Assessment of Knowledge, Attitudes, and Prevalence of Different Types of Tobacco Products Smoking in Rania District, Sulaimani-Iraq

Abstract

Background: Tobacco smoking remains one of the leading preventable causes of morbidity and mortality worldwide. While global and regional data are abundant, localized studies are essential for understanding the knowledge, attitudes, and prevalence (KAP) of tobacco use within specific communities.

Methods: A community-based cross-sectional study was conducted between April and July 2025 in Rania District and its sub-districts (Chwarqwrna and Hajyawa). Using a multistage convenience sampling method, 820 individuals aged ≥12 years were recruited. Data were collected via a validated, bilingual (English/Kurdish) questionnaire adapted from the Global Youth Tobacco Survey (GYTS). Statistical analysis was performed with SPSS version 25, using descriptive statistics, Chi-square tests, and logistic regression to determine associations. A p-value <0.05 was considered significant.

Results: The mean age of participants was 29.6 ± 12.5 years, with 83.2% males. Among respondents, 61% were active smokers, while 39% were non-smokers. Knowledge levels were fair in 66% of participants, with a significant association between knowledge and tobacco use (p=0.021). Neutral attitudes toward smoking predominated (84.1%) and were significantly associated with smoking behaviors (p<0.001). Peer influence and sociodemographic factors, including male gender and middle socioeconomic status, were strongly associated with smoking initiation and continuation.

Conclusion: The study highlights a high prevalence of smoking in Rania District, compounded by moderate knowledge and neutral attitudes toward tobacco use. Targeted interventions addressing knowledge gaps, reshaping social norms, and strengthening local tobacco control measures are urgently required.