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Knowledge, Attitudes and Beliefs about Smoking in Jordanian Men who are Smokers and Hospitalized with a Cardiovascular Diagnosis

  • Author(s): Elshatarat, Rami Azmi
  • Advisor(s): Froelicher, Erika S
  • et al.


Background: Tobacco use is the most preventable cause of death worldwide. Despite high rates of tobacco use and high prevalence of cardiovascular disease (CVD) in Jordan, little is known about smoking behaviors in patients who smoke and have CVD.

Objectives: To describe perceptions and patterns of smoking in patients hospitalized with CVD in Amman, Jordan.

Methods: This cross-sectional study recruited a convenience sample from two hospitals. Data were collected using medical record abstraction and structured interviews.

Results: This sample of consists of 112 men who were hospitalized with CVD; they were middle-aged (52.5 ± 9.7 years), most were married, educated (≥ high school), and had incomes above the national average. The mean number of years of cigarette smoking was [35.9 (±10.4)], and they smoked 24.5(±13.62) cigarettes per day. The majority (82.3%) had medium to high nicotine dependence. About 40% had attempted to quit smoking in the past 12 months using "their own way without help from others," and intend to quit in the future using the same unsuccessful methods. The men were unaware of hazards of smoking such as stroke and addiction to nicotine; nor of the long term health benefits of quitting smoking. A logistic regression analysis showed that men with higher income (OR: 7.7, 95% CI: 2.7, 22.3), with longer hospital stays (OR: 2.6, 95% CI:1.3, 5.3), in acute cardiac settings (OR:3.9, 95% CI:1.2, 12.7), and a diagnosis of an acute CVD event (OR:3.0, 95% CI:1.1, 8.3) were more confident in their ability to quit smoking.

Discussion: The key findings were that men with CVD were heavy smokers, unaware of the addictive nature of smoking and of the benefits of quitting. Some had previous unsuccessful quit attempts using their own methods, but planned to use these methods again in the future. These findings suggest that every patient admitted to the hospital must be screened for smoking status. Those who smoke need to be offered evidence based smoking cessation education and counseling.

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