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.

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