Abstract
In Jordan, a developing country with a high tobacco burden and where roughly 40% of cancers are tobacco-related, limited knowledge exists on public awareness regarding tobacco. This is a hindrance for experts seeking to strengthen anti-tobacco health promotion and counter growing tobacco use. We sought to evaluate public awareness regarding tobacco; to gauge exposure to anti-tobacco public messages; and to draw attention to the lay public's informational needs. A cross-sectional survey of lay public in the capital, Amman, capturing knowledge regarding tobacco harms and anti-tobacco laws, perceptions regarding tobacco use and control, and exposure to and recall of anti-tobacco messages, was conducted. Statistics on perceptions were generated and analyzed by smoking status and sociodemographic factors. Multivariate regression was performed to estimate independent associations of smoking and sociodemographic factors with knowledge. Of 1,169 respondents, 17.8% could recall specific anti-tobacco messages. With regard to knowledge, despite high proportions of respondents exhibiting knowledge for individual statements regarding tobacco health harms, variables capturing breadth of knowledge showed that much lower proportions could correctly identify all the listed health harms of tobacco, and all listed Jordanian anti-tobacco regulations (47.5% and 36.2%, respectively). On multivariate analysis, breadth of knowledge varied by smoking status, age and educational level. There is need for more salient, evocative and multi-faceted anti-tobacco messages in Jordan, tailored to subgroups, given detected variability in knowledge across smoking status and sociodemographic characteristics.
Highlights
In Jordan, a developing country with a high tobacco burden and where roughly 40% of cancers are tobacco-related, limited knowledge exists on public awareness regarding tobacco
This is a hindrance for experts seeking to strengthen anti-tobacco health promotion and counter growing tobacco use
Despite high proportions of respondents exhibiting knowledge for individual statements regarding tobacco health harms, variables capturing breadth of knowledge showed that much lower proportions could correctly identify all the listed health harms of tobacco, and all listed Jordanian anti-tobacco regulations (47.5% and 36.2%, respectively)
Summary
There is ample evidence regarding the effectiveness of anti-tobacco public education (PE) in increasing both motivation to quit and quit rates among smokers, and deterring smoking initiation among non-smokers (Schar et al, 2006; Durkin et al, 2012; Centers for Disease Control and Prevention, 2013; World Health Organization, 2013). While health warning labels exist and cover 40% of cigarette boxes (no warning labels exist for waterpipes), these are considered to be “missing...appropriate characteristics” (World Health Organization, 2011), do not appear to add information, and do not have a substantial impact in terms of motivating smokers to consider quitting (Hawari et al, 2011) This is troubling, given that prevalence of tobacco use in the country is increasing: 32% of the population reported being current regular tobacco users in 2011 (Jaghbir et al, 2014), a figure higher than the previous population estimate of 29% for tobacco use in 2007 (Al-Nsour et al, 2012). Conclusions: There is need for more salient, evocative and multi-faceted anti-tobacco messages in Jordan, tailored to subgroups, given detected variability in knowledge across smoking status and sociodemographic characteristics
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