Int. J. Environ. Res. Public Health 2011, 8 4218 studies are also needed using large random samples to examine the effect of SHS avoidance programs for the home and especially for poorly educated, low income and women. Future research will be needed to develop and test interventions tailored to meet the needs of various segments of Jordanian society. Adults, teens and children will need special programs to prevent tobacco use, to provide cessation treatment and to reduce SHS exposure. 5.4. Conclusions The level of exposure to SHS is relatively high among well educated Jordanian women. The findings support the need for effective strategies to reduce the prevalence of smoking in Jordan and protect non-smokers from SHS exposure. Moreover, culturally tailored intervention programs will need to be developed to target both smokers and non-smokers of all ages. Smoking is a culturally sensitive issue in Jordan, especially among men. However, due to the overall increase in poor health outcomes due to smoking and SHS in Jordan and the Middle East, it is critical to reverse this harmful social norm that accepts and tolerates smoking. Acknowledgements References The study was funded by award #218/2010, Jordan University of Science and Technology, Deanship of Scientific Research. 1. 2. 3. 4. 5. 6. 7. 8. Murray, C.; Lopez, A. Alternative projections of mortality and disability by cause 1990–2020: Global burden of disease study. Lancet 1997, 349, 1498-1504. Nakkash, R.; Lee, K. The tobacco industry’s thwarting of marketing restrictions and health warnings in Lebanon. Tob. Control 2009, 18, 310-316. Fact Sheet: Secondhand Smoke and Cancer; National Cancer Institute: Bethesda, MD, USA, 2011; Available online: http://www.cancer.gov/cancertopics/factsheet/Tobacco/ETS (accessed on 9 February 2011). Bloch, M.; Tong, V.T.; Novotny, T.E.; England, L.J.; Dietz, P.M.; Kim, S.Y.; Samet, J.M.; Tolosa, J.E. Tobacco use and secondhand smoke exposure among pregnant women in low- and middle-income countries: A call to action. Acta Obstet. Gynecol. Scand. 2010, 89, 418-422. Huerta, M.; Bibi, H.; Haviv, J.; Scharf, S.; Gdalevich, M. Parental smoking and education as determinants of overweight in Israeli children. Prev. Chronic Dis. 2006, 3, A48. Haddad, L.; Al-Zyoud, S.; Abu Baker N.; Gharaibeh, H.; El Shahawy, O; Alramadhani, R. Secondhand smoking in Jordan: Clearing the air for one of the highest tobacco prevalence countries in the Middle East. Tob. Use Insights 2011, 4, 1-7. Madanat, H.; Barnes, M.D.; Cole, E.C. Knowledge of the effects of indoor air quality on health among women in Jordan. Health Educ. Behav. 2008, 35, 105-118. Badran, E.; Salhab, A.S.; Al-Jaghbir, M. Infant exposure to environmental tobacco smoke: Jordan University hospital-based study. East. Mediterr. Health J. 2009, 15, 39-46.