Factors Associated With Smoking Initiation Among Jordanians: Implications for Tobacco Control and Prevention
Hamzah A. Hasan, Mohaned Odah, Lana Sbitan, Shahed Al-Ghsoon, Omar Alzraikat, Omar H. Suleiman, Nour Elsahoryi, Ayman Issa Nabhan, Kamal Bani-HaniBackground
The study of determinants shaping the process of smoking initiation is essential for developing effective preventive programs, especially in regions experiencing a surge in the number of smokers, as well as shifting in gender norms. This paper, as part of a broader study targeting smoking-related behaviors among the Jordanian population, represents an analysis of factors associated with smoking initiation.This sub-study specifically focuses on smoking initiation-associated factors.
Methods
An analytical cross sectional surgery-based study was conducted among 1022 Jordanian smokers, assessing social influences, educational level at time of smoking uptake, motivational factors, and tobacco and nicotine products used. Associations between variables and gender were studied and interpreted using Cramer’s V values to estimate effect size.
Results
The strongest association was reported between educational level at time of initiation and gender (Cramer’s V = 0.345, p < 0.001). While males were more likely to start smoking at lower educational levels and earlier ages, women tended to report smoking uptake during university stages (bachelor’s or postgraduate). Regarding the type of tobacco product used, a strong statistically significant association was identified (Cramer’s V = 0.37, p < 0.001), with younger smokers preferring e-cigarettes. The most prevalent social factor encouraging smoking uptake was peer influence, with 75.5% of responders reporting close friends as smokers at time of starting.Male participants were significantly more likely than females to report that school peers, favorite teachers, and identity-related concerns, such as appearing mature, were motivations for smoking initiation.
Conclusion
This paper demonstrates that smoking uptake is shaped by a complicated interaction between age, gender norms, educational level, peer influence, and social/cultural motivational factors. Such findings highlight the critical need for educational stage and gender tailored preventive interventions targeting the social environments mostly associated with smoking initiation.