Smoking and Ramadan in Tunisia: A qualitative study of religious influence and gender related dynamics on behaviors’ and coping strategies

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Published Sep 13, 2026
https://doi.org/10.62438/tunismed.v104i08.6477
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Vol. 104 No. 08 (2026): Tunis Med Aug 2026

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Afef Skhiri
Department of Preventive and community medicine, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, « LR 19SP03 » 4000 Sousse, Tunisia
Wael Garnaoui
The Sousse School of Health Sciences and Techniques, University of Sousse, 4000 Sousse, Tunisia
Hajer Ammari
Faculty of Arts and Human Sciences of Sousse, University of Sousse, 4000 Sousse, Tunisia
Manar Taamallah
Faculty of Arts and Human Sciences of Sousse, University of Sousse, 4000 Sousse, Tunisia
Ghada Bouzaabia
Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
Sihem Ben Fredj
Department of Preventive and community medicine, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, « LR 19SP03 » 4000 Sousse, Tunisia
Nawel Zammit
Department of Preventive and community medicine, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, « LR 19SP03 » 4000 Sousse, Tunisia
Boutheina Trabelsi
Department of Preventive and community medicine, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, « LR 19SP03 » 4000 Sousse, Tunisia
Firas Chouikha
Department of Preventive and community medicine, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, « LR 19SP03 » 4000 Sousse, Tunisia
Rim Ghammem
Department of Preventive and community medicine, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, « LR 19SP03 » 4000 Sousse, Tunisia
Imed Harrabi
Department of Preventive and community medicine, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, « LR 19SP03 » 4000 Sousse, Tunisia

Abstract

Introduction: Ramadan requires a daily break from habitual behaviours, including smoking; while smoking is tolerated beyond this period, it is forbidden during the fast. It could therefore be a favourable time to quit smoking. Indeed, the daytime fast is a time of physical, mental and spiritual discipline. It is also a test of one’s relationship with pleasure, time and oneself. From this perspective, Ramadan appears to many smokers as an ambivalent period, characterized by both an effort to exercise control and a rise
in frustrated desire. Our study aims to explore whether Ramadan does indeed promote sustained smoking cessation.
Methods: We conducted a qualitative study based on semi-structured individual interviews with Tunisian adults who are regular tobacco users. Participants were recruited via snowball sampling, initiated by three investigators. Three heterogeneous selection sites (school, universities and
public areas) were strategically chosen to initiate recruitment.
Results: Participants reported early initiation and a significant reutilization of their consumption, which they perceived as providing psychological support. During the month of Ramadan, religious constraints imposed a daytime break, leading to temporary nocturnal consumption. Some considered this month as an opportunity to quit, while others saw it as a temporary constraint. Various coping mechanisms have emerged,
reflecting the particular complexity of the tobacco addiction.
Conclusion: The religious context has a temporary influence on smoking behavior, but its long-term impact is limited without additional targeted strategies. The diversity of smoking experiences, shaped by religious prohibitions ....( abstract truncated at 250 words).

Keywords:

Smoking, Ramadan, Tobacco addiction, Behavioral coping, Religious influence, Gender dynamics, Tunisia

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