1
|
Seyyedsalehi MS, Shah A, Rashidian H, Hadji M, Marzban M, Ansari-Moghaddam A, Nejatizadeh A, Boffetta P, Zendehdel K. Determinants of waterpipe smoking in Iranian adults: results from the IROPICAN study. Front Psychiatry 2023; 14:1292503. [PMID: 38146282 PMCID: PMC10749298 DOI: 10.3389/fpsyt.2023.1292503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/22/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction Waterpipe smoking has become increasingly popular in Western countries, particularly among young individuals. This study aims to identify the factors influencing waterpipe smoking by focusing on consumption patterns. Methods We utilized data from a multicenter case-control study (IROPICAN) conducted in Iran. Multivariate logistic regression estimated the adjusted odds ratio and 95% confidence intervals as a measure of association between waterpipe smoking and different factors. Results Among 3,477 subjects were included, 11.8% were waterpipe smokers. Most of <50 years old smokers were occasional (80%), while daily smokers were often >50 years (85%). Around 59% of occasional users started it before 30 years old. Low education, low SES, alcohol consumption, cigarette smoking, secondhand smoke exposure, and opium use were associated with waterpipe smoking. Stratified analysis by frequency pattern showed an association between occasional smoking with age 0.97 (0.96-0.98), university degree 0.36 (0.17-0.76), urban dwellers 1.40 (1.06-1.86) and between high SES and daily smoking 0.34 (0.17-0.69). Conclusion Our results offer valuable information to policymakers for developing waterpipe smoking control measures. The occasional waterpipe smoking results may be generalized to the younger people in Western countries.
Collapse
Affiliation(s)
- Monireh Sadat Seyyedsalehi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Aneri Shah
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Hamideh Rashidian
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Hadji
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Maryam Marzban
- Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Clinical Research Development Center, The Persian Gulf Martyrs, Bushehr University of Medical Science, Bushehr, Iran
| | | | - Azim Nejatizadeh
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, United States
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Hosseini J, Shojaeefar E, Pooladgar P, Aliakbari F, Ganji M, Hamdieh M, Kheradmand A, Fashami MA. Prevalence of substance use among Iranian male adolescents: Systematic review and meta-analysis. Health Sci Rep 2022; 5:e885. [PMID: 36304760 PMCID: PMC9595342 DOI: 10.1002/hsr2.885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/08/2022] [Accepted: 09/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background and aims Substance use among adolescents is one of the most challenging behavioral disorders with direct consequences. It is of the essence (that) the prevalence of substance use is investigated among Iranian male adolescents. Methods The present study is a systematic review and meta-analysis. All published articles titled "prevalence of substance use among Iranian adolescents" authored in Persian and English from 2004 to 2020 on Pub Med, Scopus, SID, and Google Scholar, a top list of academic research databases, were reviewed. Thirty-three out of 805 articles, hinge on the inclusion and exclusion criteria, were eligible. Statistical analysis carried out in STATA 14.0.Q index, I2 index, and χ 2 test were applied. Results Overall prevalence reported with (95% confidence interval) for substance use 7% (4%-11%), methamphetamine 4% (3%-6%), tobacco 10% (3%-19%), and any addictive substances 4% (2%-7%) among male adolescents respectively. Besides, overall prevalence of alcohol consumption reported 10% (8%-11%). Conclusion The prevalence of substance use among male adolescents is high, so it is indispensable for researchers to pay special attention to this issue.
Collapse
Affiliation(s)
- Jalil Hosseini
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Ehsan Shojaeefar
- Immunology Board for Transplantation and Advanced Cellular Therapeutics (ImmunoTACT)Universal Scientific and Education Network (USERN)TehranIran
| | - Parham Pooladgar
- School of MedicineShahid Beheshti University of Medical ScienceTehranIran
| | - Fereshteh Aliakbari
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Maryam Ganji
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Mostafa Hamdieh
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Ali Kheradmand
- Department of Psychiatry, Taleghani Hospital Research Development Committee, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Mahta Abbasi Fashami
- School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| |
Collapse
|
3
|
Panahi R, Ghaderi N, Latifi A, Rezaei Z. Prevalence of smoking and its related factors among Iranian adolescents. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2098848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Rahman Panahi
- School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Naseh Ghaderi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Arman Latifi
- Department of Public Health, Maragheh University of Medical Scienses, Maragheh, Iran
| | - Zahed Rezaei
- Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran
| |
Collapse
|
4
|
Makvandi Z, Mostafavi F, Bashirian S, Zamani-Alavijeh F, Kelishadi R. Sociocultural factors contributing to waterpipe tobacco smoking among adolescents and young adult women: a qualitative study in Iran. Int J Qual Stud Health Well-being 2021; 16:1857043. [PMID: 33435855 PMCID: PMC7808745 DOI: 10.1080/17482631.2020.1857043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose: Waterpipe tobacco smoking (WTS) is currently a serious and growing public health threat in the world, especially in adolescents and young women. The aim of the study was to explore sociocultural factors contributing to WTS among adolescents and young adult women in Iran. Methods: This qualitative study was conducted from August 2017 to January 2019 in Isfahan and Hamadan cities, Iran; it included 13-30-year-old females with experience of WTS. For data collection, in-depth semi-structured personal interviews were conducted at participants' preferred time and place. Concurrent with data collection, data were analysed through conventional content analysis. Results: The study participants described the various sociocultural factors contributing to WTS. These factors were categorized into four following main categories: waterpipe glamorization by its producers and sellers, media advertisement or silence, common sociocultural traditions, and governmental policies and regulations. Conclusion: A wide range of sociocultural factors affects WTS among Iranian adolescents and young adult women. Therefore, interdisciplinary multidimensional strategies are needed for WTS management and prevention among these at-risk groups. Public education, strict supervision of tobacco import, export, and selling, ample employment opportunities for young people and effective leisure time management are essential to reduce WTS.Abbreviation WTS: Waterpipe Tobacco Smoking; MPOWER: Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, Raise taxes on tobacco.
Collapse
Affiliation(s)
- Zeinab Makvandi
- Student Research Committee, School of Heath, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical sciences, Hamadan, Iran
| | - Fereshteh Zamani-Alavijeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
5
|
Afrashteh S, Ansarifar A, Vali M, Nami Nazari L, Keshtkar N, Memar S, Mohebbi E, Hadji M, Ostovar A, Zendehdel K, Marzban M. Geographic distribution and time trends of water-pipe use among Iranian youth and teenage students: A meta-analysis and systematic review. J Ethn Subst Abuse 2021; 22:285-315. [PMID: 34486927 DOI: 10.1080/15332640.2021.1943097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Water-pipe tobacco smoking is harmful to health, yet its rate of prevalence remains uncertain. Recent evidence has shown that the prevalence of water-pipe smoking among students is higher than in the general population. In this study, a systematic review of related literature on water-pipe use was conducted, and for this purpose, 76 articles were examined in the study. In this vein, geographic distribution and time trends of water-pipe consumption in Iran were considered. The results of this study showed that lifetime, last-year, and last-month prevalence of water-pipe smoking use among Iranian students were 28.78 (25.07-32.49), 20.84 (16.01-25.66), and 16.36 (11.86-20.85), respectively. The results also showed a wide variation by the region and sex in Iran. This study has shown the importance of addressing public prevention and alerting programs in schools and universities.
Collapse
Affiliation(s)
- Sima Afrashteh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Mohebat Vali
- Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Sara Memar
- Bushehr University of Medical Sciences, Bushehr, Iran
| | - Elham Mohebbi
- Tehran University of Medical Sciences, Tehran, Iran.,Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Hadji
- Health Unit, Faculty of Social Science, Tampere University, Tampere, Finland
| | | | | | - Maryam Marzban
- Department of Epidemiology, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran.,The Persian Gulf Martyrs, Bushehr University of Medical Sciences, Bushehr, Iran
| |
Collapse
|
6
|
Prevalence of High-Risk Behaviors among Iranian Adolescents: a Comprehensive Systematic Review and Meta-Analysis. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2021. [DOI: 10.52547/jech.8.2.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
7
|
Zamiri-Miandoab N, Hassanzadeh R, Kamalifard M, Mirghafourvand M. The effect of cognitive behavior therapy on body image and self-esteem in female adolescents: a systematic review and meta-analysis. Int J Adolesc Med Health 2021; 33:323-332. [PMID: 33915608 DOI: 10.1515/ijamh-2021-0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
Low self-esteem and negative body image expose girls to many risks and damages. Cognitive-behavior counseling is one of the ways of improving body image and self-esteem. The aim of this systematic review was to determine the effects of cognitive-behavior therapy on body image and self-esteem of adolescent girls. The English (Cochrane library, Web of sciences, EBSCO, PubMed, Google Scholar) and Persian (SID, MagIran) databases were searched without any time limit. The quality of included studies in terms of risk of bias was assessed using Cochran handbook and the quality of evidence was evaluated through Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analysis was performed using RevMan software. Heterogeneity of studies was analyzed by index I 2. Subgroup analysis was performed on the basis of outcome evaluation intervals (after intervention, one month and two months later). A total of 2,664 articles were accessed in different databases of which 2,655 articles were excluded and finally nine studies were systematically reviewed. Meta-analysis results on seven studies (228 participants) showed that the group receiving cognitive-behavior counseling was significantly better than the control group regarding body image (Standardized Mean Difference [SMD]: 13.01; 95% CI: 10.68 to 15.34; I²=26.1%). Likewise, meta-analysis results on two studies (50 participants) showed that self-esteem was not significantly different between the group receiving cognitive-behavior counseling and the control group (SMD: 1.13; 95% CI: -0.7 to 2.32, I²=73%). Meta-analysis results of this study represent effectiveness of cognitive-behavior therapy on body image of adolescent girls; however, since the number of studies in the field of self-esteem is low, more trials in this field with stronger designs are suggested.
Collapse
Affiliation(s)
- Nasrin Zamiri-Miandoab
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Robab Hassanzadeh
- Department of Midwifery, Bonab Branch, Islamic Azad University, Bonab, Iran
| | - Mahin Kamalifard
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
8
|
Nazarianpirdosti M, Abdi A, Abdi A, Ramazani U. Smoking among High School Students in Iran: A Meta-Analysis Study. IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:226-237. [PMID: 34221048 PMCID: PMC8233551 DOI: 10.18502/ijps.v16i2.5823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Cigarette smoking is an important and preventable risk factor, especially for adolescents and high school students. This issue has become one of the challenges for health system. Thus, the present study aimed to investigate the prevalence of smoking among Iranian high school students. Method: This systematic review and meta-analysis study was done by searching PubMed, Scopus, Web Science (WOS), Science Direct, SID, and Google Scholar using the following keywords: “student” and “smoking” from 2000 to March 2018. After initial and critical appraisal, data were entered into a checklist and analyzed by a comprehensive meta-analysis software. Results: The prevalence of smoking was 7.9% by combining the results of 49 articles. Males and females had 10.6% and 4.5% smoking prevalence, respectively. The overall prevalence of smoking was higher in northern areas in Iran (22.4%). Males in the northern (22.4%) and females in western regions (5.3%) were more smokers. There was a significant relationship between the prevalence of smoking with the year of publication, sample size, and age (P < 0.001). Conclusion: In this study, Students' tendency to smoke was different in various regions of Iran, and had a high rate (7.9%). This figure indicates the necessity for planning some coherent educational programs for the public.
Collapse
Affiliation(s)
| | - Arsalan Abdi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Uosef Ramazani
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
9
|
Keshavarzian K, Nadrian H, Allahverdipour H, Mohammadpoorasl A. Development of a Hookah Smoking Obscenity Measurement Scale for Adolescents. ADDICTION & HEALTH 2020; 12:77-86. [PMID: 32782730 PMCID: PMC7395934 DOI: 10.22122/ahj.v12i2.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background The worldwide trend of hookah use among adolescents is increasing, and literature shows a relationship between obscenity and adolescents’ tendency toward hookah smoking. As there is a lack of appropriate instruments to measure the obscenity of hookah smoking, in the present study, we aimed to develop an instrument to measure hookah smoking obscenity among adolescents. Methods In this methodological study, a sequential exploratory design was used to conduct the study from February 2017 to July 2018 on adolescents in Tabriz, Iran. In the qualitative phase, we conducted semi-structured individual interviews (with 18 students) and a focus group discussion (FGD) (with 13 students) to explain the concept of obscenity and develop the items of hookah smoking obscenity scale (HSOS). We then examined the psychometric properties of the HSOS based on face, content, construct and predictive validities as well as internal consistency and repeatability. Findings The HSOS was developed with 21 items based on the results of qualitative data analysis. Applying confirmatory factor analysis (CFA), the χ2/degree of freedom (df) ratio was found to be 3.792 for the four-factor structure of the questionnaire and the fit indices of this structural model were satisfactory. The values of Cronbach’s alpha and the intraclass correlation coefficient (ICC) for the constructs in the HSOS ranged 0.81-0.93 and 0.79-0.92, respectively. Conclusion We found the HSOS with a good level of fit indices, validity, and reliability. The HSOS may be applied by school healthcare providers and health practitioners to find valid and reliable data on the obscenity of hookah smoking when developing hookah smoking prevention/cessation interventions among adolescents.
Collapse
Affiliation(s)
- Khadijeh Keshavarzian
- Department of Statistics and Epidemiology, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haidar Nadrian
- Department of Health Education and Promotion, School of Health AND Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Department of Health Education and Promotion, School of Health AND Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Mohammadpoorasl
- Department of Statistics and Epidemiology, School of Health AND Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
10
|
Kader Z, Roman NV, Crutzen R. Determinants of Adolescent Hookah Pipe Use: A Systematic Review. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2020. [DOI: 10.1080/1067828x.2020.1789525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Zainab Kader
- University of the Western Cape, Cape Town, South Africa
| | | | - Rik Crutzen
- Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
11
|
Keshavarzian K, Nadrian H, Mohammadpoorasl A. Development of a Cigarette Smoking Obscenity Scale (CSOS) in adolescents: an exploratory sequential mixed method design. Health Promot Perspect 2020; 10:129-134. [PMID: 32296625 PMCID: PMC7146041 DOI: 10.34172/hpp.2020.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 02/20/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Considering the increasing prevalence rate of smoking among Iranian adolescents,and recent evidence on the relationship between obscenity of smoking and tendency of adolescents towards the behavior, there is a need for an appropriate measurement tool to measure the level of obscenity on cigarette smoking among adolescents. This study was conducted to develop a valid and reliable questionnaire for measuring the obscenity of cigarette smoking in adolescents. Methods: This study was conducted in Tabriz, Iran, using an exploratory sequential mixed methods design. To explain the concept of obscenity and develop the questionnaire’s items, 18 students attended semi-structured individual interviews and 13 others took part in focus group discussions (FGDs) in three groups of 4-5. Extracting and summarizing the codes derived from the interviews, an item pool was developed, from which the initial draft of the scale was provided.Next, the psychometric properties of the scale were assessed using face, content, construct, and predictive validity, as well as internal consistency, and reliability in a sample of 1013 high school students. Results: The 22-item Cigarette Smoking Obscenity Scale (CSOS) was developed based on thecodes derived from qualitative data. Explanatory factor analysis revealed five-factor structure(Negative Attitude; Negative Consequence; Negative Valuation; Inappropriate Relationship; Agateway to addiction). In confirmatory factor analysis, the χ2/df ratio was 3.911 for the CSOS five-factor structure. Suitable values were obtained for the goodness of fit indices (GFI = 0.88,AGFI = 0.85, NFI = 0.87, IFI = 0.90, CFI = 0.90, RFI = 0.85, and RMSEA = 0.072). The Cronbach’s alpha and intraclass correlation (ICC) coefficients for the constructs ranged between 0.77 to 0.90 and 0.80 to 0.91, respectively. Conclusion: The validity and reliability of the CSOS was appropriate; therefore, it can be used infuture studies as a suitable tool for measuring the obscenity of cigarette smoking in adolescents.
Collapse
Affiliation(s)
- Khadijeh Keshavarzian
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haidar Nadrian
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran.,Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Mohammadpoorasl
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran.,Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
12
|
Parizadeh D, Momenan AA, Amouzegar A, Azizi F, Hadaegh F. Tobacco Smoking: Findings from 20 Years of the Tehran Lipid and Glucose Study. Int J Endocrinol Metab 2018; 16:e84738. [PMID: 30584430 PMCID: PMC6289312 DOI: 10.5812/ijem.84738] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/02/2018] [Accepted: 10/07/2018] [Indexed: 12/25/2022] Open
Abstract
CONTEXT Smoking is a global public health priority and accurate data of the local population is essential to improve the health policies against its use. Hence, this study aimed to summarize the important findings available on the prevalence of smoking and its association with non-communicable diseases, documented by one of the largest prospective community-based studies of Iran. EVIDENCE ACQUISITION All articles derived from the Tehran Lipid and Glucose Study (TLGS) in the last two decades, from the earliest publications until 30 January 2018 were reviewed for their findings on tobacco smoking. RESULTS The prevalence of smoking in non-diabetic adults ≥ 20 years increased between baseline (phase I, 1999 - 2001) and follow-up (phase V, 2008 - 2011) from 25.5% to 35.4% among men and from 3.4% to 6.8% among women. In TLGS adolescents (10 - 18 years) water pipe use increased between 2003 and 2005 from 35.5% to 40.9% among boys and from 19.7% to 26.1% among girls. Regarding health hazards, smoking in men was associated with increased risk of combined impaired fasting glucose/impaired glucose tolerance [hazard ratio (HR) 1.69; confidence interval (CI) 95% 1.15 - 2.48] and hypertension (HR 1.26; CI 95% 0.98 - 1.63). Moreover, men, even smoking less than 10 cigarettes per day, were at increased risk for cardiovascular diseases by HR 2.12 (CI 95% 1.14 - 3.95). For women, the risk of chronic kidney disease dramatically increased 5.74-fold (CI 95% 2.71 - 12.15) among smokers. In the whole population, smoking contributed to 7.7% of all-cause mortality with HR 1.75 (CI 95% 1.38 - 2.22). Other health aspects of tobacco smoke, including its impact on metabolic status, thyroid function, female reproductive system and life style have also been reviewed. CONCLUSION Considering hazards of smoking, there is the urgency for more effective preventive measures in Iran; emphasizing the need for further local studies on the hazards of smoking with special attention to women and adolescents and the independent hazards of water pipe use.
Collapse
Affiliation(s)
- Donna Parizadeh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Momenan
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Atieh Amouzegar
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
13
|
Sabzmakan L, Ghasemi M, Asghari Jafarabadi M, Kamalikhah T, Chaleshgar Kordasiabi M. Factors Associated with Tobacco Use among Iranian Adolescents: An Application of Protection Motivation Theory. Subst Use Misuse 2018; 53:1511-1518. [PMID: 29313745 DOI: 10.1080/10826084.2017.1415356] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Tobacco use is a significant predisposing factor to many diseases. Protection motivation theory is a well-suited theory, since fear can motivate individuals to change their unhealthy behaviors. OBJECTIVE This study was conducted to examine the associations between the constructs of this theory with intention and tobacco use behavior. METHOD The present cross-sectional study was conducted in Noshahr, Iran. The participants were 440 high school boys selected using a stratified random sampling in 2016. A questionnaire about tobacco use based on protection motivation theory was developed and its validity and reliability were assessed. The questionnaire included the demographic information, the constructs of theory, and tobacco use behavior. Structural equation modeling was used to test the associations between the constructs with intention and tobacco use. RESULTS The variables of perceived vulnerability (β = 0/137, P < 0.001), fear (β = 0/149, P < 0.001), self-efficacy (β = 0/249, P < 0.001), perceived intrinsic reward (β = -0.285, P < 0.001), threat appraisal (β = -0.25, P < 0.001), and coping appraisal (β = 0.358, P < 0.001) had direct effect and are significant with intention. Moreover, perceived vulnerability (β = -0.158, P < 0.001), fear (β = -0.172, P < 0.001), self-efficacy (β = -0.288, P < 0.001), perceived intrinsic reward (β = 0.329, P < 0.001), threat appraisal (β = 0.265, P < 0.001), and coping appraisal (β = -0.379, P < 0.001) affected tobacco use indirectly through intention and were significantly associated with behavior. Also, intention had direct effect and is significant with tobacco use (β = -1.156, P < 0.001). CONCLUSIONS The protection motivation theory provides a useful framework for investigating factors of tobacco use among male students. Future tobacco prevention interventions should focus on increasing the vulnerability and fear, decreasing intrinsic reward, and improving self-efficacy to reduce tobacco use.
Collapse
Affiliation(s)
- Leila Sabzmakan
- a Department of Health Education & Promotion , Alborz University of Medical Sciences , Karaj , Iran
| | - Mahmood Ghasemi
- a Department of Health Education & Promotion , Alborz University of Medical Sciences , Karaj , Iran
| | | | - Tahereh Kamalikhah
- c Department of Health Education & Promotion , Semnan University of Medical Sciences , Semnan , Iran
| | | |
Collapse
|
14
|
Bashirian S, Barati M, Abasi H, Sharma M, Karami M. The role of sociodemographic factors associated with waterpipe smoking among male adolescents in western Iran: A cross-sectional study. Tob Induc Dis 2018; 16:29. [PMID: 31516429 PMCID: PMC6659475 DOI: 10.18332/tid/91601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/12/2018] [Accepted: 05/24/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Waterpipe smoking (WPS) is an increasingly popular leisure activity among young people in Iran. The purpose of this study was to identify the role of sociodemographic factors associated with WPS among male adolescents in Iran. METHODS The study used a cross-sectional design. It included 730 high school male students (Grades 10–12) recruited through multistage random sampling conducted in 2017 in Hamadan city, western Iran. The self-administered questionnaires included information on demographic variables and behavioral risk factors related to WPS. Descriptive statistics and multinomial logistic regression modeling were conducted using SPSS. RESULTS The student mean age, and standard deviation (SD), and age at WPS initiation were 16.41 (0.84) and 13.31 (2.43) years, respectively. The percentages of never, former and current WPS were 37.3%, 36.4% and 26.3%, respectively. We found that ever cigarette smoking (OR=5.14, 95% CI: 2.56–10.32) and WPS family (OR=2.55, 95% CI: 1.40–4.64) were significantly associated with former WPS. Furthermore, being 18 years, studying in technical fields, reporting ever and current smoking of cigarettes and family usage of WP were significantly associated with current WPS. Friends with WPS (OR= 0.50, 95% CI: 0.34–0.72) however played a protective role on former WPS. CONCLUSIONS The results indicate that the prevalence of former and current WPS was high in Hamadan city. Thus, designing and implementing interventions for increasing students’, friends’ and family’s awareness regarding the harms of WPS and cigarette smoking are necessary to facilitate behavior change.
Collapse
Affiliation(s)
- Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamid Abasi
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Manoj Sharma
- Behavioral & Environmental Health School of Public Health, Jackson State University, Jackson, United States
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
15
|
Jawad M, Charide R, Waziry R, Darzi A, Ballout RA, Akl EA. The prevalence and trends of waterpipe tobacco smoking: A systematic review. PLoS One 2018; 13:e0192191. [PMID: 29425207 PMCID: PMC5806869 DOI: 10.1371/journal.pone.0192191] [Citation(s) in RCA: 171] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/19/2018] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Waterpipe tobacco smoking is harmful to health however its prevalence estimates remain uncertain. We aimed to systematically review the medical literature on waterpipe tobacco prevalence and trends. METHODS We searched Medline, Embase and ISI Web of Science for 'waterpipe' and its synonyms, without using language or date restrictions. We included any measure of waterpipe tobacco smoking prevalence in jurisdictionally representative populations. We stratified findings by prevalence measure (past 30 day, ever, regular or occasional, daily, other or unspecified) and age (adults or youth). RESULTS We included 129 studies reporting 355 estimates for 68 countries. In general, prevalence estimates among adults were highest in the Eastern Mediterranean, and among youth were about equal between Eastern Mediterranean and European regions. Past 30 day use was highest among Lebanese youth (37.2% in 2008), ever use was highest among Lebanese youth in 2002 and Lebanese university students in 2005 (both 65.3%), regular or occasional use was highest in among Iranian university students (16.3% in 2005), and daily use was highest among Egyptian youth (10.4% in 2005). Trend data were limited but most studies reported increased use over time, ranging from 0.3-1.0% per year among youth in the US to 2.9% per year among youth in Jordan (both for past 30 day use). Results were similar for ever use trends. Turkey (2.3% in 2008 to 0.8% in 2010) and Iraq (6.3% in 2008 and 4.8% in 2012) both witnessed decreased waterpipe use. CONCLUSION Waterpipe tobacco smoking is most prevalent in Eastern Mediterranean and European countries, and appears higher among youth than adults. Continued surveillance will be important to assess and inform policy measures to control waterpipe tobacco use.
Collapse
Affiliation(s)
- Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London, United Kingdom
- * E-mail:
| | - Rana Charide
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Reem Waziry
- Department of Epidemiology Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Andrea Darzi
- AUB GRADE Center, Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Rami A. Ballout
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Elie A. Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| |
Collapse
|
16
|
Ziaei R, Mohammadi R, Dastgiri S, Viitasara E, Rahimi VA, Jeddi A, Soares J. The Prevalence, Attitudes, and Correlates of Waterpipe Smoking Among High School Students in Iran: a Cross-Sectional Study. Int J Behav Med 2017; 23:686-696. [PMID: 26940816 DOI: 10.1007/s12529-016-9555-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of the present study was to determine the correlates of waterpipe (WP) smoking among 15-17-year-old high school students in Iran. METHOD Data were collected using the Global Youth Tobacco Survey (GYTS), a self-administrated questionnaire distributed to a representative sample of high school students aged 15-17 in the city of Tabriz. Current WP smoking was defined as past 30-day use, and ever WP smoking was defined as at least one or two lifetime puffs. Differences in WP use, knowledge, and attitudes were analyzed using chi-square and Fisher exact tests. Binary logistic regression estimated the association between relevant independent variables (e.g., age) and the dependent variables (current/ever WP smoking). RESULTS Of 1517 students, 21.6 % (95 % confidence interval [CI] = 19.5, 23.8) were ever WP smokers, and 9.7 % (95 % CI = 8.2, 11.2) were current WP smokers. Of current WP smokers, 40.3 % have stated that they want to stop smoking now. Moreover, 14.1 % of non-WP smokers reported that they might enjoy smoking WP. Of current WP smokers, 49.0 % have smoked at cafés. Additionally, 95.3 % of current WP smokers reported that their age did not prevent them from being served a WP. Studying in high school third grade (adjusted odds ratios (AORs) = 1.70; 95 % CI [1.10, 2.63]), experience of cigarette smoking (AORs = 1.57; 95 % CI [1.12, 2.20]), and being prepared to accept a WP offered by close friends (AORs = 3.31; 95 % CI [2.17, 5.04]) were independently associated with ever WP smoking, and accepting a WP offered by close friends (AORs = 4.36; 95 % CI [2.69, 7.07]) and gender (female) (AORs = 0.45; 95 % CI [0.30, 0.70] were independently associated with current WP smoking. CONCLUSION Prevalence of current and ever WP smoking is high in Tabriz. There is an urgent need to design interventions in order to increase students' and their parents' awareness regarding the harmfulness of WP, and to establish legal measures to restrict adolescents' access to WPs and tobacco in society.
Collapse
Affiliation(s)
- Reza Ziaei
- Department of Health Sciences, Unit for Public Health Science, Mid Sweden University, Sundsvall, Sweden.
| | - Reza Mohammadi
- Department of Neurobiology, Care Sciences and Society, Unit for Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - Saeed Dastgiri
- Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Eija Viitasara
- Department of Health Sciences, Unit for Public Health Science, Mid Sweden University, Sundsvall, Sweden
| | - Vahab Asl Rahimi
- Unit for Adolescence Health, Province Health Center, Tabriz, Iran
| | - Abolfazl Jeddi
- Unit for Adolescence Health, Province Health Center, Tabriz, Iran
| | - Joaquim Soares
- Department of Health Sciences, Unit for Public Health Science, Mid Sweden University, Sundsvall, Sweden
| |
Collapse
|
17
|
Bahtouee M, Maleki N, Nekouee F. The prevalence of chronic obstructive pulmonary disease in hookah smokers. Chron Respir Dis 2017; 15:165-172. [PMID: 28534421 PMCID: PMC5958464 DOI: 10.1177/1479972317709652] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Hookah smoking is growing worldwide and particularly in Iran. The aim of this study was to determine the prevalence of obstructive pulmonary dysfunction in hookah smokers. We conducted a population-based study in Bushehr Province, Iran. A total of 245 subjects aged 35 years or older who were taking hookah for at least 15 years and 245 healthy controls were enrolled in the study and spirometry was done. Statistical analyses were performed using SPSS for windows software version 19. The prevalence of COPD among the exposed group of hookah smoke was 10.2%, with the rate being significantly higher in the patients with older age (p < 0.001), duration of hookah smoking (p < 0.001), men (p = 0.026), ≥3 hookahs/day (p = 0.006), history of cough for ≥2 years (p = 0.002), in patients with a history of sputum for ≥2 years (p = 0.031), and in patients with a history of dyspnea for ≥2 years (p = 0.001). The results of the logistic regression analysis demonstrated that older age, male gender, smoking, and occupational exposure were independent predictive factors for COPD. The results of our study suggest that hookah smoking significantly increases the risk of COPD. Given the importance of COPD in the global burden of diseases, it is necessary to carry out further studies on the relationship between hookah use and COPD.
Collapse
Affiliation(s)
- Mehrzad Bahtouee
- 1 Department of Internal Medicine, Shohadaye Khalije Fars Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Nasrollah Maleki
- 2 Department of Endocrine and Metabolic Diseases, The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Fatemeh Nekouee
- 1 Department of Internal Medicine, Shohadaye Khalije Fars Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| |
Collapse
|
18
|
Baheiraei A, Mirghafourvand M, Mohammadi E, Majdzadeh R. Experiences of Cigarette Smoking among Iranian Educated Women: A Qualitative Study. Int J Prev Med 2016; 7:93. [PMID: 27563429 PMCID: PMC4977981 DOI: 10.4103/2008-7802.186585] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 05/10/2016] [Indexed: 11/28/2022] Open
Abstract
Background: Smoking is a well-known public health problem in women as well as men. In many countries including Iran, there is an increase in tobacco use among women. Exploring the experience of smoking by educated women in order to develop effective tobacco prevention programs in these women is necessary. This study aimed to explore the experiences of smoking among Iranian educated women. Methods: This study used a method of qualitative content analysis with the deep individual, semi-structured interviews on a sample of 14 educated female smokers, selected purposefully. Data were analyzed using qualitative content analysis with conventional approach while being collected. Results: The data analysis led to 16 subcategories which were divided into four main categories: (1) Personal factors including subcategories of imitation, show-off and independence, inexperience and curiosity, personal interest and desire, improved mood, and social defiance; (2) family factors including smokers in the family, intrafamily conflicts, and family strictures and limitations; (3) social factors including subcategories of effects of work and school environment, gender equality symbols, peer pressure, and acceptance among friends; and (4) negative consequences of smoking including subcategories of a sense of being physically hurt, psychological and emotional stress, and being looked upon in a negative and judgmental manner. Conclusions: The findings of this study showed that smoking among Iranian educated women is a multifactorial problem. Thus, it is necessary to address smoking among educated women in a holistic approach that focuses on different determinants including personal, family, and social factors particularly the gender roles and stereotypes.
Collapse
Affiliation(s)
- Azam Baheiraei
- Department of Reproductive Health, Tehran University of Medical Sciences, Tehran, Iran; Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Eesa Mohammadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Reza Majdzadeh
- Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
19
|
Prevalence and determinants of cigarette smoking among college students: a cross-sectional study in Douala, Cameroon. ACTA ACUST UNITED AC 2015; 73:47. [PMID: 26693277 PMCID: PMC4685632 DOI: 10.1186/s13690-015-0100-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/24/2015] [Indexed: 11/21/2022]
Abstract
Background Tobacco is the most important avoidable risk for non communicable diseases. While tobacco consumption is stable or declining in developed countries, it is increasing in the developing world with a rate of 3.4 % per annum. The objective of this study was to estimate the prevalence and factors associated with cigarette smoking among college students. Methods A cross-sectional study was conducted from December 2012 to April 2013 in secondary schools in Douala, Cameroon. A self-administered questionnaire was used to collect sociodemographic data, smoking behavior and peer smoking among college students. Logistic regression analyses was employed to identify factors associated with cigarette smoking. Results Of a total of 2623 students included, 1579 (60.2 %) were female. The mean age of participants was 19.2 ± 2.53 years. The prevalence of current smoking was 11.2 % [95 % confidence interval (CI) 10 – 12], with 20 % in males and 5.3 % in females. Cigarette smoking was with significantly associated with friends smoking [Odds ratio (OR) 6.66; 95 % CI 4.69 – 9.45)], male gender (OR 3.61; 95 % CI 2.52 – 5.16), increase in age (OR 1.10; 1.03 – 1.17), parental smoking 1.69 (1.04 – 2.76), and attending general education (OR 1.85; 1.23 – 2.78). Conclusions Cigarette smoking constitutes a significant health hazard in college students in Douala. Youth population and especially male students should be continuously targeted by preventive measures and sensitization campaigns against tobacco use. Parents should be aware on the influence of their smoking behavior on initiation of smoking in their children and should be encouraged to quit smoking.
Collapse
|