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.

Assessment of the Relationship between Nutritional Knowledge and Anthropometric Indices in Isfahan Children and Adolescent.

BACKGROUND: Anthropometric indices are one of the ways to assess physical growth and nutritional status of children and adolescents considering the importance of nutrition in children and the role of healthy nutrition in preventing diabetes, obesity and other chronic diseases, the objective of this study is determine the relationship between nutritional knowledge and anthropometric indices in children and adolescents in Isfahan. MATERIALS AND METHODS: This survey conducted using multistage cluster sampling on 1776 students aged 15-7 years old in Esfahan province in 2015. Nutritional knowledge was measured by questionnaire and height, weight, and body mass index (BMI) were measured as anthropometric index. Pearson and Spearman coefficients, regression, and T Independent were used to analyze the data; regression analysis was used to adjust the variables. RESULTS: The mean age of students were 12.6 ± 1.9 years. About 50.3% of students were male, and most of them were studying in 5th grade of elementary school (23.8%). Most of them had normal status in terms of BMI (60.6%) and height (77.8%). There was no significant relationship between the level of BMI and height of children and adolescents, and the total score of nutritional knowledge and its domains (P > 0.05), direct and significant relationship was found between nutritional knowledge in two domains of meals and food habits and age. CONCLUSION: As no relationship between nutritional knowledge and anthropometric index in our study, other factors are effective in this regard, and studies are required to be conducted to examine the nutritional attitude and performance, in addition to knowledge.

Psychological and Familial Factors of Depression in Relation to Adolescent Smoking Behavior.

BACKGROUND: Several common factors have been identified for smoking and depression. The The present study explores the relation of psychological and familial factors with depression, by student smoking behavior. MATERIALS AND METHODS: A total of 5500 middle- and high-school students were selected in Isfahan province in 2010. A self-administered questionnaire collected data on background characteristics, smoking status, depression, and risk factors. Univariate analysis multiple logistic regressions were conducted to compare between depressed and nondepressed people by adolescent smoking status. Odds ratios and the corresponding 95% confidence intervals (CIs) were reported. RESULTS: Fathers lower education attainment was accompanied adolescents higher depression prevalence. Parental smoking and sibling smoking increased the depression likelihood by 1.41 (95% CI: 1.18, 1.68) and 1.43 folds (95% CI: 1.04-1.94) for never-smokers. Positive attitude toward smoking increased the probability of depression by 1.18 among never-smokers. Never-smokers lacking refusal skill had 1.23 (1.03-1.47) higher chance of depression. A higher level of self-efficacy related to lower chance of depression. Taking risky behavior, increased the depression likelihood by 1.56 (95% CI: 1.29-1.89) in never-smokers, by 1.85 (95% CI: 1.37-2.44) in experimental smokers, and by 1.14 times (95% CI: 1.01-1.72) in current smokers. Family conflict increased depression chance by 2.25 times (95% CI: 1.89-2.66) in never-smokers, by 1.95 (95% CI: 1.46-2.61) in experimental smokers, and by 2.06 times (95% CI: 1.38-3.08) in current smokers. CONCLUSIONS: Targeting self-efficacy level, risky behavior, and family conflict can drop the comorbidity of smoking and depression simultaneously. This may help public health practitioners and policymakers to develop common strategies in reducing adolescents smoking and depression comorbidity.

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.

Better view on attitudes and perceived parental reactions behind waterpipe smoking among Iranian students.

BACKGROUND: Because of the increasing usage of waterpipe globally, we need to know more about the different factors related to waterpipe and cigarette smoking. Therefore, the present study aims at gaining more insight on waterpipe and cigarette smoking based on perceived parental reaction and appeal and repellent of smoking among adolescents. MATERIALS AND METHODS: A cross-sectional survey entitled "Isfahan Tobacco Use Prevention Program" (ITUPP) was conducted among 5,500 adolescents in Isfahan Province, Iran in 2010 using a self-administered anonymous questionnaire. Demographic factors, cigarette and waterpipe smoking status, appeal and repellent of smoking, perceived parental reactions, and the main reasons behind the increase in waterpipe smoking were measured. Chi-square, univariate logistic regression, and multiple logistic regression were used. For all analyses, we defined statistical significance a priori with a two-tailed alpha of 0.05. Statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS) version 15. RESULTS: 50% of the sample was female and 89% lived in urban areas. The average age of the respondents was 14.37 ± 1. 70 years. While a majority of cigarette smokers (70.9%) were waterpipe smokers, only 35.7% of waterpipe smokers smoked cigarettes. The incidence of smoking was high in those who expected less extensive parental reaction with odds ratio (OR) = 1.89 [95% confidence interval (CI): 1.35-2.63] (P < 0.001) among cigarette smokers and OR = 2.75 (95% CI: 2.16-3.50) (P < 0.001) among waterpipe smokers. "Taste" was rated the most attractive feature by waterpipe and cigarette smokers 2.83-fold (95% CI: 2.06, 3.90) (P < 0.001). Most waterpipe smokers compared to nonsmokers believed that the main reason behind waterpipe popularity was habit. CONCLUSION: The factors related to waterpipe smoking were different from those in cigarette smoking; so we need to implement different interventions to overcome the surging usage of tobacco use.

Short-term Effects of a Physical Activity Intervention on Obesity and Aerobic Fitness of Adolescent Girls.

BACKGROUND: In the past two decades, physical activity has decreased during both childhood and adolescence, and particularly adolescence. It seems that schools are attractive settings in which to implement interventions designed in order to promote physical activity in children; but in Iranian students, few studies have evaluated the effects of such interventions on overweight and obese children. The aim of this study was to evaluate the effects of a short-term school-based physical activity on obesity and aerobic fitness in 12-14 years aged girls. METHODS: This is a study with single group pretest and posttest design, in which 129 middle school girls in city of Isfahan were assessed based on preventive plan of inactivity in children at the Provincial Health Office. Variables, including weight, height, body mass index (BMI), waist-hip ratio (WHR), body fat percentage and aerobic power of subjects were measured using valid tests. RESULTS: This study showed that subjects' body fat percentage changed about 3.6% (37.74% pretest vs. 36.39% posttest), VO2 max changed 7.43% (29.72 pretest vs. 31.93 posttest), WHR changed 1.12% (0.89 pretest vs. 0.88 posttest), whereas BMI was changed 1.65% (27.80 pretest vs. 27.34 posttest). Findings also revealed that there were significant differences between fat percent, (P = 0.001) and VO2 max (P = 0.001) of subjects, but there was no difference between BMI of them in pre- and post-tests (P = 0.361). CONCLUSIONS: These results suggest that even a short-term exercise intervention may lead to positive changes in body fat percentage, WHR and aerobic fitness of overweight children. Therefore, school-based physical activity interventions can be an effective preventive strategy to control obesity and overweight in students.

Knowledge and Practice of Junior and Senior High School Students Regarding Violent Behaviors in Isfahan Province.

BACKGROUND: Considering the importance of anger, aggression, violence and other misbehaviours in schoolchildren education, the present study was conducted to evaluate the knowledge and practice of students in Isfahan province regarding violence, in order to figure out the required interventions for violence-reduction. METHODS: In a survey during 2008-2009, 5500 junior and senior high school students of Isfahan province were assessed in a multistage sampling process to determine their level of knowledge about various types of violent behaviors, causes of violence, its consequences, and preventive behaviors. Validity and reliability of the data collection tool (questionnaire) were assessed. RESULTS: The study revealed that the mean scores of violent behaviors knowledge, knowledge of violent behavior outcomes, and knowledge of violence preventive behaviors, were 6.6 ± 2.1, 5.5 ± 1.9, and 4.7 ± 1.3, respectively. Sources of violent behaviors in 92% of urban students and 89% of rural students were personal reasons and family behaviors, and 85% of urban and 88% of rural students considered mass media and computer games blameworthy, and the differences were statistically significant in all cases (P < 0.0001). In terms of practice, overall, 69.7% of girls and 84.2% of boys had violent behaviors. Physical and verbal violence were 31.3% and 40.7%in girls, and 66% and 52.8% in boys, respectively (intersexes P values were P < 0.001 and P = 0.7 respectively, and intra-sex P value was P < 0.0001). CONCLUSIONS: Results showed that girls and city dwellers were more aware of recognizing violent behaviors, outcomes, and causes, compared with boys and villagers, and in terms of general practice, violence was observed among boys more than girls. Further complementary studies in this area seem required.

Adolescent Perception on School Environment and Smoking Behavior: Analysis of Isfahan Tobacco use Prevention Program.

BACKGROUND: School provides a set of condition which is very important determinant for student smoking behavior. This study aims at exploring the association of the school environment on Iranian middle and high school students smoking. METHODS: A self-administered anonymous questionnaire was circulated among 5500 randomly selected students with 98.3% response rate. The questionnaire asked on demographic information, student smoking status, and their perception on the school environment. School environment factor was consist of teacher smoking, implementation of smoke-free policy at school, student adherence to this policy, student perception of school personnel attitude and attention on smoking and finally receiving information on smoke-related issues via teachers. Analyses were performed with SPSS software using Chi-square and multiple logistic regression. RESULTS: Boys with higher level of witness to teachers smoking had higher odds of being smoking (odds ratio [OR] =1.62, 95% confidence interval [CI] =1.17, 2.25); significant relationship was seen between boy's perception regarding school anti-smoking rules and their smoking (OR = 1.40, 98% CI 1.12, 1.75); fewer concern of school personnel on student smoking behavior was correlated to boys smoking behavior (OR = 1.31, 98% CI 1.06-1.63). Among girls, only higher perceived teacher smoking (OR = 2.59, 95% CI = 1.04, 6.44) was associated with their smoking. CONCLUSIONS: Teachers have a crucial role in student smoking; therefore, they strategies must be taken to persuade the student, school staff, and students to adhere free-smoking policies in and out of school.

The Relationship of Parental Education with Knowledge and Practice Level of Middle School and High School Students of Isfahan Regarding Violent Behaviors.

BACKGROUND: It can be concluded from the existing theories that parental education status, by affecting socioeconomical status of families, can impact the incidence of violent behaviors in teenagers. Therefore, this study was conducted aiming at investigating the relationship between parental education and teenagers' knowledge of violent behaviors and their incidences. METHODS: For this cross-sectional, descriptive-correlational study, a sample of 5500 teenager students from Isfahan province were selected by random cluster sampling and responded to a 61-item questionnaire. The data collected from by questionnaire was analyzed by Spearman's statistical correlation and multiple regression methods. RESULTS: Most of the students under study (89.1%) were living in cities and the rest were rural dwellers. In terms of gender, female to male ratio was approximately equal (49.8% vs. 50.2%). The statistical results showed that there is a significant positive relationship between practice and knowledge (R = 0.092 and P = 0.00), but there is no significant relationship between parental education and practice and there is a significant relationship between parental education and knowledge (Mothers' education P = 0.00 and R = 0.121 and fathers' education P = 0.00 and R = 0.109). Moreover, there was a positive significant relationship between teenagers' knowledge of violence consequences (P = 0.005 and B = 0.048) violent behavior causes (P = 0.00 B = 0.085) and methods of preventing violent behaviors (P = 0.00 and B = 0.085) with teenagers' practice. CONCLUSIONS: Based on the results of the present study that indicates teenagers are less aware of the consequences of violent behavior compared to other subscales of knowledge, it is better that teenagers' education about the violent behaviors are more about the consequences of violent behavior rather than its definitions. Moreover, parental education is related to teenagers' knowledge of the violent behavior so it is better that in various grades more comprehensive and suitable information regarding violent behaviors be presented.

Nutritional Knowledge, Practice, and Dietary Habits among school Children and Adolescents.

BACKGROUND: Although nutritional status of children and adolescents is of great concern various interventions and modifications aiming at promotion of healthy eating behaviors have limited impact due to insufficient understanding of dietary habits between different age groups and genders. The aim of this study in not only evaluation of nutritional knowledge, practice, and dietary habits of primary school and junior high school students in Isfahan province, but also this research explore crucial differences regarding gender and living area of the above-mentioned population in Iran. METHODS: This cross-sectional study was conducted on 4700 primary school and junior high school pupils in Isfahan province. Data were collected through standard 24-h recall food frequency questionnaire and researcher-designed questionnaire. Independent t-test was applied for comparison of mean values of total units of consumed food materials. Qualitative variables were compared by using the Chi-square test. Data were analyzed by ACCESS 2010 and SPSS 18 software. RESULTS: Nutritional knowledge of female pupils and junior high school students was higher than their male and elementary school students respectively; still, theses superiorities did not lead to higher practice score. Bread and cereals group received daily intakes in accordance with food and drug administration (FDA) recommendations. Indeed, vegetables, milk, and dairy products, as well as meat daily intakes, were lower than the FDA recommendation, whereas fats, oils, and sugars intakes were higher. In comparison to females, male participants had significantly lower consumption of vegetables and fruits whilst they had a higher intake of carbohydrates, fats, and meats. CONCLUSIONS: Our results showed that adolescents failed to meet sufficient nutritional requirements, and they had an imbalanced diet, which was considerably low in several essential nutrients and high in some food materials.

The Relationships between Environmental Factors and Violent Behaviors in Adolescent Students of Isfahan, Iran.

BACKGROUND: Violence is a global issue that has received considerable attention during recent years. Available research has suggested various factors, mostly family and social factors, to possibly affect violence. As previous studies have not examined the relationship between these factors and violent behaviors in adolescents, this study aimed to assess the relationship between environmental factors and violence in adolescents. METHODS: This descriptive, correlational research used cluster sampling to select 5500 adolescent students from Isfahan Province (Iran). Data were collected through a 21-item researcher-made questionnaire. The questionnaire was modified according to the relevant experts' opinions and had Cronbach's alpha of 0.82. The collected data were analyzed by applying multiple regression analysis in SPSS (SPSS Inc., Chicago, IL, USA). RESULTS: Most participants (89.1%) lived in urban areas and about half (49.8%) of them were female. Linear regression test showed violent behaviors to have significant, inverse relationships with love and affection in the family (ß = -0.097; P < 0.001) and watching drama and comedy movies (ß = -0.128; P < 0.001 and ß = -0.032; P = 0.030, respectively). There were significant, direct relationships between violent behaviors in adolescents and aggressive behaviors in the family (ß =0.099; P < 0.001) and watching crime, police, and action movies (ß =0.129; P < 0.001, detective movies ß =0.043; P < 0.001, and ß =0.061; P < 0.001, respectively). However, the incidence of violent behaviors was not significantly related with the effects of peers and presence of sports facilities. CONCLUSIONS: Our findings confirmed love and affection and healthy pastime (e.g. watching comedy and drama movies) in the family to reduce violent behaviors in adolescents. In contrast, aggressive behaviors in the family, watching crime, police, and action movies were found to increase violent behaviors in adolescents.

Methodology of isfahan tobacco use prevention program: first phase.

Background. Tobacco use continues to be the leading global cause of preventable death. The majority of smokers begin using tobacco products at teen ages. The aims of this study were providing a methodology of Isfahan Tobacco Use Prevention Program and investigating the prevalence of tobacco use and its related factors. Method. It was a cross-sectional study among guidance and high school students in Isfahan province. Initiation, social, psychological (depression and self-efficacy), family, and attitudinal and belief factors and school policy toward smoking (cigarettes and water-pipe) were investigated. Saliva qutinin was given from 5% of participants for determination of accuracy of responses. A self-administered anonymous questionnaire was used for gathering all data. Results. Of all 5500 questionnaires distributed, about 5408 completed questionnaires were returned (with response rate of 98.3%). Of all participants, 2702 (50.0%) were girls and 2706 (50.0%) were boys. Respectively, 4811 (89.0%) and 597 (11.0%) were from urban and rural. Of all participants, 2445 (45.2%) were guidance school and 2962 (54.8%) were high school students. Conclusion. This study will provide a unique opportunity to study prevalence of smoking cigarettes and water-pipe (ghelyan) among guidance and high school students in Isfahan province and determine the role of initiation, social, psychological, family, and attitudinal and belief factors and school policy toward smoking.