title: Factors related to knowledge and perception of women about smoking: a cross sectional study from a developing country.
abstract: BACKGROUND
  Smoking rates among women are currently low, but they are the fastest growing segment of cigarette smoking population in developing countries. We aimed to assess the knowledge and perceptions towards smoking and to identify the factors related with level of knowledge and perceptions among adult women in urban slums.
  
  
  METHODS
  This was a cross sectional study conducted on 250 adult (≥18 years of age) women attending primary care clinics in three slums of Karachi, Pakistan. A pre-tested and structured, interviewer administered questionnaire was used for data collection. Factors associated with level of understanding about smoking were analyzed with chi-square test.
  
  
  RESULTS
  Most of the women knew that smoking has adverse effects on women and children's health but the knowledge of specific health effects was limited. About one third of the women knew that active smoking can cause lung disease, but only a small percentage (7%) knew that it could lead to heart disease. None of the women were aware that smoking contributes to infertility and osteoporosis. A small proportion of women were aware that smoking can lead to low birth weight (7%), congenital anomalies (5%) and less than 1% of women knew that it contributes to pregnancy loss, still birth and preterm delivery. The understanding of passive smoking affecting children's lung was low (20%) and a similar proportion voiced concern about the bad influence of maternal smoking on children. Educated women had better knowledge of health effects of smoking. Education was associated with having better knowledge about effects on women health in general (p = 0.02) and specific effects like lung (p = 0.03) and reproductive health effects (p < 0.001). Education was also associated with knowledge regarding effects on fetus (p < 0.001) and children (p < 0.005). Although most of the women disliked being around smokers, more than one third thought that smoking decreases boredom (39%), tension (38%) and also helps to relax (40%). A large proportion (48%) of women had the misconception that smoking helps to reduce weight.
  
  
  CONCLUSIONS
  This study reveals that women are aware of the general ill effects of smoking but fail to identify smoking to be associated with female maladies particularly those who were illiterate and had lower levels of education. Understanding and attitudes needs to be improved by increasing health awareness and education of women in these urban communities with special emphasis on the effects of smoking on women's health.
authors: Department of Family Medicine, The Aga Khan University, Stadium Road, PO Box 3500, Karachi-74800, Pakistan.
authors: Seema
authors: S
authors: Bhanji
authors: Marie
authors: M
authors: Andrades
authors: Fawad
authors: F
authors: Taj
authors: Ali K
authors: AK
authors: Khuwaja
references: Women Health. 2006;44(4):1-23
references: 17456461
references: Tob Control. 2006 Jun;15 Suppl 3:iii65-70
references: 16754949
references: J Pak Med Assoc. 2008 Dec;58(12):664-7
references: 19157317
references: Southeast Asian J Trop Med Public Health. 2005 Mar;36(2):498-504
references: 15916062
references: Addict Behav. 2005 May;30(4):725-40
references: 15833577
references: J Obstet Gynaecol. 2005 Jul;25(5):432-4
references: 16183574
references: Obstet Gynecol Clin North Am. 2009 Dec;36(4):877-90, xi
references: 19944306
references: Prev Med. 2005 Aug;41(2):446-53
references: 15917040
references: Nicotine Tob Res. 2004 Apr;6 Suppl 2:S125-40
references: 15203816
references: Addiction. 2005 Oct;100(10):1423-31
references: 16185204
references: J Pak Med Assoc. 2005 Mar;55(3):111-4
references: 15852747
references: Clin Sci (Lond). 2007 Sep;113(5):233-41
references: 17663660
references: J Community Health. 2000 Oct;25(5):377-88
references: 10982011
references: Nicotine Tob Res. 2004 Jun;6(3):397-425
references: 15203775
references: Trop Doct. 2003 Oct;33(4):231-4
references: 14620430
references: Heart. 2008 Apr;94(4):408-13
references: 17646192
references: Paediatr Respir Rev. 2008 Mar;9(1):11-9; quiz 19-20
references: 18280975
references: MMWR Morb Mortal Wkly Rep. 2008 Jul 11;57(27):744-7
references: 18614993
references: Best Pract Res Clin Obstet Gynaecol. 2006 Apr;20(2):227-51
references: 16543119
references: Nicotine Tob Res. 2001 Nov;3(4):341-5
references: 11694201
references: PLoS Med. 2006 Nov;3(11):e442
references: 17132052
references: MMWR Recomm Rep. 2002 Aug 30;51(RR-12):i-iv; 1-13
references: 12222832
references: Int J Tuberc Lung Dis. 2007 Dec;11(12):1366-71
references: 18034960
references: Am J Obstet Gynecol. 2001 Apr;184(5):934-9
references: 11303201
references: J Pak Med Assoc. 2007 Apr;57(4):186-8
references: 17489526
references: Am J Public Health. 2008 Oct;98(10):1833-40
references: 18309125
references: J Pak Med Assoc. 2010 Jun;60(6):509-12
references: 20527661