A study from the University of Auckland has revealed that a faith-based smoking cessation programme delivered through WhatsApp messages can help Muslims reduce or quit smoking. The research tested an intervention that combines Islamic teachings with health information in Saudi Arabia and New Zealand.
The study found that 23.5% of participants receiving faith-based messages quit all tobacco use, compared to 17.6% in a control group receiving only health messages. While these differences were not statistically significant due to the small sample size, researchers say the results are encouraging and warrant larger trials.
The research began with a comprehensive review of existing faith-based smoking cessation programmes worldwide. It found that most such interventions targeted Christian populations in Western countries, with limited evidence available for Muslim communities. Key gaps included a lack of theoretical frameworks, insufficient measurement of religiosity, and underrepresentation of women.
Qualitative interviews with 16 Muslim smokers and former smokers in Saudi Arabia and New Zealand identified several barriers to quitting. These included peer and family influence, cultural norms that normalise smoking, nicotine addiction, and easy access to affordable tobacco products. Religious beliefs, health concerns, and family responsibilities emerged as key motivators for quitting.
Participants expressed strong support for an intervention combining religious content with practical health advice. Many emphasised that religion alone would not be sufficient, recommending the inclusion of willpower-strengthening strategies and awareness of smoking’s harms.
The intervention was developed through workshops with religious leaders (Imams) who helped select appropriate Quranic verses and Hadith to support health messages. The final programme delivered 44 WhatsApp messages over 21 days, with two daily messages covering topics such as nicotine withdrawal, social support, and the spiritual benefits of quitting.
A pilot randomised controlled trial recruited 34 participants from an anti-smoking clinic in Makkah, Saudi Arabia. The study achieved a 79% recruitment rate and 64.7% retention rate. Most participants (88.2% in the intervention group) read the daily messages consistently. Among those who completed the acceptability survey, 88.9% rated the programme as acceptable or very acceptable.
The research identified that organisational religiosity, measured by mosque attendance, showed a borderline association with smoking abstinence. This suggests that community-based religious activities may play a role in supporting cessation efforts.
Researchers recommend that future studies should recruit larger samples, begin recruitment earlier, and consider delivering such interventions during Ramadan when religious motivation is naturally heightened. They also emphasise the importance of measuring multiple dimensions of religiosity to understand how faith influences smoking behaviour.
The study makes a significant contribution to the limited evidence base on faith-based health interventions for Muslim communities and provides a model that could be adapted for other religious groups.
A New Approach to an Old Problem
Smoking remains one of the world’s leading preventable causes of death, killing more than seven million people annually. Among Muslim populations, the problem persists despite Islamic teachings that discourage or prohibit the habit. Now, a pioneering study offers hope through an innovative approach that speaks to both the body and the soul.
Abdullah Kalantan, a doctoral researcher at the University of Auckland, has developed and tested a faith-based smoking cessation intervention that delivers messages combining Islamic teachings with health information directly to participants’ mobile phones. The research, which spanned Saudi Arabia and New Zealand, represents the first study to explore smoking behaviours among Muslims across two distinct cultural settings and use those findings to create a tailored intervention.
The programme arrived at a critical moment. Smoking prevalence remains alarmingly high in many Muslim-majority countries, with Saudi Arabia reporting adult smoking rates of 16.5% in 2022. Among Muslim minorities in Western nations, rates are often higher than the general population due to language barriers, cultural factors, and limited access to culturally appropriate cessation services.
Why Faith Matters in Health
The connection between religion and health has been well-documented in scientific literature. People who regularly participate in religious activities tend to live healthier lives, partly because most faiths discourage harmful behaviours like smoking. Islam, in particular, emphasises the preservation of life and health as fundamental obligations.
For many Muslims, however, the religious ruling on smoking has not always been clear. Until the early 20th century, scholars classified tobacco as neutral. As evidence of its harms emerged, many jurists reclassified smoking as discouraged, and later as prohibited. Yet this information has not always reached ordinary worshippers, and tobacco industry efforts have sometimes muddied the waters.
Kalantan’s research found that participants held varied views on whether smoking is forbidden or merely discouraged. Some used the ambiguity to justify continuing the habit, while others found motivation to quit in the belief that smoking displeases God. This variation highlights the importance of clear religious guidance combined with practical health information.
The study also explored how Ramadan, the Islamic holy month of fasting, affects smoking behaviour. During Ramadan, Muslims abstain from food, drink, and smoking from dawn to dusk. This natural reduction in tobacco use creates what researchers call a “teachable moment” when people who smoke may be more open to quitting permanently.
Listening to Those Who Smoke
Before designing the intervention, Kalantan conducted in-depth interviews with 16 Muslim smokers and former smokers. Ten participants came from Saudi Arabia, and six were based in New Zealand. The conversations revealed a complex web of factors that influence smoking behaviour.
Social connections emerged as both a powerful driver of smoking and a potential tool for quitting. Many participants described smoking as integral to their social lives, whether gathering with friends at cafés or bonding with colleagues during work breaks. At the same time, encouragement from family members and friends provided crucial motivation during quit attempts.
Cultural normalisation played a significant role, particularly in Saudi Arabia. One participant explained how smoking at home was simply accepted: “In the house, it is okay. If I want to smoke cigarettes or shisha, it is okay.” Another described growing up surrounded by smokers: “I grew up around it. My dad smoked, and all my uncles and aunties. It was just so normal.”
Gender differences also emerged. While smoking was largely accepted among men, women reported hiding the habit due to social stigma. This double standard creates unique challenges for female smokers seeking support.
The Intervention
The programme Kalantan developed delivered 44 WhatsApp messages over 21 days. Each day, participants received two messages: one in the morning and one in the evening. The messages combined health information about nicotine addiction, withdrawal symptoms, and the benefits of quitting with Quranic verses and sayings of Prophet Mohammed.
Religious leaders, known as Imams, played a central role in developing the content. Through workshops conducted in both Saudi Arabia and New Zealand, they helped select appropriate religious texts and ensure that messages accurately reflected Islamic teachings. One Imam suggested replacing a verse initially chosen to support a health message with a more directly relevant verse: “And do not kill yourselves. Indeed, Allah is ever Merciful to you.”
The involvement of religious leaders was not merely symbolic. Previous research has shown that Imams hold significant influence in Muslim communities and can serve as effective health promoters. Their participation helped ensure the intervention’s cultural and religious authenticity.
Participants who received the faith-based messages showed slightly higher quit rates than those who received health messages alone. While the difference was not statistically significant, researchers noted that the study was not designed to measure effectiveness definitively.
What Participants Said
Feedback from participants was largely positive. Among those who completed the acceptability survey, 88.9% expressed a positive view of the programme. One participant described the combination of faith and health as “a very good combination,” adding that “when you combine these two, I think the impact will be very good.”
Another participant emphasised that religious content should be supported by practical information: “Don’t use religion alone. You must support it with something else. Focus more on the health and financial perspectives.”
The study found that participants appreciated messages about the financial costs of smoking. One message quoted a participant who noted, “The money that I was earning was spent mostly on tobacco.” Such practical concerns resonated alongside spiritual motivations.
However, not all participants found religion to be a strong motivator. Some described it as a weak influence on their behaviour, suggesting that for faith-based interventions to succeed, they must address multiple factors simultaneously.
Lessons for Future Research
The study encountered several challenges that offer valuable lessons. Recruitment in New Zealand proved difficult due to the small Muslim population and low overall smoking rates. The research team eventually shifted the trial to Saudi Arabia, where they partnered with an anti-smoking clinic in Makkah.
Timing also proved problematic. The intervention was originally planned for delivery during Ramadan, when religious motivation is naturally heightened. Delays in obtaining ethics approvals and finalising partnership agreements meant the programme was delivered outside Ramadan instead.
Researchers recommend that future studies begin recruitment much earlier, collaborate with multiple clinics and community organisations, and consider offering more substantial incentives to improve retention rates. The study’s retention rate of 64.7% fell short of the recommended 80% benchmark for feasibility studies.
Key Findings at a Glance
| What Was Studied | What Was Found |
|---|---|
| Faith-based messages via WhatsApp | Feasible and acceptable to participants |
| Quit rates (all tobacco) | 23.5% intervention vs 17.6% control |
| Recruitment rate | 79% within three months |
| Retention rate | 64.7% completed follow-up |
| Message adherence | 88.2% read messages daily |
| Participant satisfaction | 88.9% rated programme acceptable |
| Religiosity measure | Mosque attendance showed borderline association with quitting |
Barriers and Motivators for Quitting Smoking
| Barriers to Quitting | Motivators for Quitting |
|---|---|
| Peer and family influence | Health concerns |
| Cultural acceptance of smoking | Religious beliefs and practices |
| Nicotine addiction | Financial savings |
| Easy availability of tobacco | Family responsibilities |
| Stress and coping needs | Social encouragement |
| Lack of willpower | Role modelling for children |
| Ramadan challenges (for some) | Ramadan opportunities (for others) |
The Road Ahead
Kalantan’s research makes a significant contribution to a neglected area of public health. While faith-based health interventions have been extensively studied in Christian populations, Muslim communities have received far less attention. This gap is particularly concerning given the high smoking rates in many Muslim-majority countries.
The study also highlights the importance of measuring religiosity in faith-based interventions. Most previous studies failed to assess how religious commitment influences outcomes, making it difficult to understand why some interventions succeed while others fail. Kalantan used a validated multidimensional scale that measured organisational religious activity, private religious practices, and intrinsic religiosity.
The findings suggest that mosque attendance may play a particularly important role in supporting smoking cessation. This makes intuitive sense: regular attendance at religious services exposes individuals to moral teachings that discourage smoking while providing social support and accountability.
Future research should explore how faith-based interventions can be adapted for Muslim women, who face unique cultural barriers to seeking help. The study included only two female participants in the pilot trial, reflecting broader challenges in recruiting women who smoke in Muslim communities.
Conclusion
The journey to quit smoking is rarely straightforward. Nicotine addiction creates powerful physical and psychological dependencies that make cessation difficult even for highly motivated individuals. Faith-based interventions offer a promising approach by connecting health behaviour change to deeply held spiritual values.
Kalantan’s research demonstrates that carefully designed, religiously tailored messages can reach Muslim smokers and support their quit attempts. The intervention was feasible, acceptable, and showed promising preliminary results. While larger trials are needed to confirm effectiveness, the study provides a template for developing culturally and religiously appropriate health interventions.
The key lesson is that faith matters. For many Muslims, quitting smoking is not just a health decision but a spiritual one. By speaking to both dimensions, interventions can harness the power of religious belief to promote healthier lives.
