Factors associated with smoking contemplation and maintenance among Iranian adolescents

Background: Evidence is scarce on which factors contribute to cigarette and waterpipe contemplation and no previous study has examined the factors associated with waterpipe maintenance.

Aims: This study aimed to determine the factors associated with cigarette and waterpipe smoking contemplation and maintenance among Iranian adolescents.

Methods: Factors including depression, risky behaviour, family conflict, attitude to smoking acceptability and self-efficacy were examined using a questionnaire for 5500 adolescents at the smoking contemplation or maintenance stage.

Results: Students with depression had nearly double the chance [95% confidence interval [CI]: 1.41–2.72] of cigarette smoking contemplation. Risk takers had odds of 2.13 [95% CI: 1.51–2.94] and 1.49 [1.22–1.85] of cigarette and waterpipe [hookah] smoking contemplation, respectively. Those facing family conflict had odds of 1.87 [95% CI: 1.38–2.53] and 1.53 for cigarette and waterpipe smoking contemplation, respectively. The contemplation odds for students with more positive attitude to smoking acceptability were 2.12 [95% CI: 1.51–2.97] and 1.72 for cigarette and waterpipe smoking, respectively. Higher self-efficacy was associated with lower cigarette and waterpipe smoking contemplation. Risky behaviour was related to smoking maintenance. A more positive attitude to smoking acceptability was related to higher waterpipe maintenance [odds ratio = 1.57 95% CI: 1.03–2.40].

Conclusions: Depression, attitude to smoking acceptability and risky behaviour are factors associated with smoking contemplation and maintenance.

Chronic obstructive pulmonary disease [copd]: a role for inflammation

Chronic obstructive pulmonary disease [COPD] is a common respiratory condition, especially among smokers. The interest in this condition has been disappointingly modest in contrast to its widespread occurrence and seriousness. This review explores different aspects of airway inflammation in COPD and their implications for treatment. A review of studies related to the inflammatory process in COPD in the last ten years was done utilizing two major medical databases [MedLine and EMBASE]. Evidence suggests an important role of airway inflammation in the development of airflow limitation in smokers. A possible important role of neutrophils in this inflammation and in the pathogenesis of COPD has been suggested as well. Some of the inflammatory mediators of COPD could prove to be valuable targets for therapeutic interventions, and others could serve as markers to monitor disease activity and response to treatment. The issue of corticosteroids in COPD is still controversial. Good response to these agents is often related to the coexistence of features of asthma. Since smoking cessation is still the only intervention that leads to an improvement in the natural history of COPD, identifying cells and mediators that drive this smoking-induced airway inflammation and obstruction should guide our development of novel therapies to treat this condition