ArticleBMC public health2022
Towards a better understanding of the psychosocial determinants associated with adults' use of smokeless tobacco in the Jazan Region of Saudi Arabia: a qualitative study.
Article in BMC public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Cultural Drivers, Modes of Use, and Perceived Harms of Traditional and Non-Traditional Smokeless Tobacco Use in South Africa: A Qualitative Study.Tobacco use insights · 2026Article
- Demographics and psychosocial determinants of quit intention among oral smokeless tobacco users: an analytical cross-sectional study in Saudi Arabia.BMC public health · 2025Article
- Community awareness regarding smokeless tobacco (Shamma) as a cause of oral cancer in Jazan region, Saudi Arabia: A cross-sectional study.Journal of family medicine and primary care · 2024Article
- TRENDING CULTURAL DRIVERS OF SMOKELESS TOBACCO: FOR RECENT REFUGEE AND IMMIGRANTS AS KNOWLEDGE, ATTITUDES, AND BEHAVIOR DETERMINANTS: A SOUTH TEXAS ORAL HEALTH NETWORK COLLABORATIVE STUDY.Texas dental journal · 2024Article
- Oral Potentially Malignant Disorders and Oral Cancer in Saudi Arabia: An Epidemiological Review of the Literature.Journal of clinical medicine · 2024Review
- Awareness and utilization of smoking cessation clinics in Saudi Arabia, findings from the 2019 Global Adult Tobacco Survey.Substance abuse treatment, prevention, and policy · 2023Article
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9 authors.
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Abstract
backgroundMost diagnosed oral cancer cases in Saudi Arabia are in the Jazan region. A common type of smokeless tobacco "Shammah" is prevalent in this region. This study aimed to gain an in-depth understanding of the possible psychosocial determinants of Shammah consumption among adult Shammah users in Jazan region.
methodsA qualitative study was conducted by means of one-on-one interviews among thirty adult Shammah users. Participants were recruited by means of a purposive sampling technique. Data were collected using a semi-structured interview guide utilizing face-to-face and phone-call interviews. Thematic analysis with hybrid approach was used to analyze the dataset.
resultsTwenty-four sub-codes within four overarching themes were generated. Participants revealed uncertainty related to Shammah composition, how to quit knowledge and Shammah prevention/cessation programs. Shammah use identified as a normal phenomenon in society. Its use was frequently reported in participants' close network but most users faced family and peers' disapproval. Some users expressed joy, happiness and focused when using Shammah. Others were disgusted or neutral. Many users believed Shammah causes cancer and tears oral tissues. Others believed it relieves toothache or has no effect. Majority of users were confident to quit and recalled some quitting aids. Toothache, craving, drinking tea and chewing Khat (leaves of Catha edulis plant that causes moderate euphoria) perceived to be triggers to use Shammah. Availability of Shammah, withdrawal symptoms, stress, lack of support, seeing others using Shammah, losing part of routine and toothache were barriers to quit.
conclusionsShammah use was associated with uncertainty about Shammah composition and quitting knowledge, social acceptability, influence from family/friends, a range of positive and negative attitudinal beliefs toward its use and high quitting efficacy beliefs. Future interventions targeting Shammah should address the acknowledged triggers and barriers in the present study including the dual use of Shammah and Khat.
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