Perceived Stress and Self-Esteem as Significant Predictors of Cigarette Smoking Behavior of Bangladeshi Male Adults

A large body of research has documented that smoking behavior is associated with a number of psychological variables. Weiss, Mouttapa, Cen, Johnson, and Unger (2011) studied a culturally diverse sample of 1,771 adolescents who reported that the risk of smoking initiation was significantly higher among students who scored higher on hostility and depressive symptoms, and were bully-victims. Mykletun, Overland, Aaro, Liabo, and Stewart (2008) carried out a population-based health survey on 60,814 adults aged between 20 to 89 years and reported that anxiety and depression were the most common in current smokers followed by quitters, and then never-smokers. Siahpush, Borland, and Scollo (2003) found the probability of experiencing financial stress to be 1.5 - 2.0 times higher for smoking households than for non-smoking homes. Baker, Brandon, and Chassin (2004) reported that anxiety and depression may also cause smoking initiation and heavy smoking. Liu (2003) in his study on a sample of 1360 Chinese adolescents reported that smokers experienced more life stress than nonsmokers. Siqueira, Diab, Bodian, and Rolnitzky (2000) based on a study on a population of 954 clinic patients aged between 12 to 21 years reported that negative life events, perceived stress, greater use of the negative coping methods of anger and helplessness, and the use of the positive coping methods of parental support and cognitive coping were significantly and independently related to smoking status.Trinidad and Johnson (2002) conducted a study on 205 multi-ethnic adolescents with a mean age of 12.63 years to explore the relationship between emotional intelligence and tobacco and alcohol use. They found emotional intelligence to be negatively correlated with a general, overall measure of tobacco and alcohol use, and with individual tobacco and alcohol scales and items. However, they suggested the need to carry out further research to validate these findings. Kim (2004) conducted a research on Korean secondary school students and reported self-esteem among other variables to have strongly related to smoking behavior of the students. Mullan and NicGabhainn (2002) in a study on 7,706 Irish young people have reported that there was no significant difference in selfesteem scores between those who had and had not tried smoking.Tobacco use is widespread in the subcontinent including Bangladesh, India, Nepal, and Pakistan with significant differences in prevalence between male and female. The Bangladesh Bureau of Statistics in 1997 reported that smoking rates were higher among men than women; the highest reported rate was 70.3% for men aged 35^9 years, while the lowest was 0.1% for girls aged 10-14 years (cited in Efroymson & Ahmed, 2003). Expenditure on cigarettes represents a major burden for impoverished Bangladeshis (Efroymson, Ahmed, Townsend, et al., 2001). An average male cigarette smokers spent more than twice as much on cigarettes as per capita expenditure on clothing, housing, health and education combined and a typical poor smoker could easily add over 500 calories to the diet of one or two children with his or her daily tobacco expenditure. Prevalence of tobacco smoking is 36% for males and 9% for females of Pakistani sample (cited in Ahmed, Rashid, McDonald, & Ahmed, 2008); 20.5% for boys and 2.9% for girls of Nepalese sample of college students (Sreeramareddy, Kishore, Paudel, & Menezes, 2008). A survey on 599 college students of Andhra Pradesh in India demonstrated that the prevalence of tobacco smoking is 48 out of 387 male students and 1 out of 212 female students (Gavarasana, Doddi, Prasad, Allam, & Murthy, 1991).It appears from the literature discussed that stress, self-esteem, and emotional intelligence are some of the important psychological variables reported to have been associated with smoking behavior. However, the association appears inconclusive across studies. Additionally, there is no known research documented so far addressing the issue of smoking behavior in relation to those psychological variables in the cultural context of the subcontinent in general and Bangladesh in particular. …