Smokeless Tobacco Use in Iran: A Systematic Review

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.

Psychometric properties of Fagerström Tolerance Questionnaire among Turkmen Nass (Naswar) users

BACKGROUND

Smokeless tobacco (SLT) products are gaining popularity around the globe, particularly in Asia, Africa, and the Middle East. Among these products, Nass (aka Naswar) is popular among the Turkmen ethnicity in Iran. Although several studies reported nicotine dependence (ND) among SLT users, psychometric instruments have never been utilized to specifically measure ND among Nass users. Therefore, in this study, we aimed to evaluate the reliability and validity of the Fagerström Tolerance Questionnaire (FTQ) among Turkmen Nass users.

METHODS

A cross-sectional, descriptive study was conducted in June-December 2018 among 411 Turkmen adults who currently (past 30 days) used Nass. Two bilinguals (Persian English) individuals translated and back-translated the FTQ-SLT, which maintained both the questionnaire's accuracy and cultural sensitivity. Construct validity was assessed using exploratory and confirmatory factor analysis.

RESULTS

The mean age and standard deviation for initiating Nass were 22.5 ± 11.81 years. Exploratory and confirmatory factor analysis indicated a single-factor solution with 8-items that captured several important ND components. Using Nass frequently, soon after waking, when sick, and experiencing a craving were some of the main components. Subgroups comparison revealed that higher scores occurred among those who were married, had Nass user(s) in their immediate family, and consumed bulk form of Turkmen Nass directly without using a tissue.

CONCLUSION

Our findings show that the FTQ- SLT is a fairly reliable and valid scale to measure ND among Turkmen Nass users and warrants further testing to accommodate cross-cultural differences in other populations.

Students' beliefs about smokeless tobacco use in Chabahar city: A qualitative study using focus groups

BACKGROUND

Smokeless tobacco use is a public health problem. This study explored students' beliefs about smokeless tobacco use in Chabahar, Iran.

MATERIALS AND METHODS

The qualitative study was conducted using three Focused Group Discussions among 24 students aged 12-14 years in Chabahar City. Focus Group Guide Morgan was used. Qualitative Content Analysis was used to explore and extract codes and themes. The data analysis process was carried out in accordance with the stages of proposed by Graneheim and Lundman. Guba and Lincoln criteria were used for evaluating research transferability.

RESULTS

Two main themes emerged from the analysis including; beliefs of being useful and harmful. Each of these themes is divided into subthemes with useful or harmful physical and psychological beliefs. Four subthemes included: beliefs of being useful physically, beliefs of being useful psychologically, harmful beliefs physically, and harmful beliefs psychologically.

CONCLUSIONS

One of the more significant findings to emerge from this study is that many students mentioned the benefits of using smokeless tobacco to reduce toothache, relieve headaches, and bad breath. This information can be used to develop targeted interventions aimed at reducing smokeless tobacco consumption. However, more research on this topic needs to be undertaken before the association between kinds of beliefs and smokeless tobacco consumption is more clearly understood.