Individual and Social Factors Associated with Naswar Consumption Among Adults in Bandar Abbas, Southern Iran

Naswar, a form of smokeless tobacco, has become an important public health concern in southern Iran due to its increasing use and associated health risks. Despite its growing social acceptance, limited evidence is available regarding the combined influence of individual, cognitive, and social factors on Naswar consumption. This study aimed to investigate the individual and social determinants of Naswar use among residents of Bandar Abbas, southern Iran. This cross-sectional study was conducted from June to September 2024 among 399 individuals aged 15 years and older recruited from urban healthcare centers in Bandar Abbas. Data were collected through face-to-face interviews using a validated questionnaire assessing demographic characteristics, knowledge, attitudes, social norms, behavioral intention, and Naswar use. Descriptive statistics, univariate analyses, and multivariable logistic regression were performed to identify factors associated with current Naswar consumption. The prevalence of Naswar use was 6% in the study population. Univariate analyses indicated that male gender, lower educational level, and lower socioeconomic status were associated with higher odds of use. Greater knowledge of Naswar harms, more negative attitudes toward use, and stronger anti-use social norms were associated with lower odds of consumption. In the multivariable model, higher knowledge and stronger anti-use social norms remained significant protective factors, whereas stronger behavioral intention toward Naswar use was identified as a significant risk factor. Naswar use in Bandar Abbas is influenced more by psychosocial factors than demographic characteristics alone. Prevention strategies should strengthen health knowledge, reinforce anti-use social norms, and target behavioral intentions through culturally appropriate interventions.