The Reasons for Using Smokeless Tobacco: A Review

A qualitative study to explain the determinants of naswār consumption from the point of view of its consumers

BACKGROUND

One of the health problems related to tobacco that is increasing in society is the consumption of naswār. This study aimed to investigate the determinants of naswār consumption from the point of view of its consumers.

MATERIALS AND METHODS

In this qualitative study, 47 men with an age range of 23- 54 years who consumed naswār from the southern cities of Fars province in Iran were selected and interviewed. These participants were selected using purposive and snowball sampling methods, and data was collected using semi-structured interviews. Data analysis was done using the conventional approach of qualitative content analysis.

RESULTS

Three main categories were extracted: (1) Individual factors and beliefs related to naswār consumption (Non-addictive, similar and replacement with smoking, Not causing confusion, Being relaxing and enjoyable, increasing the effect of using other substances, reducing fatigue, causing body aches due to lack of use, having long effect, not causing physical problems, not causing weakness, having fast effect, increasing energy to work), (2) Environmental factors (being available, Having the low price, being consumed anywhere, being easy to store and carry, Not understanding others), and (3) Social factors (as a hobby, lack of entertainment, relatives and friends of the consumer, lack of ban on the consumption of naswār, lack of family opposition).

CONCLUSION

As the results showed, there are many reasons for consuming naswār based on individual, environmental, and social factors. Formulation of laws, health policies, and education can be effective in adopting strategies to prevent and control the consumption of naswār.

Oral mucosal changes caused by nicotine pouches: case series

Oral nicotine pouches are the latest products in the tobacco industry. They are manufactured by large tobacco companies and entice tobacco or nicotine addicts, although the products are presented as a 'harmless choice.' Nevertheless, dentists and oral health specialists worry about oral mucosal changes due to product interactions with the oral mucosa. Unfortunately, there are no case reports of oral mucosal changes from nicotine pouches that are also investigated histopathologically. The aim of the present study was to visually and histopathologically investigate oral mucosal changes in nicotine pouch users. An online retrospective survey regarding medical and dental health, dietary habits, and tobacco consumption habits was conducted (n = 50). Respondents were selected for further intraoral and histopathological investigation based on the inclusion criteria. All five respondents had oral lesions that were histopathologically analyzed. Visually, the lesions varied in form and intensity, but all appeared white at the location where the pouches were placed. Histopathological analyses revealed parakeratosis with acanthotic epithelium, intraepithelial and connective tissue oedema, and chronic inflammatory infiltration with lymphocytes and macrophages. Participants received information about nicotine cessation and oral health recommendations. In conclusion, nicotine pouches significantly impacted oral mucosa with white lesions that revealed important changes at the cellular level.

Health effects associated with chewing tobacco: a Burden of Proof study

Chewing tobacco use poses serious health risks; yet it has not received as much attention as other tobacco-related products. This study synthesizes existing evidence regarding the health impacts of chewing tobacco while accounting for various sources of uncertainty. We conducted a systematic review and meta-analysis of chewing tobacco and seven health outcomes, drawing on 103 studies published from 1970 to 2023. We use a Burden of Proof meta-analysis to generate conservative risk estimates and find weak-to-moderate evidence that tobacco chewers have an increased risk of stroke, lip and oral cavity cancer, esophageal cancer, nasopharynx cancer, other pharynx cancer, and laryngeal cancer. We additionally find insufficient evidence of an association between chewing tobacco and ischemic heart disease. Our findings highlight a need for policy makers, researchers, and communities at risk to devote greater attention to chewing tobacco by both advancing tobacco control efforts and investing in strengthening the existing evidence base.

A model to explain smokeless tobacco consumption in adults: A grounded theory study

Introduction

Smokeless tobacco use remains a significant public health concern, necessitating the acquisition of comprehensive and extensive data to effectively address and control its consumption. Understanding the underlying patterns of consumption is crucial for this purpose.

Objective

This study aimed to develop a model that explains smokeless tobacco consumption among adults in the southeastern province of Iran, specifically in the city of Chabahar.

Methods

A qualitative study was conducted using a grounded theory approach with inductive processes. The participants consisted of 30 adults aged 18-64 years from Chabahar City in southeastern Iran. Purposive sampling was used to select participants, and data collection continued until theoretical saturation was achieved. Data analysis followed Strauss and Corbin's perspective, involving four stages: Analyzing Data for Concepts, Analyzing Data for Context, Bringing Process into the Analysis, and Integrating Categories.

Results

The analysis of data yielded three main categories: "starting to use," "continued use," and "cessation attempts," each with their respective subcategories. Additionally, two main categories related to the consequences of smokeless tobacco consumption were identified: "addiction and efforts to overcome addiction," also with their respective subcategories.

Conclusion

The Dependency Cycle Model in Consumption provides a comprehensive understanding of the contextual factors, processes, and consequences associated with smokeless tobacco consumption. This model serves as a valuable tool for researchers aiming to develop effective interventions in the field of smokeless tobacco consumption.

Psychological impacts of the COVID-19 on health care providers

BACKGROUND

Psychological distress, functional impairment, reduced quality of life, and subjective well-being were the most common negative psychological effects during the COVID-19 outbreak. The present study was to investigate the impact of job stress, hospital resources, and fear of infection on job burnout of medical staff in Iran during the Covid-19 pandemic.

MATERIALS AND METHODS

In this cross-sectional study, 223 hospital staff from several public and private hospitals in Tehran and Mazandaran provinces, selected through convenience sampling. The questionnaire included the validated "Maslach Burnout Inventory (MBI)", "job stress scale (Parker and DeCotiis, 1983)", and the questions about "hospital resources", and "fear of infection" developed by the researcher wereused to collect data. Data were analyzed by correlation and regression methods using SPSS software.

RESULTS

The results revealed that there was a significant difference in the scores on the burnout scale, in the dimension of emotional exhaustion, but the differences were not significant in the dimensions of depersonalization and self-accomplishment. Also, job stress and fear of infection significantly correlated with job burnout in the dimensions of emotional exhaustion and personal-accomplishment. However, the correlation between the adequacy of hospital resources and job burnout in these two dimensions was not significant. None of the three variables of the study showed a significant correlation with the dimension of depersonalization.

CONCLUSION

It is essential to consider the package of psychological interventions which, primarily includes finding the sources of stress to resolve them through stress management programs, based on education and training in stress coping and management strategies.