Exploring the perceived sociocultural factors in the initiation of smokeless tobacco among adolescents: a qualitative systematic review protocol

Publication Name

JBI evidence synthesis


OBJECTIVE: The objective of the review is to identify and explore the perceived sociocultural factors leading to smokeless tobacco initiation among the adolescent population. INTRODUCTION: Smokeless tobacco use is associated with oral cancer and premalignant lesions. The initiation of smokeless tobacco often occurs in adolescence, with multiple sociocultural factors facilitating the commencement of this habit. An in-depth understanding of the factors influencing smokeless tobacco uptake can assist policymakers and tobacco-control units in establishing global policies and implementing control strategies to prevent adolescents' taking up smokeless tobacco. INCLUSION CRITERIA: This review will consider qualitative studies conducted within the last 20 years on adolescent smokeless tobacco users, focusing on sociocultural factors influencing smokeless tobacco initiation. Studies involving cigarette smoking, other alternative forms of smoking, and any form of tobacco cessation intervention will be excluded. METHODS: A systematic search will be conducted in MEDLINE, Scopus, CINAHL, Embase, PsycINFO, and the Cochrane CENTRAL databases, using a 3-step search process. ProQuest Dissertations and Theses, OAIster, and Google will be searched for unpublished studies. Only studies published from January 2002 until the present and in English will be considered. Study screening, extraction, and critical appraisal will be performed by 2 independent reviewers using the standardized JBI qualitative appraisal and data extraction tools. Data synthesis will involve aggregation of the review findings to generate a set of statements based on similarity of meaning. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021240588.

Open Access Status

This publication may be available as open access





First Page


Last Page




Link to publisher version (DOI)