A model to explain smokeless tobacco consumption in adults: A grounded theory study

Esmaeil Fattahi; Mahnaz Solhi; Seyed Saeed Hashemi Nazari; Hadis Barati; Fardin Mehrabian; Zahra Sadat Manzari; Iraj Zareban; Abolhasan Afkar

doi:10.1016/j.heliyon.2023.e20734

A model to explain smokeless tobacco consumption in adults: A grounded theory study

Heliyon. 2023 Oct 13;9(10):e20734. doi: 10.1016/j.heliyon.2023.e20734. eCollection 2023 Oct.

Authors

Esmaeil Fattahi¹, Mahnaz Solhi², Seyed Saeed Hashemi Nazari³, Hadis Barati³, Fardin Mehrabian⁴, Zahra Sadat Manzari⁵, Iraj Zareban⁶, Abolhasan Afkar⁷

Affiliations

¹ Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran.
² Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran.
³ Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Department of Health Education and Promotion, Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, Rasht, Iran.
⁵ Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
⁶ Health Promotion Research Centre, Zahedan University of Medical Sciences, Zahedan, Iran.
⁷ Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, Rasht, Iran.

Abstract

Introduction: Smokeless tobacco use remains a significant public health concern, necessitating the acquisition of comprehensive and extensive data to effectively address and control its consumption. Understanding the underlying patterns of consumption is crucial for this purpose.

Objective: This study aimed to develop a model that explains smokeless tobacco consumption among adults in the southeastern province of Iran, specifically in the city of Chabahar.

Methods: A qualitative study was conducted using a grounded theory approach with inductive processes. The participants consisted of 30 adults aged 18-64 years from Chabahar City in southeastern Iran. Purposive sampling was used to select participants, and data collection continued until theoretical saturation was achieved. Data analysis followed Strauss and Corbin's perspective, involving four stages: Analyzing Data for Concepts, Analyzing Data for Context, Bringing Process into the Analysis, and Integrating Categories.

Results: The analysis of data yielded three main categories: "starting to use," "continued use," and "cessation attempts," each with their respective subcategories. Additionally, two main categories related to the consequences of smokeless tobacco consumption were identified: "addiction and efforts to overcome addiction," also with their respective subcategories.

Conclusion: The Dependency Cycle Model in Consumption provides a comprehensive understanding of the contextual factors, processes, and consequences associated with smokeless tobacco consumption. This model serves as a valuable tool for researchers aiming to develop effective interventions in the field of smokeless tobacco consumption.

Keywords: Adults; Concepts; Grounded theory; Model; Qualitative research; Smokeless tobacco.