Women's attitude toward smoking: effect of a community-based intervention on smoking-related social norms

Background: Smoking has long been discouraged in Iranian women. However, in recent years, more women have started smoking. This study aimed to investigate the role of women's attitude towards smoking on smoking prevalence in women in the context of a community-based intervention program. Methods: Participants were samples of the third and fifth evaluation stages of the 'Isfahan Healthy Heart Program', which is a comprehensive community-based intervention program for noncommunicable disease prevention and control. A total of 3112 and 4794 women were investigated in 2004 and 2007, respectively. Intervention and reference groups were assessed for smoking habits and attitude towards smoking. T test and chi-square test were used to compare the parameters between the intervention and the reference groups. Results: Negative attitude towards smoking increased significantly in the intervention and the reference groups from 2004 to 2007 (P = 0.0001). Negative attitude towards smoking in women decreased significantly in the intervention group (P - 0.0001), whereas it increased significantly in the reference group (P - 0.0001). However, smoking prevalence showed a significant decrease in women in the intervention group, from 2.5 to 1% (P < 0.0001) and a nonsignificant decrease in the reference group. Conclusion: A change in social norms towards acceptability of smoking for women can be overcome by effective strategies that discourage the population from smoking.