Why most women in Syria do not smoke: can the passive barrier of traditions be replaced with an information-based one?

To explore the subjective motivations why most Syrian women do not smoke, we performed a cross-sectional survey among primary healthcare patients in Aleppo using an interviewer-administered questionnaire with motivations categorized as traditions and norms, family values, health concerns, personal conviction, economic, religious and other. Study participants (n = 240) had a mean age of 29 years. Among non-smokers, traditions and norms, and health concerns were the main reasons for not smoking, followed by family values, husband's views about smoking, personal conviction, economic reasons and religious reasons. Motivations differed according to the participants' previous smoking, marital and educational status. Better-educated women tended to have their own motives based on a more complete awareness of the smoking problem. Tobacco control efforts should aim at replacing the passive barrier of traditions with a well-informed positive one.