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      Factors contributing to nass consumption among Iranian Turkmen: A qualitative study

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          Abstract

          INTRODUCTION

          Nass is a smokeless tobacco product. Iranian Turkmen have a long history of nass consumption. However, the factors contributing to nass consumption among Iranian Turkmen are not known. The purpose of the present study is to examine the factors contributing to nass consumption among Iranian Turkmen.

          METHODS

          This qualitative study was conducted between January and March 2016 in four Turkmen cities of Golestan province in Iran. Participants included 34 male Turkmen nass consumers. Data were collected through individual and group interviews and were analyzed by content analysis. Data management was done by qualitative data analysis software MAXQDA, Version 10.

          RESULTS

          The results of data analysis revealed the following as the main reasons for nass consumption by the study population: 1) cultural, social, and environmental facilitators, 2) nass was considered as an alternative to cigarette smoking, 3) nass was believed to intensify the effects of opium and other drugs, 4) specific occupations and circumstances, and 5) beliefs related to nass.

          CONCLUSIONS

          Cultural and historical backgrounds, convenient access to nass at a very low price, curiosity, emulation, and peer pressure were the main factors driving nass consumption among Iranian Turkmen. Various beliefs, such as the idea that nass intensifies the effects of opium and alcohol, calms the nerves, and helps individuals quit smoking were also found to contribute to this phenomenon. Finally, individuals in certain lines of work, such as fishing, driving combines, and military service, were more likely to consume nass.

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          Most cited references14

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          Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review

          Background In spite of the negative health effects of waterpipe tobacco smoking, its use is becoming more common. The objective of this study is to systematically review the medical literature for motives, beliefs and attitudes towards waterpipe tobacco smoking. Methods We electronically searched MEDLINE, EMBASE, and the ISI the Web of Science in January 2012. We included both quantitative and qualitative studies. We selected studies and abstracted data using standard systematic review methodology. We synthesized data qualitatively. Results We included 58 papers reporting on 56 studies. The main motives for waterpipe tobacco smoking were socializing, relaxation, pleasure and entertainment. Peer pressure, fashion, and curiosity were additional motives for university and school students while expression of cultural identity was an additional motive for people in the Middle East and for people of Middle Eastern descent in Western countries. Awareness of the potential health hazards of waterpipe smoking was common across settings. Most but not all studies found that the majority of people perceived waterpipe smoking as less harmful than cigarette smoking. Waterpipe smoking was generally socially acceptable and more acceptable than cigarette smoking in general. In Middle Eastern societies, it was particularly more acceptable for women’s use compared to cigarette use. A majority perceived waterpipe smoking as less addictive than cigarette smoking. While users were confident in their ability to quit waterpipe smoking at any time, willingness to quit varied across settings. Conclusions Socializing, relaxation, pleasure and entertainment were the main motives for waterpipe use. While waterpipe users were aware of the health hazards of waterpipe smoking, they perceived it as less harmful, less addictive and more socially acceptable than cigarette smoking and were confident about their ability to quit.
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            Effect of smokeless tobacco (snus) on smoking and public health in Sweden.

            J Foulds (2003)
            To review the evidence on the effects of moist smokeless tobacco (snus) on smoking and ill health in Sweden. Narrative review of published papers and other data sources (for example, conference abstracts and internet based information) on snus use, use of other tobacco products, and changes in health status in Sweden. Snus is manufactured and stored in a manner that causes it to deliver lower concentrations of some harmful chemicals than other tobacco products, although it can deliver high doses of nicotine. It is dependence forming, but does not appear to cause cancer or respiratory diseases. It may cause a slight increase in cardiovascular risks and is likely to be harmful to the unborn fetus, although these risks are lower than those caused by smoking. There has been a larger drop in male daily smoking (from 40% in 1976 to 15% in 2002) than female daily smoking (34% in 1976 to 20% in 2002) in Sweden, with a substantial proportion (around 30%) of male ex-smokers using snus when quitting smoking. Over the same time period, rates of lung cancer and myocardial infarction have dropped significantly faster among Swedish men than women and remain at low levels as compared with other developed countries with a long history of tobacco use. Snus availability in Sweden appears to have contributed to the unusually low rates of smoking among Swedish men by helping them transfer to a notably less harmful form of nicotine dependence.
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              The group interview in social research

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                Author and article information

                Journal
                Tob Induc Dis
                Tob Induc Dis
                TID
                Tobacco Induced Diseases
                European Publishing on behalf of the International Society for the Prevention of Tobacco Induced Diseases (ISPTID)
                2070-7266
                1617-9625
                27 August 2018
                2018
                : 16
                : 37
                Affiliations
                [1 ]Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
                [2 ]Environmental Health Research Center, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
                Author notes
                CORRESPONDENCE TO Abdurrahman Charkazi. Environmental Health Research Center, School of Health, Golestan University of Medical Sciences, Gorgan, Iran. E-mail: rcharkazi@ 123456yahoo.com
                Article
                37
                10.18332/tid/93697
                6659511
                31516436
                0487c624-beb9-4cc5-ad0c-adc11582bbc4
                © 2018 Sighaldeh S. S

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License.

                History
                : 26 July 2017
                : 21 July 2018
                : 23 July 2018
                Categories
                Research Paper

                Respiratory medicine
                smokeless tobacco,nass,contributing factors,turkmen,qualitative study
                Respiratory medicine
                smokeless tobacco, nass, contributing factors, turkmen, qualitative study

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