Cigarettes' use and capabilities-opportunities-motivation-for-behavior model: a multi-country survey of adolescents and young adults

Heba Jafar Sabbagh, Wafaa Abdelaziz, Maryam Quritum, Nada Abu Bakr AlKhateeb, Joud Abourdan, Nafeesa Qureshi, Shabnum Qureshi, Ahmed H. N. Hamoud, Nada Mahmoud, Ruba Odeh, Nuraldeen Maher Al-Khanati, Rawiah Jaber, Abdulrahman Loaie Balkhoyor, Mohammed Shabi, Morenike Oluwatoyin Folayan, Omolola Alade, Noha Gomaa, Raqiya Alnahdi, Nawal A. Mahmoud, Hanane El WazzikiManal Alnaas, Bahia Samodien, Rawa A. Mahmoud, Nour Abu Assab, Sherin Saad, Sondos G. Alhachim, Maha El Tantawi

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
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The use of cigarettes among adolescents and young adults (AYA) is an important issue. This study assessed the association between regular and electronic-cigarettes use among AYA and factors of the Capability-Motivation-Opportunity-for-Behavior-change (COM-B) model. A multi-country survey was conducted between August-2020 and January-2021, Data was collected using the Global-Youth-Tobacco-Survey and Generalized-Anxiety-Disorder-7-item-scale. Multi-level logistic-regression-models were used. Use of regular and electronic-cigarettes were dependent variables. The explanatory variables were capability-factors (COVID-19 status, general anxiety), motivation-factors (attitude score) and opportunity-factors (country-level affordability scores, tobacco promotion-bans, and smoke free-zones) controlling for age and sex. Responses of 6,989-participants from 25-countries were used. Those who reported that they were infected with COVID-19 had significantly higher odds of electronic-cigarettes use (AOR = 1.81, P = 0.02). Normal or mild levels of general anxiety and negative attitudes toward smoking were associated with significantly lower odds of using regular-cigarettes (AOR = 0.34, 0.52, and 0.75, P < 0.001) and electronic-cigarettes (AOR = 0.28, 0.45, and 0.78, P < 0.001). Higher affordability-score was associated with lower odds of using electronic-cigarettes (AOR = 0.90, P = 0.004). Country-level-smoking-control policies and regulations need to focus on reducing cigarette affordability. Capability, motivation and opportunity factors of the COM-B model were associated with using regular or electronic cigarettes.

Original languageEnglish
Article number875801
JournalFrontiers in Public Health
Publication statusPublished - 22 Jul 2022


  • adolescents
  • anxiety
  • smoking
  • young adults

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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