Tobacco smoking in men and women with different perceptions of social well- being: Findings of a large population-based study

Abstract Background: This study aimed to investigate cigarette and hookah smoking in a population of Eastern-Mediterranean adults in relation to their perceived social well-being. Methods: Data of 2592 adults who participated in the 6th phase (2014-2016) of the Tehran Lipid and Glucose Study (TLGS) was used. After excluding those with missing data (n=235), 2357 remained for the sex-specific logistic regression to investigate the association between social well-being and current smoking (cigarette and hookah). The final model was adjusted for age, marital status, education, occupation, physical activity, and chronic disease history. Results: Compared to cigarette and hookah smokers, the mean scores of social well-being and all its dimensions were higher in non-smokers. While in men, cigarette smoking was significantly related to social well-being and all its dimensions, only women with higher social well-being, social integration, and coherence, were further at risk of cigarette smoking. Unlike men, whose hookah smoking was not at all related to their social well-being, women's hookah consumption was associated with social well-being, social integration and acceptance; one unit increase in the mean scores of social integration and acceptance in women reduced the risk of hookah use by 8%. Conclusion: Social well-being and tobacco smoking are related, and evident sex differences in this relationship should not be ignored in future tobacco control efforts.