journal of sustainable rural development

journal of sustainable rural development

Assessment of the Execution of a Tobacco-Free Village with a social development and sustainable rural health approach A Case Study: Damagh Sefid Village in Sarpol-e Zahab, Iran

Document Type : Research Paper

Authors
Aeizh Azmi 1
Mohammad Reza Masjedi 2
1 Associate Professor, Department of Geography, Faculty of Literature and Humanities, Razi University, Kermanshah, Iran
2 professor of pulmonary medicine, Tobacco Control Research Center (TCRC), Iranian Anti-Tobacco Association, Tehran, Iran
10.22034/jsrd.2025.508268.1213
Abstract
Purpose: Rural communities often face the challenge of high rates of tobacco use, with both cigarette smoking and hookah consumption being particularly prevalent. Therefore, it is critical to manage and implement measures that effectively eliminate tobacco consumption in these settings. Several villages have implemented measures and achieved zero tobacco use, thereby earning recognition as “tobacco-free villages”. Damagh  Sefid, located in Sarpol-e Zahab, is one such example. Accordingly, the present study seeks to analyze the process and factors influencing the implementation of the tobacco-free initiative in Damagh  Sefid.
Methods: This study is an interpretivist approach using a Grounded Theory method. A total of 30 individuals participated, and thus, the sample size was determined through (situational) sampling until data saturation was reached, employing snowball sampling techniques.
Results: The results reveal the significant roles of non-governmental organizations and private institutions, alongside influential village figures, such as health officers, clerics, and elders. Visual campaigns, including banners and public lectures, along with active engagement from local broadcast media, particularly the Islamic Republic of Iran Broadcasting (IRIB), successfully raised awareness and motivated residents.. Academically educated youth, particularly university students residing in the area, played a crucial role in encouraging smoking cessation, while schoolchildren served as effective health ambassadors. Furthermore, the schoolchildren served as prominent health ambassadors. Key obstacles include the village’s geographic isolation, visitors disregarding the smoking ban, and decreased shopkeeper earnings due to the cessation of cigarette sales.
Conclusion: The involvement of governmental and non-governmental organizations has facilitated the adoption of effective policies to combat tobacco use. Furthermore, the selection of the village as a tobacco-free zone has served as a powerful incentive for maintaining anti-tobacco efforts. However, there are several challenges. Notably, the a lack of recreational and tourism places alongside educational classes to spend their free time. Employment opportunities remain scarce, and tourists sometimes undermine tobacco control efforts. Moreover, persistent unemployment, especially seasonal unemployment, remains a critical challenge despite broad collaboration.
Keywords
Tobacco-free village
Smoking cessation
Non-governmental organizations (NGOs)
Incentives
Damagh Sefid village
Ebrahimpour, Habib, and Najjari, Reza. (2007). Philosophical Foundations of Organizational Studies in Four Paradigms, Methodology of Human Sciences, 13(53), 9-33.
Ahmadizadeh Fini, Akram; Rafiee Zad, Emadoddin; Dashtian, Mohammad; Ahmadizadeh Fini, Elham. The Status of Tobacco Use in Urban and Rural Populations Aged 46-51 in Hormozgan Province, Preventive Medicine Journal, 2(2): 62-67.
Esmaeili, Maryam; Salsali, Mahvash; and Cheraghi, Mohammad Ali. (2013). Quality in Grounded Theory Studies. Qualitative Research in Health Sciences, 2(3), 287-296.
Pars Online (2025). Grounded Theory, https://parsmodir.com/research/grounded-theory
Khabaronline (2012). What Are the Tobacco Control Strategies in Other Countries? Khabaronline.
IRNA News Agency (2022). Damagh Sefid Village of Sarpol-e Zahab Introduced as a Tobacco-Free Village.
National Tobacco Control Secretariat (2023). Hidden Costs of Smoke and Breath: Analysis of Cigarette Consumption Across Different Income Deciles.
Rostami, Mehran; Amirian, Hossein; Eskandari, Batoul; Zarei, Mina (2018). Economic Inequality in Cigarette Use in Rural Areas of Hamadan, Using a Concentration Index Approach. Scientific Journal of Researchers, 16(4): 28-36. https://doi.org/10.21859/psj.16.4.28
Zarei, Aref, Bagherzadeh, Razieh; Ravani Pour, Maryam. (2019). An Investigation of Tobacco Use among Adolescents in Bushehr and Related Factors in 2019. Pediatric Nursing, 7(3): 80-91.
Ziaadini, Hassan; Ziaadini, Mohammad Reza. (2006). Epidemiology of Tobacco Use and Its Association with Some Demographic Factors in a Rural Region of Kerman. Journal of Principles of Mental Health, 8(30), 17-22. https://doi.org/10.22038/jfmh.2006.1815
Fathi, Mansour; Ajamnajad, Reza; Khak Rangin, Maryam. (2012). Factors Related to Social Health of Teachers in Maragheh City. Social Welfare Quarterly, 12(47), 225-243.
Statistical Centre of Iran (2021). Tobacco Consumption Status in Different Groups, Iran Statistics Center.
Meysami, Ali Pasha; Ghodsi, Seyed Mohammad; and Eftekhar, Behzad. (2004). Cigarette Consumption Patterns in a Rural Area of Iran. Tanaffos Journal, 3(10), 53-61.
Valizadeh, Behzad (2020). Details of the Implementation of the Five-Year Tobacco-Free Urban and Rural Program, ISNA News Agency.
Aghajanian A, Mehryar AH, Ahmadnia S, Kazemipour S. Impact of rural health development programme in the Islamic Republic of Iran on rural-urban disparities in health indicators. EMHJ Eastern Mediterranean Health Journal. 2007;13(6):1466-75. https://doi.org/ 10.26719/2007.13.6.1466.
Amerion A, Mesgarpour Amiri M, Amini Anabod H. Rate of inequality in kidney transplantation services access in Iran. Jccnursing. 2010;3(3):129-33.
Azagba S, Sharaf MF. The effect of job stress on smoking and alcohol consumption. Health Economics Review. 2011;1:15. https://doi.org/doi:10.1186/2191-1991-1-15.
Azmi, A., & Masjedi, M. R. (2023). Pathological analysis of smoking prevalence in rural communities( case study of Kermanshah province, West of Iran). Sustainable Rural Development, 7(1), 45-62. https://doi.org/doi: 10.22034/jsrd.2023.177090
Brathwaite R, Addo J, Kunst AE, Agyemang C, OwusuDabo E, Aikins Ad-G, et al.(2017). Smoking prevalence differs by location of residence among Ghanaians in Africa and Europe: The RODAM study. PloS one. 12(5):e0177291.https://doi.org/10.1371/journal.pone.0177291
Dickman SL, Himmelstein DU, Woolhandler S. Inequality and the healthcare system in the USA. The Lancet. 2017;389(10077):1431-41. https://doi.org/ doi: 10.1016/S0140-6736(17)30398-7.
Douthit NT, Biswas S (2018). Global Health Education and Advocacy: Using BMJ Case Reports to Tackle the Social Determinants of Health. Front Public Health. 2018; 6: 114. https://doi.org/10.3389/fpubh.00114
Kaur, A., Sherbinin, A., Toure, A., and Jensen, L. 2005. Economic Empowerment of Women, United Nations Population, New York 10017(UNPF).
Keyes, C. L. M. 1998. Social Well-being, Social Psychology Quarterly, (61): 121-141. http://dx.doi.org/10.2307/2787065
Laurie, S. A. and Christine, L. 2015. Influences of social determinants of health on African Americans living with HIV in the rural southeast: A qualitative meta-synthesis. Journal Of The Association Of Nurses In AIDS Care, 26(4): 340-356. Available in http://dx.doi .org/10.1016/j.jana.2015 .03.004
Madani A, Aghamolaei T, Madani M, Zarei F.(2016). Prevalence of smoking and associated internal and external factors in high school students in Bandar Abbas, Iran. Journal of Preventive Medicine 2(4): PP.39-49.
Momenabadi V, Kaveh M, Hashemi S, Borhaninejad V. (2016). Factors Affecting Hookah Smoking Trend in the Society: A Review Article. Addiction & health 8(2).PP.123-35.
Rezakhani Mogaddam H, Shojaezadah D, Sadeghi R, Pahlevanzadah B, Shakouri Moghaddam R, Fatehi V.(2013); Survey of prevalence and causes of the trend of hookah smoking in Tehran University Students of Medical Sciences 2010-2011. Toloo e Behdasht.11(4):PP.103- 13.
Sedaghat H, Ahmadi S, Mokhtari M, Sarami Forooshani H. (2023).The Relationship between Socioeconomic Development Indicators and Death Due to Drug Use in Iran from 1991 to 2020: A Time-Series Analysis. etiadpajohi 17 (67) :329-3 https://doi.org/ 10.52547/etiadpajohi.17.67.329
Sharif H, Sigari S, Sadr M, Abdolahinia A(2014). Masjedi M. Smoking and Substance Abuse Relation: Is Tobacco a Gateway for Substance Abuse?. Nafas.1(2):19-24.
Yousefei F, Darabi H, Nabei Pour I, Asadi M, Katayoun V, Kardeh E, et al.(2014). Prevalence of Tobacco Smoking in Bushehr Province: Comparison of Two Phases of the Persian Gulf Healthy Heart Study. Iranian South Medical Journal 17(3): PP. 487-95.
Toebes, B. The right to health as a human right in international law. Refug Surv Q. 2001;20(3):180-8.
Scamber G. Habermas, Critical Theory and Health. Nozari HA, translator. Tehran: Elmi Farhangi Publisher; 2017. 371 p.https://doi.org/ https://doi.org/10.4324/9781315008547
Shojaei Tehrani H, Ebadi Fard Azar F. Principles of health services. 1st ed. Tehran: Samat Publisher. p. 197.
journal of sustainable rural development
Volume 9, Issue 2 - Serial Number 16
Autumn and Winter
Autumn 2025