Rethinking Anti-tobacco Health Education in an Eastern Mediterranean Country with Growing Tobacco Use

Background: 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. Materials and
Methods: 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.
Results: 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.
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.