Psychosocial Factors, Smoke-Free Restrictions, and Media Exposure in Relation to Smoking-Related Attitudes and Behaviors among Adults in Armenia and Georgia.

Christina N Wysota,Varduhi Hayrumyan,Ana Dekanosidze,Marina Topuridze,Carla J Berg,Arusyak Harutyunyan,Lela Sturua,Zhanna Sargsyan,Michelle C Kegler,Varduhi Petrosyan

doi:10.3390/ijerph18084013

Abstract

Background: Perceived harm, social influences, smoke-free policies, and media exposure have been understudied in relation to tobacco-related attitudes/behaviors in aggregate or in low and middle-income countries; thus, this study examined these factors collectively in relation to smoking-related outcomes among Armenian and Georgian adults. Methods: Using 2018 cross-sectional survey data (n = 1456), multivariable regression analyses examined these factors in relation to smoking status, perceived harm among nonsmokers, and readiness to quit and past-year quit attempts among smokers. Results: Significant predictors (p < 0.05) of current smoking (27.3%) included lower perceived harm, more smoking friends, and fewer home and vehicle restrictions. Among nonsmokers, more home and restaurant/bar restrictions, fewer vehicle restrictions, greater anti-tobacco media exposure, and less pro-tobacco media exposure predicted greater perceived harm. Among smokers, greater perceived social acceptability of smoking, less anti-tobacco media exposure, and greater pro-tobacco media exposure predicted readiness to quit (12.7% of smokers). More smoking friends, more home restrictions, less anti-tobacco media exposure, and greater pro-tobacco media exposure predicted past-year quit attempts (19.2%). Conclusions: Findings support the importance of smoke-free policies but were counterintuitive regarding the roles of social and media influences, underscoring the need to better understand how to address these influences, particularly in countries with high smoking rates.

Highlights

Cigarette smoking remains a leading cause of preventable death, and those living in low-and middle-income countries (LMICs) are at disproportionate risk for tobaccorelated diseases and deaths [1]
Given the gaps in the literature and the nuances of the tobacco-related environments in Armenia and Georgia, the current study examined tobacco use behaviors and attitudes among Armenian and Georgian adults in relation to sociocontextual factors, perceived harm of tobacco use; social influences; smoke-free policies in private spaces, at the workplace, and in the community; and tobacco-related media exposure
It was anticipated that having more friends who smoke was associated with being a current smoker, and perceiving less favorable attitudes toward smoking among friends, family, and the general public was associated with greater importance of quitting among smokers [16,36]

Summary

Introduction

Cigarette smoking remains a leading cause of preventable death, and those living in low-and middle-income countries (LMICs) are at disproportionate risk for tobaccorelated diseases and deaths [1]. Social influences, smoke-free policies, and media exposure have been understudied in relation to tobacco-related attitudes/behaviors in aggregate or in low and middle-income countries; this study examined these factors collectively in relation to smoking-related outcomes among Armenian and Georgian adults. Included lower perceived harm, more smoking friends, and fewer home and vehicle restrictions. More home and restaurant/bar restrictions, fewer vehicle restrictions, greater anti-tobacco media exposure, and less pro-tobacco media exposure predicted greater perceived harm. Greater perceived social acceptability of smoking, less anti-tobacco media exposure, and greater pro-tobacco media exposure predicted readiness to quit (12.7% of smokers). More home restrictions, less anti-tobacco media exposure, and greater protobacco media exposure predicted past-year quit attempts (19.2%).

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Conclusion