Social desirability and self-reported cigarette smoking among Lebanese adults

Cigarette smoking remains highly prevalent in Lebanon, posing a significant public health challenge. This study examined how social desirability and smoking unacceptability influence self-reported cigarette use and dependence among Lebanese adults, accounting for relevant sociodemographic factors. An online, cross-sectional study recruited 460 Lebanese adults between February and March 2025 through snowball sampling by disseminating the survey link on social media. Validated measures were used to assess the various concepts. Among 460 Lebanese adults (mean age 25.35±9.17 years, 70.2% female), multivariate logistic regression revealed that higher Socially Strategic Pragmatism was negatively associated with current smoking (ORa=0.94, p=0.019), while Independent Thinking showed a marginal positive association (ORa=1.05, p=0.085). School-level education (ORa=5.00, p=0.004) and unemployment (ORa=3.13, p=0.003) were associated with higher smoking odds. For cigarette dependence, Virtuous Perfectionism was negatively associated (ORa=0.99, p=0.009), and smoking social unacceptability showed a strong protective effect (ORa=0.80, p<0.001). Male gender (ORa=1.69, p<0.001), older age (ORa=1.02, p=0.002), and higher AUDIT scores (ORa=1.04, p<0.001) were positively associated with dependence, while unemployment (ORa=0.70, p=0.004) and not consuming alcohol while smoking (ORa=0.55, p=0.004) were negatively associated. This study demonstrated that social desirability bias was significantly associated with reported cigarette use and dependence patterns among Lebanese adults, in addition to sex, religion, social influence, and socioeconomic factors. Tobacco control interventions in Lebanon should incorporate culturally sensitive approaches that address social norms and use validated measures to account for social desirability bias, potentially ensuring more accurate prevalence estimates and more effective public health strategies.