Smoking motivators are different among cigarette and waterpipe smokers: the results of ITUPP

The present study explores different drivers of cigarette and water pipe smoking among middle and high school students in Isfahan province. A questionnaire-based cross-sectional study was conducted. Trained staff collected questionnaires and saliva samples for response accuracy evaluation. Prevalence by demographic, parental and educational factors was calculated. Logistic regression was applied to compare behavior drivers of those who purely smoked cigarettes or a waterpipe. Waterpipe smokers were considered as the reference category. This study reported ORs along 95% confidence intervals; 5408 questionnaires were returned. The sample age was 15.37 +/- 01.70 on average. The self-reported prevalence of cigarette and waterpipe experimentation was 11.60% [n = 624] and 20.70% [n = 1,109], respectively; and 5.08% [n = 311], 11.06% [n = 619] for smokers, and 13.30% [n = 711] for the whole sample. Psychological factors were the most important driver for cigarette smoking; bad event happening with odds of 2.38 [95% CI: 1.29-4.39]; angriness 2.58 times [95% CI: 1.51-4.43]; and distress by 2.49 times [95% CI: 1.42-4.40]. Habitual situations were strong predictors of cigarette smoking, but not a predictor of waterpipe smoking, such as smoking after a meal [OR = 3.11, 95% CI: 1.67-5.77]; and smoking after waking up [OR = 2.56, 95% CI: 1.42-4.40]. Comprehensive and multifaceted preventive programs must tailor identified factors and increase family's awareness

Establishment of health clinics as mass screening and referral systems for chronic non-communicable diseases in primary health care

This study aimed to establish a comprehensive screening and referral system for chronic non-communicable diseases [CNCD] in the routine primary health care, and to determine the prevalence of diabetes, pre-diabetes, metabolic syndrome, and dyslipidemia in adult population invited by public announcement to the Health clinics in Isfahan, Iran. This survey was conducted from March 2010, and the current paper presents data obtained until November 2011. To provide health services for prevention and control of CNCDs, with priority of type2 diabetes mellitus, Health clinics were established in different parts of Isfahan city with a population of approximately 2,100,000 in Iran. The general populations aged 30 years and above were invited to the Health clinics by public announcement. A total of 198972 participants were screened. The mean age of participants was 47.8 years [48.5 men, 47.3 women], with a range of 1 to 95 years old and standard deviation of 12.3 years [12.7 men, 12.1 women]. Overall, 22% of participants had impaired fasting glucose, 25% had hypercholesterolemia, 31% had hypertriglyceridemia, and 20% had metabolic syndrome. The high prevalence of dysglycemia and diabetes in our survey may serve as confirmatory evidence about the importance of mass screening and early diagnosis of CNCDs' risk factors. Our model of establishing Health clinics, as a comprehensive referral system in the routine primary health care can be adopted by Middle Eastern countries, where CNCDs notably diabetes are an emerging health problem