1
|
Pahlavanzadeh B, Kolagari S, Ebrahimi Kalan M, Taleb ZB, Ward KD, Zare S, Charkazi A. Psychometric properties of Fagerström Tolerance Questionnaire among Turkmen Nass (Naswar) users. Addict Sci Clin Pract 2023; 18:32. [PMID: 37217987 DOI: 10.1186/s13722-023-00390-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/08/2023] [Indexed: 05/24/2023] Open
Abstract
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.
Collapse
Affiliation(s)
| | - Shohreh Kolagari
- Faculty of Nursing & Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, 411 S. Nedderman Drive Box 19407, Arlington, TX, 76019-0407, USA
| | - Kenneth D Ward
- School of Public Health, University of Memphis, 3720 Alumni Ave, Memphis, TX, 38152, USA
| | - Samane Zare
- School of Medicine, Department of Social Medicine, Population, & Public Health, University of California Riverside, 3333 14th Street, Riverside, CA, 92501, USA
| | - Abdurrahman Charkazi
- Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Late Falsefi University Complex, KM 5of Gorgan-Sari Road, Gorgan, Iran.
| |
Collapse
|
2
|
Bongongo T, Jeewa Y, Nzaumvila DK, Govender I. Awareness of health risks associated with smokeless tobacco use among users in Pretoria. S Afr Fam Pract (2004) 2022; 64:e1-e6. [PMID: 36453800 PMCID: PMC9724137 DOI: 10.4102/safp.v64i1.5560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Smokeless tobacco (ST) refers to all tobacco-containing products that are not smoked but rather consumed through other means. Contrary to the popular belief that ST products are safe, the use of such products exposes users to health risks. To assess the awareness of health risks associated with ST use among users in a Pretoria community, the study was conducted in Ramotse community, located in Tshwane region 2, Gauteng, South Africa. METHODS This was a cross-sectional design, using a piloted, structured and self-administered questionnaire. RESULTS Of 479 participants with a mean age of 43 years (ranging from 18 to 89 years), most were in the age group 30-39 years (148; 31.6%), followed by ≥ 50 years (138; 29.4%). There were more females (371; 77.5%), more unemployed (263; 54.9%), married (236; 49.7%), had reached the secondary level of education (270; 56.4%), did not have any chronic illness (274; 57.2%), used snuff by nose (338; 70.6%), and were unaware of health risks associated with ST use (452; 94.4%). CONCLUSION This study has demonstrated a poor awareness of health risks associated with ST use among the users in a Pretoria community. As a result, health education at various levels of the community (clinic, schools, ward-based outreach team or WBOT, etc.) could be one strategy for resolving the problem.
Collapse
Affiliation(s)
- Tombo Bongongo
- Department of Family Medicine & Primary Health Care, School of Health, Sefako Makgatho Health Sciences University, Pretoria.
| | | | | | | |
Collapse
|
3
|
Thawal VP, Tzelepis F, Ahmadi S, Palazzi K, Paul C. Addiction perceptions among users of smokeless or combustible tobacco attending a tertiary care hospital in India. Drug Alcohol Rev 2022; 41:1184-1194. [PMID: 35238094 DOI: 10.1111/dar.13440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/02/2022] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Addiction plays a key role in continued tobacco use. The study assessed association of perceived personal addiction and the perceived addictiveness of different forms of tobacco with type of tobacco product used, demographic characteristics and socio-cultural factors. METHODS A cross-sectional survey of 607 adult tobacco users with age 18 years and above attending a general medicine out-patient department was conducted. Participants were asked questions on perceived personal addiction to tobacco use and perception of addiction on tobacco products. Logistic regression was applied to investigate the association between demographic characteristics, type of tobacco, socio-cultural factors and addiction perceptions. RESULTS The odds of perceived addiction (PA) were lower among smokeless tobacco (SLT) users [OR (95% CI): 0.57 (0.37, 0.89) P = 0.01]. An increase in the odds of PA was seen as age increased [OR (95% CI):1.02 (1.00, 1.03) P = 0.01] and participants with secondary education and above had higher odds of PA compared to participants with no formal education [OR (95% CI): 1.68 (1.09, 2.58) P = 0.02]. The odds of perceiving SLT products to be addictive was lower among SLT users [OR (95% CI): 0.48 (0.30, 0.75) P = 0.002)] compared to combustible tobacco users. The odds of perceiving SLT products to be addictive was lower [(OR (95% CI): 0.35 (0.18, 0.67) P = 0.002)] among females. Participants with secondary education and above had higher odds of perceiving combustible [OR (95% CI): 1.80 (1.17, 2.77) P = 0.008)] and SLT products [OR (95% CI): 1.98 (1.20, 3.30) P = 0.008)] to be addictive compared to no schooling. DISCUSSION AND CONCLUSIONS There is a need to raise awareness in India of the addictiveness of tobacco, particularly for users of SLT, younger people and those with less education.
Collapse
Affiliation(s)
- Vaibhav P Thawal
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
| | - Sima Ahmadi
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia
| | - Kerrin Palazzi
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia
- Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, Newcastle, Australia
| |
Collapse
|
4
|
Moafa I, Crutzen R, van den Borne B, Jafer M, Shabi M, Al-Khaldi A, Abu-Zawah A, Al-Jabri H, Hedad I. Towards a better understanding of the psychosocial determinants associated with adults' use of smokeless tobacco in the Jazan Region of Saudi Arabia: a qualitative study. BMC Public Health 2022; 22:732. [PMID: 35418076 PMCID: PMC9006419 DOI: 10.1186/s12889-022-13120-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most diagnosed oral cancer cases in Saudi Arabia are in the Jazan region. A common type of smokeless tobacco "Shammah" is prevalent in this region. This study aimed to gain an in-depth understanding of the possible psychosocial determinants of Shammah consumption among adult Shammah users in Jazan region. METHODS A qualitative study was conducted by means of one-on-one interviews among thirty adult Shammah users. Participants were recruited by means of a purposive sampling technique. Data were collected using a semi-structured interview guide utilizing face-to-face and phone-call interviews. Thematic analysis with hybrid approach was used to analyze the dataset. RESULTS Twenty-four sub-codes within four overarching themes were generated. Participants revealed uncertainty related to Shammah composition, how to quit knowledge and Shammah prevention/cessation programs. Shammah use identified as a normal phenomenon in society. Its use was frequently reported in participants' close network but most users faced family and peers' disapproval. Some users expressed joy, happiness and focused when using Shammah. Others were disgusted or neutral. Many users believed Shammah causes cancer and tears oral tissues. Others believed it relieves toothache or has no effect. Majority of users were confident to quit and recalled some quitting aids. Toothache, craving, drinking tea and chewing Khat (leaves of Catha edulis plant that causes moderate euphoria) perceived to be triggers to use Shammah. Availability of Shammah, withdrawal symptoms, stress, lack of support, seeing others using Shammah, losing part of routine and toothache were barriers to quit. CONCLUSIONS Shammah use was associated with uncertainty about Shammah composition and quitting knowledge, social acceptability, influence from family/friends, a range of positive and negative attitudinal beliefs toward its use and high quitting efficacy beliefs. Future interventions targeting Shammah should address the acknowledged triggers and barriers in the present study including the dual use of Shammah and Khat.
Collapse
Affiliation(s)
- Ibtisam Moafa
- Department of Preventive Dental Science, Jazan University, Jazan, Saudi Arabia. .,Department of Health Promotion, Maastricht University/CAPHRI, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Rik Crutzen
- Department of Health Promotion, Maastricht University/CAPHRI, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Bart van den Borne
- Department of Health Promotion, Maastricht University/CAPHRI, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Mohammed Jafer
- Department of Preventive Dental Science, Jazan University, Jazan, Saudi Arabia
| | - Maan Shabi
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | | | | | - Ismaeel Hedad
- Jazan Dental Center, Ministry of Health, Jazan, Saudi Arabia
| |
Collapse
|
5
|
Arora M, Chugh A, Jain N, Mishu M, Boeckmann M, Dahanayake S, Eckhardt J, Forberger S, Huque R, Kanaan M, Khan Z, Mehrotra R, Rahman MA, Readshaw A, Sheikh A, Siddiqi K, Vidyasagaran A, Dogar O. Global impact of tobacco control policies on smokeless tobacco use: a systematic review protocol. BMJ Open 2020; 10:e042860. [PMID: 33361080 PMCID: PMC7768955 DOI: 10.1136/bmjopen-2020-042860] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/15/2020] [Accepted: 12/02/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Smokeless tobacco (ST) was consumed by 356 million people globally in 2017. Recent evidence shows that ST consumption is responsible for an estimated 652 494 all-cause deaths across the globe annually. The WHO Framework Convention on Tobacco Control (FCTC) was negotiated in 2003 and ratified in 2005 to implement effective tobacco control measures. While the policy measures enacted through various tobacco control laws have been effective in reducing the incidence and prevalence of smoking, the impact of ST-related policies (within WHO FCTC and beyond) on ST use is under-researched and not collated. METHODS AND ANALYSIS A systematic review will be conducted to collate all available ST-related policies implemented across various countries and assess their impact on ST use. The following databases will be searched: Medline, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Scopus, EconLit, ISI Web of Science, Cochrane Library (CENTRAL), African Index Medicus, LILACS, Scientific Electronic Library Online, Index Medicus for the Eastern Mediterranean Region, Index Medicus for South-East Asia Region, Western Pacific Region Index Medicus and WHO Library Database, as well as Google search engine and country-specific government websites. All ST-related policy documents (FCTC and non-FCTC) will be included. Results will be limited to literature published since 2005 in English and regional languages (Bengali, Hindi and Urdu). Two reviewers will independently employ two-stage screening to determine inclusion. The Effective Public Health Practice Project's 'Quality Assessment Tool for Quantitative Studies' will be used to record ratings of quality and risk of bias among studies selected for inclusion. Data will be extracted using a standardised form. Meta-analysis and narrative synthesis will be used. ETHICS AND DISSEMINATION Permission for ethics exemption of the review was obtained from the Centre for Chronic Disease Control's Institutional Ethics Committee, India (CCDC_IEC_06_2020; dated 16 April 2020). The results will be disseminated through publications in a peer-reviewed journal and will be presented in national and international conferences. PROSPERO REGISTRATION NUMBER CRD42020191946.
Collapse
Affiliation(s)
- Monika Arora
- HRIDAY, New Delhi, India
- Health Promotion Division, Public Health Foundation of India, Gurugram, Haryana, India
| | | | - Neha Jain
- Health Promotion Division, Public Health Foundation of India, Gurugram, Haryana, India
| | - Masuma Mishu
- Department of Health Sciences, University of York, York, UK
| | | | - Suranji Dahanayake
- Department of Health Sciences, University of York, York, UK
- Ministry of Health, Nutrition and Indigenous Medicine, Colombo, Sri Lanka
| | | | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | | | - Mona Kanaan
- Department of Health Sciences, University of York, York, UK
| | - Zohaib Khan
- Khyber Medical University, Peshawar, Pakistan
| | - Ravi Mehrotra
- Indian Council of Medical Research, India Cancer Research Consortium, New Delhi, India
| | - Muhammad Aziz Rahman
- School of Health, Federation University Australia, Berwick, Victoria, Australia
- La Trobe University, Melbourne, Victoria, Australia
| | - Anne Readshaw
- Department of Health Sciences, University of York, York, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
| | | | - Omara Dogar
- Department of Health Sciences, University of York, York, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
6
|
Solhi M, Fattahi E, Barati H, Mohammadi M, Kasmaei P, Rastaghi S. Smokeless Tobacco Use in Iran: A Systematic Review. ADDICTION & HEALTH 2020; 12:225-234. [PMID: 33244399 PMCID: PMC7679486 DOI: 10.22122/ahj.v12i3.274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Smokeless tobacco (ST) use is one of the most important public health problems in Southeast Asia. The use of these substances increases the incidence of some cancers and other diseases. The purpose of this review study was to investigate on ST use in Iran. Methods A literature search was conducted on PubMed, Google Scholar, and three national databases [Scientific Information Database (SID), IranMedex, and IranDoc] based on the standard search strategy. Findings Most consumer people lived in Sistan and Baluchestan Province (Zahedan and Chabahar Cities) and Golestan Province, Iran. ST use rates ranged from 11.0% to 45.7% among college students in Sistan and Baluchestan (Zahedan and Chabahar) and Golestan. There are various types of ST consumed in Iran that have been mentioned in various articles, including Pan, Gutka, Nass, Naswar, Biti, and Supari. Conclusion Most studies on ST have been conducted in Sistan and Baluchestan and Golestan Provinces and we need more research for other provinces. Consumption by women is a warning and a threat to women's health in the future. Further studies will be needed to find out more precisely the prevalence of consumption in Iran.
Collapse
Affiliation(s)
- Mahnaz Solhi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Fattahi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hadis Barati
- Student Research Committee AND Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parisa Kasmaei
- Department of Health Education and Promotion, School of Health AND Research Center of Health and Environment, Guilan University of Medical Sciences, Rasht, Iran
| | - Sedighe Rastaghi
- Student Research Committee AND Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|