical neoplasia and cancer in the infected population. The present research aimed to explore the predictors of GW preventive behaviors based on the health belief model (HBM). METHODS The present analytical and cross-sectional research was conducted in 2019 among 720 women between 15 and 49 years of age in Bandar Abbas in the south of Iran. The sample was selected in a multi-stratified clustering method. The participants responded to a reliable and valid researcher-made questionnaire which explored demographic information, knowledge-related items and the model constructs. A multivariate linear regression analysis was run to determine the predictors of adopting GW preventive behaviors. A path analysis was also run to test the direct and indirect effects of the model constructs on the dependent variable. RESULTS The mean and standard deviation of participants' age was 30.43 ± 8.697 years. As Pearson's correlation coefficients showed, knowledge (r = 0.197, p < 0.001), perceived susceptibility (r = 0.434, p < 0.001), severity (r = 0.463, p < 0.001) and self-efficacy (r = 0.434, p < 0.001) were significantly correlated with the adoption of GWs preventive behaviors. Multiple linear regression analysis showed that self-efficacy (B = - 0.010, p < 0.001), perceived susceptibility (B = 0.070, p < 0.001) and severity (B = 0.078, p < 0.001) were the predictors of GW preventive behaviors. Path analysis showed that perceived susceptibility, severity and self-efficacy directly affected healthy behaviors while perceived benefits and barriers indirectly affected the preventive behaviors. CONCLUSIONS The present findings help to promote knowledge of the predictors of GW preventive behaviors. HBM can be a useful theoretical framework to evaluate the preventive behavior of the disease and help to reduce the rate of sexually-transmitted infections including GW.
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Affiliation(s)
- Saeideh Shahsavari
- Mother and Child Welfare Research Center, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azin Alavi
- Mother and Child Welfare Research Center, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Parisa Razmjoue
- Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shokrollah Mohseni
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Vahid Ranae
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Hosseini
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sakineh Dadipoor
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Nakkash R, Khader Y, Chalak A, Abla R, Abu-Rmeileh NME, Mostafa A, Jawad M, Lee JH, Salloum RG. Prevalence of cigarette and waterpipe tobacco smoking among adults in three Eastern Mediterranean countries: a cross-sectional household survey. BMJ Open 2022; 12:e055201. [PMID: 35246419 PMCID: PMC8900030 DOI: 10.1136/bmjopen-2021-055201] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/06/2022] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Tobacco smoking is on the rise in the Eastern Mediterranean region. In light of limited surveillance of smoking in the region, this study sought to understand the prevalence of cigarette and waterpipe smoking among adults and the factors associated with smoking in Lebanon, Jordan and Palestine (West Bank only). DESIGN, SETTING AND PARTICIPANTS Household surveys were conducted with participants over the age of 18 in Lebanon (n=1680), Jordan (n=1925) and Palestine (n=1679) between June and August 2019. A multistage cluster sampling approach with probability-proportional-to-size random selection method was followed in the three countries. PRIMARY AND SECONDARY OUTCOME MEASURES Gender-specific prevalence rates for cigarette and waterpipe smoking were estimated. Multivariable logistic regression was used to examine factors associated with current cigarette and waterpipe tobacco smoking. RESULTS The prevalence of cigarette smoking among males and females respectively was 48.6% and 21.5% in Lebanon, 50.4% and 9.1% in Jordan, and 53.4% and 3.1% in Palestine. The prevalence of waterpipe smoking among males and females respectively was 32.7% and 46.2% in Lebanon, 13.4% and 7.8% in Jordan, and 18.0% and 7.9% in Palestine. Cigarette smokers were significantly (p<0.05) more likely to be male, younger and with lower educational attainment across the three countries. Waterpipe smokers were more likely to be young adults across the three countries (p<0.001). They were more likely to be male in Jordan and Palestine, and more likely to be female in Lebanon. CONCLUSIONS The high prevalence rates of smoking in Lebanon, Jordan and Palestine are concerning. Continued surveillance is key to monitor smoking patterns and inform stronger tobacco control measures.
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Affiliation(s)
- Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Yousef Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ali Chalak
- Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Ruba Abla
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Aya Mostafa
- Department of Community, Environmental and Occupational Medicine, Ain Shams University Faculty of Medicine, Cairo, Egypt
| | - Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London School of Public Health, London, UK
| | - Ji-Hyun Lee
- Department of Biostatistics and UF Health Cancer Center, University of Florida, Gainesville, Florida, USA
| | - Ramzi G Salloum
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
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Makvandi Z, Mostafavi F, Bashirian S, Zamani-Alavijeh F, Kelishadi R. Sociocultural factors contributing to waterpipe tobacco smoking among adolescents and young adult women: a qualitative study in Iran. Int J Qual Stud Health Well-being 2021; 16:1857043. [PMID: 33435855 PMCID: PMC7808745 DOI: 10.1080/17482631.2020.1857043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: Waterpipe tobacco smoking (WTS) is currently a serious and growing public health threat in the world, especially in adolescents and young women. The aim of the study was to explore sociocultural factors contributing to WTS among adolescents and young adult women in Iran. Methods: This qualitative study was conducted from August 2017 to January 2019 in Isfahan and Hamadan cities, Iran; it included 13–30-year-old females with experience of WTS. For data collection, in-depth semi-structured personal interviews were conducted at participants’ preferred time and place. Concurrent with data collection, data were analysed through conventional content analysis. Results: The study participants described the various sociocultural factors contributing to WTS. These factors were categorized into four following main categories: waterpipe glamorization by its producers and sellers, media advertisement or silence, common sociocultural traditions, and governmental policies and regulations. Conclusion: A wide range of sociocultural factors affects WTS among Iranian adolescents and young adult women. Therefore, interdisciplinary multidimensional strategies are needed for WTS management and prevention among these at-risk groups. Public education, strict supervision of tobacco import, export, and selling, ample employment opportunities for young people and effective leisure time management are essential to reduce WTS.Abbreviation WTS: Waterpipe Tobacco Smoking; MPOWER: Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, Raise taxes on tobacco
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Affiliation(s)
- Zeinab Makvandi
- Student Research Committee, School of Heath, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical sciences , Hamadan, Iran
| | - Fereshteh Zamani-Alavijeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences , Isfahan, Iran
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Dadipoor S, Aghamolaei T, Mirzaei-Alavijeh M, Ghaffari M, Heyrani A, Hosseini Teshnizi S. What are the intervention goals of women's hookah cessation? A systematic, evidence-based and participatory study. J Ethn Subst Abuse 2021; 21:1-17. [PMID: 33413046 DOI: 10.1080/15332640.2020.1864538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This Study was designed to answer the question: what are the intervention goals of women for ceasing to smoke. The present research was part of a larger study and was a pioneering systematic research conducted between September 23, 2018 and September 26, 2019 through an intervention mapping in southern Iran among professional hookah Smoking (HS) women. In order to know more about the HS among women, the behavioral and environmental correlates of HS/cessation and the determiners or fundamental causes of these factors were extracted via a systematic review and a local qualitative study. As the results revealed, the expected outcomes of the educational program concerning hookah cessation were achieved. As the realization of these outcomes requires certain changes to the behavioral and environmental dimensions, in the next step, the intervention goals of hookah cessation were identified. As the results showed, four behavioral factors involved in the unhealthy HS behavior were individual HS, Being in the Company of hookah smokers, Visiting tempting and contaminated places and Physical and mental dependence on HS (habit), In addition, four effective environmental factors were found at different interpersonal, organizational, community and policy levels. These include, respectively: recommendation and motivation for cessation by influential figures, care providers' poor inadequate knowledge and skill, Easy acceptance of hookah in society, and the lack of effective rules. Knowledge, awareness, social norms, Motivation to comply, skill and self-efficacy, habit, were among the determining factors of hookah cessation. Employment of a systematic is based on evidence and cooperation and is guided by a assessing the needs of the target population. Such a method can suggest more purposive and relevant intervention goals so as to cease HS. The aim would be to intervene in the purposes of the above-mentioned change, as compared in predetermined interventions, and increase the chances of HS cessation among women.
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Affiliation(s)
- Sakineh Dadipoor
- Student Research Committee, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Heyrani
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Dadipoor S, Mirzaei-Alavijeh M, Aghamolaei T, Heyrani A, Ghaffari M, Ghanbarnejad A. Predictors of hookah smoking frequency among women in the South of Iran: A cross-sectional study. J Ethn Subst Abuse 2020; 21:1-19. [PMID: 33135955 DOI: 10.1080/15332640.2020.1836703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The prevalence of hookah smoking has grown over the past decades in Iran especially in the south of the country. This study aimed to determine the behavioral and socio-demographic predictors of the hookah smoking frequency among women in southern Iran. This research was conducted on 400 women hookah smokers selected through multi-stage sampling method. Data were collected from October 2018 to September 2019 using a questionnaire guided by literature. Ordinal logistic regression analysis was run to determine the influential behavioral and socio-demographic predictors involved in the frequency of hookah smoking. Variables with a P-value of less than 0.05 in the final fitting model were associated with the outcome variable (frequency of hookah smoking per day1 = once a day, 2 = twice a day, 3 = three times a day, 4 = more than three times a day). We found that the longer duration of hookah smoking, family usage of hookah smoking, beginning to smoke hookah with peers, absence of either parent in family (single-parent families and a lack of prior intention to cease smoking), ever-married women and low socio-economic status (SES) predicted the frequency of hookah smoking. To prevent the behavior and make effective interventions to reduce hookah smoking, policy-makers should stay focused on factors other than internal motivations. Focus on the companies surrounding women smokers, quitting the habit of hookah smoking and effective interventions to decrease one's intention to smoke hookah can help reduce such unhealthy behaviors.
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Affiliation(s)
- Sakineh Dadipoor
- Student Research Committee, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ali Heyrani
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Ghanbarnejad
- Tobacco and Health Research center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Dadipoor S, Kok G, Heyrani A, Aghamolaei T, Ghaffari M, Ghanbarnezhad A. An intervention development for cessation of hookah smoking among Iranian women: study protocol for a systematic and theory-based approach to intervention design. Addict Sci Clin Pract 2020; 15:6. [PMID: 32014048 PMCID: PMC6998820 DOI: 10.1186/s13722-020-0184-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/29/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Hookah smoking is an emerging global health issue, especially in Eastern Mediterranean region; and accordingly, women are at the center of this issue as they have a more positive attitude towards hookah smoking. Also, the rate of hookah smoking is increasing at a faster rate among women compared to men. The aim of the present study will be systematically designing and implementing an educational intervention program for hookah smoking cessation among 15 years old women and older in the Iranian southern city of Bandar Abbas. METHODS We will use intervention mapping methodology for designing the study. Due to the breadth of factors affecting hookah smoking and the complexity of hookah cessation, we will initially conceptualize hookah smoking cessation program as a set of purposeful activities designed to stop the hookah smoking. In the first step (need assessment), the environmental and behavioral factors related to hookah smoking/cessation and the determinants of these factors will be determined by systematic review and local qualitative study. Then, based on the results of the first step, the behavioral and environmental goals of hookah smoking cessation will be identified. In the second step, the practical goals will be determined for each of the behavioral and environmental outcomes; and then, the logic and matrix of change objectives will be designed using the determinants extracted from the previous step. The products of the second step will be the intervention goals. In the third step, theoretical and practical methods affecting each of the intervention goals will be identified. In the fourth step, contents of educational program for hookah cessation will be produced. The fifth step will be about planning to implement the program. In the sixth step, the effectiveness of designed program will be evaluated in a quasi-experimental intervention. DISCUSSION Appropriate development and successful implementation of a hookah cessation intervention requires a systematic and theory-based approach. We believe that using Intervention Mapping (IM) as the guiding methodology will make it possible to address complexities of developing an intervention program. Also, reflections on the quasi-experimental research and describing the context and executed methods of implementation would contribute to the development of IM and the knowledge needed for the implementation of program. Trial registration IRCT20190126042494N1, Registered 3.3.2019. https://en.irct.ir/trial/37129.
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Affiliation(s)
- Sakineh Dadipoor
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Gerjo Kok
- Department of Work and Social Psychology, School of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ali Heyrani
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Ghanbarnezhad
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Dadipoor S, Heyrani A, Aghamolaei T, Ghanbarnezhad A, Ghaffari M. Predictors of Hookah Smoking among Women in Bandar Abbas, Southern Iran: A Cross-Sectional Study Based on the Intervention Mapping Protocol. Subst Use Misuse 2020; 55:1800-1807. [PMID: 32441183 DOI: 10.1080/10826084.2020.1765807] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background: The purpose of this study was to determine the predictors of hookah smoking (HS) among professional HS women in Bandar Abbas, southern Iran using intervention mapping protocol. Methods: The present cross-sectional study is part of a larger study, which was conducted on 332 HS women using a multistage (clustered and randomized) process. Data were collected from October 2018 to August 2019 using a researcher-made questionnaire. Results: Mean age of the participants was 36.1 ± 13.3 years. Ordinal regression model, after the control of confounding variables, showed that attitudes, self-efficacy, habits, and intention were the most important predictors of HS behavior in women (OR = 1.14). The prevalence of HS was 1.76 times higher in women who did not want to quit hookah. Knowledge and Social norms were not associated with the HS behavior. Conclusions: According to the present findings, changing or eliminating women's positive attitude toward HS is deemed possible through reducing the social acceptance of HS in enculturating the negative attitude in society, enhancing women's self-efficacy via purposeful and specific education on resisting hookah temptation, unraveling all factors involved in habit formation and adjusting these factors through long-term interventions and timely interventions to affect intention to consumption before the actual occurrence of behavior (HS).
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Affiliation(s)
- Sakineh Dadipoor
- Student Research Committee, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ali Heyrani
- Student Research Committee, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amin Ghanbarnezhad
- Department of Epidemiology And Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohtasham Ghaffari
- Environmental & Occupational Hazards Control Research Center, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran
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Dadipoor S, Kok G, Aghamolaei T, Ghaffari M, Heyrani A, Ghanbarnezhad A. Explaining the determinants of hookah consumption among women in southern Iran: a qualitative study. BMC Public Health 2019; 19:1655. [PMID: 31823785 PMCID: PMC6902318 DOI: 10.1186/s12889-019-7917-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 11/07/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The prevalence of hookah consumption has been on the increase in Iran over the past two decades. This rate is higher among women than men in the south of Iran than other geographical areas. The purpose of this study was to explain the determinants of hookah consumption among indigenous women of Bandar Abbas city, southern Iran. METHODS This is the first qualitative study with the conventional content analysis approach that has examined the factors affecting the consumption of hookah at all ecological levels in 2018-2019. Participants, with a maximum variation in terms of age, education, occupation, hookah consumption and geographical areas of the city, were selected purposefully to take part in a semi-structured interview. The data were recorded, typed and analyzed according to the framework of the ecological model of health promotion at five levels (intrapersonal, interpersonal, organizational, social and political). The interview continued until data saturation. MAXQDA software version 10 was used for data management. RESULTS Interviews were conducted with 56 participants (21 female hookah smokers, 15 female ex- smokers, and 20 experienced experts). A total of eight main categories were extracted from the data including; positive attitude towards hookah consumption, psychosocial needs, sensory charms of hookah, individual factors, family factors, cultural-environmental backgrounds, social-political backgrounds, and economic challenges. CONCLUSIONS The results indicated the extensive influence of internal and external factors on the consumption of hookah. In order to successfully reduce the consumption of hookah, it is essential to consider intrapersonal, interpersonal, organizational, social and political factors.
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Affiliation(s)
- Sakineh Dadipoor
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Gerjo Kok
- Department of Work and Social Psychology, School of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Heyrani
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Amin Ghanbarnezhad
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Alzahrane A, West R, Ubhi HK, Brown J, Abdulqader N, Samarkandi O. Evaluations of clinical tobacco cessation interventions in Arab populations: A systematic review. Addict Behav 2019; 88:169-174. [PMID: 30205256 DOI: 10.1016/j.addbeh.2018.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Tobacco smoking is prevalent among Arab smokers. Interventions to support smoking cessation may differ in effectiveness in this population from Western populations usually studied. This review assessed evidence of effectiveness of clinical smoking interventions in Arab smokers. METHODS A systematic search for comparative trials evaluating tobacco cessation interventions in Arab populations was conducted in the MEDLINE, EMBASE, PyschINFO, CINHAL and Web of Science databases. Behavioural, pharmacological and combined interventions were included. Reference lists of included studies were hand searched. The outcome measure was self- reported tobacco abstinence at the final follow-up, with biochemical verification where available. Assessment of evidence for effectiveness was undertaken using Bayes Factors. RESULTS A total of 659 titles and abstracts were identified. Five studies met the inclusion criteria. Four of these were randomized controlled trials and one was a non-randomized comparative trial. Differences between study features precluded meaningful aggregation for a meta-analysis. The four randomized trials all yielded Bayes Factors <1, suggesting no effect of the intervention compared with the control condition. The non-randomized trial, conducted in tuberculosis clinics in Sudan, yielded an extremely high Bayes Factor (>1000), supporting the hypothesis of effectiveness; however, the study was judged to have a high risk of bias. CONCLUSIONS As yet, there is no convincing direct evidence that clinical smoking cessation interventions, which are found to be effective in Western populations, are also effective for Arab smokers. There is an urgent need for high quality randomized trials evaluating interventions in this population.
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Affiliation(s)
- Abdallaziz Alzahrane
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - Robert West
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
| | - Harveen Kaur Ubhi
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - Jamie Brown
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - Nabeel Abdulqader
- Prince Sultan College for Emergency Medical Services, King Saud University, Saudi Arabia
| | - Osama Samarkandi
- Prince Sultan College for Emergency Medical Services, King Saud University, Saudi Arabia
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Hani J, Abdel Nour G, Matta J, Jazzar B, Pfaffl MW, Hanna-Wakim L, Abdel Nour AM. Shisha microbiota: the good, the bad and the not so ugly. BMC Res Notes 2018; 11:446. [PMID: 29980232 PMCID: PMC6035416 DOI: 10.1186/s13104-018-3553-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 06/28/2018] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Over the last decade, there has been a rapid expansion of the trendy water pipe smoking around the world especially among younger adults. The initial objective of this study was to identify the microbiota of the shisha, which may either be of no harm for the smoker or enhance the threat on his well-being. The total DNA for the metagenomics study was conducted on three different shishas from three different delivery shops in Jounieh, Lebanon. The microbiota in two solid parts of the shisha, shaft and hose, were analysed including the fresh tobacco and the water in the bowl. All samples were analysed using high-throughput sequencing of 16S rRNA gene amplicons. RESULTS Overall, more than 40 bacterial genera were found in the three investigated shishas, some are commensal others are pathogenic. All three shishas showed similar microbial content regarding the bacteria inhabiting in water, shaft, or hose. From the results of this study it appears that a very large quantity of bacteria was found in the water pipes, some are harmful and others beneficial. We assume that the presence of gut dependent microbiota is related to the loose hygienic conditions in which the shisha is prepared.
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Affiliation(s)
- Julia Hani
- Faculty of Agricultural and Food Sciences, The Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Ghenwa Abdel Nour
- Faculty of Agricultural and Food Sciences, The Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Joanne Matta
- Faculty of Agricultural and Food Sciences, The Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Boushra Jazzar
- Faculty of Agricultural and Food Sciences, The Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Michael W. Pfaffl
- Institute of Animal Physiology & Immunology, Faculty of Life Sciences, Technical University of Munich, Freising, Munich, Germany
| | - Lara Hanna-Wakim
- Faculty of Agricultural and Food Sciences, The Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Afif M. Abdel Nour
- Faculty of Agricultural and Food Sciences, The Holy Spirit University of Kaslik, Jounieh, Lebanon
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