Factors contributing to nass consumption among Iranian Turkmen: A qualitative study

INTRODUCTION: Nass is a smokeless tobacco product. Iranian Turkmen have a long history of nass consumption. However, the factors contributing to nass consumption among Iranian Turkmen are not known. The purpose of the present study is to examine the factors contributing to nass consumption among Iranian Turkmen. METHODS: This qualitative study was conducted between January and March 2016 in four Turkmen cities of Golestan province in Iran. Participants included 34 male Turkmen nass consumers. Data were collected through individual and group interviews and were analyzed by content analysis. Data management was done by qualitative data analysis software MAXQDA, Version 10. RESULTS: The results of data analysis revealed the following as the main reasons for nass consumption by the study population: 1) cultural, social, and environmental facilitators, 2) nass was considered as an alternative to cigarette smoking, 3) nass was believed to intensify the effects of opium and other drugs, 4) specific occupations and circumstances, and 5) beliefs related to nass. CONCLUSIONS: Cultural and historical backgrounds, convenient access to nass at a very low price, curiosity, emulation, and peer pressure were the main factors driving nass consumption among Iranian Turkmen. Various beliefs, such as the idea that nass intensifies the effects of opium and alcohol, calms the nerves, and helps individuals quit smoking were also found to contribute to this phenomenon. Finally, individuals in certain lines of work, such as fishing, driving combines, and military service, were more likely to consume nass.