Social Capital, Women's Autonomy and Smoking Among Married Women in Low-Income Urban Neighborhoods of Beirut, Lebanon
Received 2 May 2009; received in revised form 9 October 2009; accepted 27 December 2009.
Purpose
We sought to examine the associations between social capital, women's empowerment, and smoking behavior among married women in three low-income neighborhoods in Beirut, Lebanon.
Methods
Data from currently married women aged 15 to 59 years in the 2003 Urban Health Study were used. The dependent variable was cigarette smoking. The main independent variables were five social capital items and three women's empowerment indices. Other socioeconomic variables as well as mental distress, happiness, and community of residence were included as covariates. Bivariate associations were conducted on all variables using chi-square tests. Adjusted odds ratios from binary logistic regression models were then modeled on smoking behavior separately for younger and older women.
Results
More than one third (35.9%) of married women reported smoking cigarettes. At the bivariate level, a variety of socioeconomic and demographic variables predicted smoking. With respect to social capital, women who lacked trust and were dissatisfied with the number friends or relatives living nearby were more likely to smoke. As for women's autonomy, high decision making and high mobility were associated with smoking. When analyzed multivariately, social capital items were statistically significant for younger women but not for older women. And the mobility variables were significant for older women but not younger women.
Conclusion
Our results support the conclusion that determinants of women's tobacco use are multilayered, and include social capital and women's autonomy. Our results also suggest that younger and older married women may be influenced by differential determinants. Reasons for these differences are explored. Interventions may need to be tailored to each age group separately.
Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
Correspondence to: Rema A. Afifi, PhD, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236; Riad El Solh 1107 2020, Beirut, Lebanon; Phone: 961-1-374374 (x4660 RAA, RTN; x4640 MK); fax: 961-1-744470.
This paper was produced in the framework of a larger, interdisciplinary research project on Urban Health, coordinated by the Center for Research on Population Health at the American University of Beirut, Lebanon, with generous support from the Wellcome Trust, the Mellon Foundation, and the Ford Foundation.
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