Hostname: page-component-5c6d5d7d68-vt8vv Total loading time: 0.001 Render date: 2024-08-18T12:19:43.491Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychosocial determinants of cigarette smoking among university students in Jordan

Published online by Cambridge University Press:  31 March 2011

M. Farajat ,
C. Hoving  and
H. De Vries
M. Farajat*
Affiliation:
Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
C. Hoving
Affiliation:
Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
H. De Vries
Affiliation:
Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
*
*Address for correspondence: M. Farajat, Department of Health Promotion, Maastricht University, Maastricht, The Netherlands. (Email M.alfarajat@alumni.maastrichtuniversity.nl)
Get access Rights & Permissions [Opens in a new window]

Abstract

The objectives of this study were to describe the prevalence of cigarette use and water pipe smoking in Jordanian university students and to analyze differences in determinants between cigarette smokers and non-smokers. A cross-sectional questionnaire was administered to a random sample of 400 students (18–24 years, 51% males). Smokers were compared with non-smokers on several smoking-related determinants. Data were analyzed using descriptive statistics, t-test, χ2 test and binary logistic regression analysis. The prevalence rates of cigarette use and water pipe smoking were 25.9% and 23.3%, respectively. Cigarette smokers differed significantly from non-smokers on almost all of the assessed determinants. The I-Change model explained 85% of the total variance of cigarette-smoking behavior. Cigarette smoking was determined by being male and older, having more depressive symptoms, having less Muslim identity, being more emancipated, perceiving more pros of smoking, having more modeling from peers and having lower self-efficacy. The popularity of cigarette use and water pipe smoking among Jordanian students necessitates health promotion interventions that motivate students not to engage in smoking behaviors by clearly outlining the outcomes of smoking and the healthier alternatives, how to cope with social influences and difficult situations in order to increase self-efficacy.

Keywords

determinantshealth promotionJordansmoking behavior
Type
Original Articles
Information
Journal of Developmental Origins of Health and Disease , Volume 2 , Issue 3 , June 2011 , pp. 152 - 161
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Mackay, J, Crofton, J. Tobacco and the developing world. Br Med Bull. 1996; 52, 206–221.CrossRefGoogle ScholarPubMed
2. Reddy, K, Yusuf, S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998; 97, 596–601.CrossRefGoogle ScholarPubMed
3. Stebbins, KR. Transnational tobacco companies and health in underdeveloped countries: recommendations for avoiding a smoking epidemic. Soc Sci Med. 1990; 30, 227–235.CrossRefGoogle ScholarPubMed
4. Jordan Department of Statistics, 2007, Retrieved 3 January 2008 from http://www.dos.gov.jo/sdb_pop/sdb_pop_e/inde_o.htm Google Scholar
5. World Health Organization. WHO Report on the Global Tobacco Epidemics, 2008, Retrieved 4 April 2008 from http://www.who.int/tobacco/mpower/mpower_report_prevalence_data_2008.pdf Google Scholar
6. Kandela, P. Nargile smoking keeps Arabs in Wonderland. Lancet. 2000; 356, 1175.Google Scholar
7. Maziak, W, Eissenberg, T, Ward, KD. Patterns of water pipe use and dependence: implications for intervention development. Pharmacol Biochem Behav. 2005; 80, 173–179.CrossRefGoogle Scholar
8. Maziak, W, Ward, K, Soweid, R, Eissenberg, T. Tobacco smoking using a water pipe: a re-emerging strain in a global epidemic. Tob Control. 2004; 13, 227–233.CrossRefGoogle Scholar
9. Tamim, H, Terro, A, Kassem, H, et al. Tobacco use by university students, Lebanon, 2001. Addiction. 2003; 98, 933–939.CrossRefGoogle ScholarPubMed
10. World Health Organization (Tobacco Free Initiative): Advisory Note. Water pipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators, 2005, Retrieved 10 December 2008 from http://www.who.int/tobacco/global_interaction/tobreg/Waterpipe%20recommendation_Final.pdf Google Scholar
11. Augood, C, Duckitt, K, Templeton, AA. Smoking and female infertility: a systematic review and meta-analysis. Hum Reprod. 1998; 13, 1532–1539.Google Scholar
12. Vine, MF, Margolin, BH, Morrison, HI, Hulka, BS. Cigarette smoking and sperm density: a meta-analysis. Fertil Steril. 1994; 61, 35–43.Google Scholar
13. Castles, A, Adams, EK, Melvin, CL, Kelsch, C, Boulton, ML. Effects of smoking during pregnancy. Five meta-analyses. Am J Prev Med. 1999; 16, 208–215.CrossRefGoogle ScholarPubMed
14. Bernstein, IM, Plociennik, K, Stahle, S, Badger, GJ, Secker-Walker, R. Impact of maternal cigarette smoking on fetal growth and body composition. Am J Obstet Gynecol. 2000; 183, 883–886.Google Scholar
15. Hanrahan, JP, Tager, IB, Segal, MR, et al. The effect of maternal smoking during pregnancy on early infant lung function. Am Rev Respir Dis. 1992; 145, 1129–1135.Google Scholar
16. Li, DK, Mueller, BA, Hickok, DE, et al. Maternal smoking during pregnancy and the risk of congenital urinary tract anomalies. Am J Public Health. 1996; 86, 249–253.Google Scholar
17. World Health Organization. Factsheet: Smoking Statistics, 2002, Retrieved 3 January 2008 from http://www.wpro.who.int/media_centre/fact_sheets/fs_20020528.htm Google Scholar
18. Willi, C, Bodenmann, P, Ghali, WA, Faris, PD, Cornuz, J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2007; 298, 2654–2664.CrossRefGoogle ScholarPubMed
19. Bergstrom, J, Eliasson, S, Dock, J. A 10-year prospective study of tobacco smoking and periodontal health. J Periodontol. 2000; 71, 1338–1347.Google Scholar
20. Kofahi, MM, Haddad, LG. Perceptions of lung cancer and smoking among college students in Jordan. J Transcult Nurs. 2005; 16, 245–254.Google Scholar
21. Al-Omari, QD, Hamasha, AA. Gender-specific oral health attitudes and behavior among dental students in Jordan. J Contemp Dent Pract. 2005; 6, 107–114.CrossRefGoogle ScholarPubMed
22. Haddad, L, Malak, M. Smoking habits & attitudes towards smoking among university students in Jordan. Int J Nurs Stud. 2002; 39, 793–802.CrossRefGoogle ScholarPubMed
23. Khader, YS, Alsadi, AA. Smoking habits among university students in Jordan: prevalence and associated factors. East Mediterr Health J. 2008; 14, 897–904.Google Scholar
24. Hashim, T. Smoking habits of students in college of applied medical science, Saudi Arabia. Saudi Med J. 2000; 21, 76–80.Google Scholar
25. Nierkens, V, de Vries, H, Stronks, K. Smoking in immigrants: do socioeconomic gradients follow the pattern expected from the tobacco epidemic? Tob Control. 2006; 15, 385–391.Google Scholar
26. De Vries, H, Mudde, A, Leijs, I, et al. The European smoking prevention framework approach (EFSA): an example of integral prevention. Health Educ Res. 2003; 18, 611–626.Google Scholar
27. De Vries, H, Dijkstra, M, Kuhlman, P. Self efficacy: the third factor besides attitude and subjective norm as a predictor of behavioral intentions. Health Educ Res. 1988; 3, 273–282.Google Scholar
28. Ariza, C, Nebot, M, Tomás, Z, et al. Longitudinal effects of the European smoking prevention framework approach (ESFA) project in Spanish adolescents. Eur J Public Health. 2008; 18, 491–497.Google Scholar
29. Haukkala, A, Vartiainen, E, de Vries, H. Progression of oral snuff use among Finnish 13–16-year-old students and its relation to smoking behaviour. Addiction. 2006; 101, 581–589.CrossRefGoogle ScholarPubMed
30. Holm, K, Kremers, SP, de Vries, H. Why do Danish adolescents take up smoking? Eur J Public Health. 2003; 13, 67–74.Google Scholar
31. Panday, S, Reddy, SP, Ruiter, RA, Bergström, E, de Vries, H. Determinants of smoking cessation among adolescents in South Africa. Health Educ Res. 2005; 20, 586–599.Google Scholar
32. Vitoria, PD, Kremers, SP, Mudde, AN, Pais-Clemente, M, de Vries, H. Psychosocial factors related with smoking behaviour in Portuguese adolescents. Eur J Cancer Prev. 2006; 15, 531–540.Google Scholar
33. De Vries, H, Dijk, F, Wetzels, J, et al. The European smoking prevention framework approach (ESFA): effects after 24 and 30 months. Health Educ Res. 2006; 21, 116–132.CrossRefGoogle Scholar
34. Lotrean, LM, Dijk, F, Mesters, I, Ionut, C, De Vries, H. Evaluation of a peer-led smoking prevention programme for Romanian adolescents. Health Educ Res. 2010; 25, 803–814.Google Scholar
35. Vartiainen, E, Pennanen, M, Haukkala, A, et al. The effects of a three-year smoking prevention programme in secondary schools in Helsinki. Eur J Public Health. 2007; 17, 249–256.Google Scholar
36. De Vries, H, Kremers, SP, Smeets, T, Brug, J, Eijmael, K. The effectiveness of tailored feedback and action plans in an intervention addressing multiple health behaviors. Am J Health Promot. 2008; 22, 417–425.Google Scholar
37. European Smoking Prevention Framework Approach. Final Report, 2002. Department of Health Education and Promotion: Maastricht.Google Scholar
38. Nierkens, V, Stronks, K, Oel, C, De Vries, H. Beliefs of Turkish and Moroccan immigrants in The Netherlands about smoking cessation: implications for prevention. Health Educ Res. 2005; 20, 622–634.Google Scholar
39. Dijkstra, A, De Vries, H, Roijackers, J. Computerized tailored feedback to change cognitive determinants of smoking: a Dutch field experiment. Health Educ Res. 1998; 13, 197–206.CrossRefGoogle ScholarPubMed
40. Ghareeb, AG. Manual of Arabic BDI-II, 2000. Alongo Press, Cairo, Egypt.Google Scholar
41. Heatherton, T, Kozlowski, L, Frecker, R, Fagerstrom, K. The Fagerstrom test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire. Br J Addict. 1991; 86, 1119–1127.Google Scholar
42. Hoving, EF, Mudde, AN, De Vries, H. Predictors of smoking relapse in a sample of Dutch adult smokers; the roles of gender and action plans. Addict Behav. 2006; 31, 1177–1189.CrossRefGoogle Scholar
43. Maziak, W, Ward, KD, Afifi Soweid, RA, Eissenberg, T. Standardizing questionnaire items for the assessment of water pipe tobacco use in epidemiological studies. Public Health. 2005; 119, 400–404.CrossRefGoogle ScholarPubMed
44. Nierkens, V. Smoking in a Multicultural Society: Implications for Prevention, 2006. Department of Social Medicine, Academic Medical Center, University of Amsterdam, Amsterdam.Google Scholar
45. Sutton, S, Marsh, A, Matheson, J. Explaining smokers’ decisions to stop: test of an expectancy-value approach. Soc Behav. 1987; 2, 35–50.Google Scholar
46. Van Oort, F, Der Ende, J, Crijnen, A, et al. Determinants of daily smoking in Turkish young adults in the Netherlands. BMC Public Health. 2006; 6, 294.CrossRefGoogle ScholarPubMed
47. Beck, AT, Steer, RA, Brown, GK. Manual of Beck Depression Inventory-Il, 1996. Psychological Corporation, San Antonio, TX.Google Scholar
48. Alansari, BM. Beck Depression Inventory (BDI-II) items characteristics among undergraduate students of nineteen Islamic countries. Soc Behav Pers. 2005; 33, 675–684.CrossRefGoogle Scholar
49. Alansari, BM. Internal consistency of an Arabic adaptation of the Beck Depression Inventory-II with college students in eighteen Arab countries. Soc Behav Pers. 2006; 34, 425–430.Google Scholar
50. World Health Organization. Diet, Nutrition and the Prevention of Chronic Diseases, 1990, Report of a WHO Study Group (WHO Technical Report Series, no. 797): Geneva.Google Scholar
51. World Health Organization. Recommended Amount of Physical Activity. Retrieved 15 June 2008 from http://www.who.int/dietphysicalactivity/factsheet_recommendations/en/index.html Google Scholar
52. Mohammed, H, Newman, I, Tayeh, R. Smoking among a sample of future teachers in Kuwait. KMJ. 2006; 38, 107–113.Google Scholar
53. Maziak, W. Smoking in Syria: profile of a developing Arab country. Int J Tuberc Lung Dis. 2002; 6, 183–191.Google Scholar
54. Islam, SM, Johnson, CA. Influence of known psychosocial smoking risk factors on Egyptian adolescents’ cigarette smoking behavior. Health Promot Int. 2005; 20, 135–145.CrossRefGoogle ScholarPubMed
55. Maziak, W, Asfar, T, Mzayek, F. Socio-demographic determinants of smoking among low-income women in Aleppo, Syria. Int J Tuberc Lung Dis. 2001; 5, 307–312.Google ScholarPubMed
56. Mandil, A, Hussein, A, Omer, H, Turki, G, Gaber, I. Characteristics and risk factors of tobacco consumption among University of Sharjah students, 2005. East Mediterr Health J. 2007; 13, 1449–1458.Google Scholar
57. Brown C. Tobacco and ethnicity: a literature review, 2004, Retrieved 20 July 2008 from http://www.ashscotland.org.uk/ash/files/tobacco%20and%20ethnicity.pdf Google Scholar
58. World Health Organization. Gender and tobacco control: a policy brief, 2007, Retrieved 13 March 2008 from http://www.who.int/tobacco/resources/publications/general/policy_brief.pdf Google Scholar
59. Afifi, M. Positive health practices and depressive symptoms among high school adolescents in Oman. Singapore Med J. 2006; 47, 960–966.Google Scholar
60. Alansari, B. Prevalence of cigarette smoking among male Kuwait University undergraduate students. Psychol Rep. 2005; 96, 1009–1010.Google Scholar
61. Yunis, F, Mattar, T, Wilson, A. The association between tobacco smoking and reported psychiatric symptoms in an adolescent population in the United Arab Emirates. Soc Behav Pers. 2003; 31, 461–465.Google Scholar
62. Klungsoyr, O, Nygard, JF, Sorensen, T, Sandanger, I. Cigarette smoking and incidence of first depressive episode: an 11-year, population-based follow-up study. Am J Epidemiol. 2006; 163, 421–432.Google Scholar
63. Lasser, K, Boyd, W, Woolhandler, S, et al. Smoking and mental illness: a population-based prevalence study. JAMA. 2000; 284, 2606–2610.Google Scholar
64. Murphy, JM, Horton, NJ, Monson, RR, et al. Cigarette smoking in relation to depression: historical trends from the Stirling county study. Am J Psychiatry. 2003; 160, 1663–1669.Google Scholar
65. Maziak, W, Hammal, F, Rastam, S, et al. Characteristics of cigarette smoking and quitting among university students in Syria. Prev Med. 2004; 39, 330–336.CrossRefGoogle ScholarPubMed
66. Afifi Soweid, RA, Khawaja, M, Salem, MT. Religious identity and smoking behavior among adolescents: evidence from entering students at the American University of Beirut. Health Commun. 2004; 16, 47–62.Google Scholar
67. Al-Haddad, N, Hamadeh, RR. Smoking among secondary-school boys in Bahrain: prevalence and risk factors. East Mediterr Health J. 2003; 9, 78–86.Google Scholar
68. Whooley, MA, Boyd, AL, Gardin, JM, Williams, DR. Religious involvement and cigarette smoking in young adults: the CARDIA study (coronary artery risk development in young adults) study. Arch Intern Med. 2002; 162, 1604–1610.Google Scholar
69. US Department of Health and Human Services. Preventing Tobacco Use among Young People: A Report of the Surgeon General, 1994. US Government Printing Office, Washington, DC.Google Scholar
70. Nierkens, V, Stronks, K, de Vries, H. Attitudes, social influences and self-efficacy expectations across different motivational stages among immigrant smokers: replication of the Ø pattern. Prev Med. 2006; 43, 306–311.CrossRefGoogle ScholarPubMed
71. Nierkens, V, Stronks, K, Oel, C, De Vries, H. Beliefs of Turkish and Moroccan immigrants in The Netherlands about smoking cessation: implications for prevention. Health Educ Res. 2005; 20, 622–634.Google Scholar
72. Dlamini, S, Taylor, M, Mkhize, N, et al. Gender factors associated with sexual abstinent behaviour of rural South African high school going youth in KwaZulu-Natal, South Africa. Health Educ Res. 2009; 24, 450–460.Google Scholar
73. Taylor, M, Dlamini, SB, Nyawo, N, et al. Reasons for inconsistent condom use by rural South African high school students. Acta Paediatr. 2007; 96, 287–291.Google Scholar
74. Taylor, M, Dlamini, SB, Sathiparsad, R, Jinabhai, C, de Vries, H. Perceptions and attitudes of secondary school students in Kwazulu-Natal towards virginity testing. Health SA Gesondheid. 2007; 12, 27–36.Google Scholar
75. Breslau, N, Peterson, EL. Smoking cessation in young adults: age at initiation of cigarette smoking and other suspected influences. Am J Pub Health. 1996; 86, 214–220.Google Scholar
76. Caraballo, RS, Giovino, GA, Pechacek, TF, Mowery, PD. Factors associated with discrepancies between self-reports on cigarette smoking and measured serum cotinine levels among persons aged 17 years or older: Third National Health and Nutrition Examination Survey, 1988–1994. Am J Epidemiol. 2001; 153, 807–814.Google Scholar
77. Morabia, A, Bernstein, MS, Curtin, F, Berode, M. Validation of self-reported smoking status by simultaneous measurement of carbon monoxide and salivary thiocyanate. Prev Med. 2001; 32, 82–88.CrossRefGoogle ScholarPubMed
78. Vartiainen, E, Seppälä, T, Lillsunde, P, Puska, P. Validation of self reported smoking by serum cotinine measurement in a community-based study. J Epidemiol Community Health. 2002; 56, 167–170.Google Scholar