Pathological analysis of smoking prevalence in rural communities( case study of Kermanshah province, West of Iran)

Smoking prevalence is pervasive across all regions of Iran, including rural areas. Consequently, developing strategies for reducing smoking in rural communities is imperative. Hence, this study presented a pathological analysis of the factors contributing to smoking prevalence in rural areas of Kermanshah province.

This study employs a mixed-methods approach, combining quantitative and qualitative methodologies. The qualitative research method adopted an interpretive paradigm and utilized grounded theory. A sample size of 45 individuals was determined through purposive sampling until saturation was achieved. The participants were categorized into two groups: villagers, members of Islamic councils, and officials and experts in tobacco control. Sampling was facilitated using the snowball sampling technique. The research design incorporates qualitative and quantitative components, employing descriptive and analytical approaches. The statistical population consisted of 417 individuals, with a sample size of 212 people selected from nine villages within Kermanshah province using Cochran's formula. Systematic random sampling was employed in the village setting.

Our findings revealed that smoking prevalence in rural communities can be attributed to five primary cultural and social factors, economic influences, infrastructural items, urban-rural dynamics, media impact, and factors associated with health and education. Effective strategies include educating residents, expanding healthcare services, developing infrastructure, creating employment opportunities, addressing rural deprivation, and fostering a culture of non-smoking to mitigate tobacco consumption in rural areas. Furthermore, Spearman's correlation analysis indicated a significant relationship between smoking prevalence and the seven mentioned components. These items significantly impact the prevalence of smoking in rural areas.

Misconceptions regarding the absence of tobacco in villages, skepticism toward medical science, and limited educational attainment pose significant challenges to tobacco reduction programs in rural areas. Moreover, government negligence and insufficient investment by public institutions contribute to the smoking prevalence.