Cigarette smoking and perceived risk of cardiovascular disease in Iran

INTRODUCTION

Studies have consistently demonstrated a strong link between cigarette smoking and an increased risk of cardiovascular diseases (CVD). On the other hand, studies have shown that most smokers do not have a real understanding of the cardiovascular health hazards of smoking. Therefore, the study aimed to determine the perceived risk of Myocardial Infarction (MI), Hypertension (HTN), and Stroke among current smokers in Iran.

METHODS

This cross-sectional study was conducted between January and May 2023, and recruited 380 smokers by convenience sampling who smoked at least 100 cigarettes in their lifetime. The data were collected using three questionnaires (1) the questionnaire to assess the risk perception for MI, HTN, and Stroke, (2) the smoking stage of change questionnaire, and (3) the Fagerström Test for nicotine dependence (FTND). The CVD risk perception consisted of two parts, perceived susceptibility and perceived severity. Each part scores between 0 and 10 and finally gets a total score of 0-20. A score of zero indicated the lowest risk perception while a score of 20 indicated the highest risk perception. We examined the relationship between the demographic and smoking-related variables and the smokers' perceived risk of MI, stroke, and HTN by using multiple linear regression.

FINDINGS

The mean age of participants was 35.57 ± 12.05 years, and 77.1% were male. The perceived risk score of MI was 10.68 ± 4.69 out of 20. The scores related to stroke and HTN were 10.00 ± 4.65 and 10.89 ± 4.73, respectively. Identified variables collectively contributed significantly to predicting the perceived risk of MI (p <.0001, Adj R-squared = 0.05%), stroke ( p <.0001, Adj R-squared = 0.08%), and HTN (p <.0001, Adj R-squared = 0.06%). We found that longer smoking duration [coefficient=-1.96 (95% CI= -3.91, - 0.09)] for 20-29 years and - 4.08 ( 95% CI= -6.70, -1.46 ) for 30 + years), older smoking age onset [coefficient=-2.10 ( 95% CI= -3.24, - 0.96 )] for 20 + years), and dual tobacco users [coefficient= -1. 04 (95% CI= -2.08, - 0.06)] were significantly associated with lower perceived risk for MI. We also found that longer smoking duration [coefficient=-2.23 (95% CI= -4.13, - 0.32)] for 20-29 years and - 5.01 (95% CI= -7.565734, -2.462361 ) for 30 + years), older smoking age onset [coefficient=-1.86 (95% CI= -2.970021, - 0.75 ] for 20 + years), and being male [coefficient= -2. 00, (95% CI= -3.53, - 0.47)] were significantly associated with lower perceived risk for stroke. We found that longer smoking duration (coefficient=-4.40 for 30 + years), older smoking age onset [coefficient=-2.02 (95% CI= -3.14, - 0.87,)] for 20 + years), and being dual users [coefficient=-1.36, 95% CI= -2.40, - 0.3241238)] were significantly associated with lower perceived risk for HTN.

CONCLUSION

The results of this study demonstrated a moderate perceived risk of participants to CVD. Also, the perceived risk decreases as the duration of smoking and the age for the smoking onset increases to 20 years and above. It seems necessary to carry out interventions to inform the public about the harms of smoking, especially for adolescents and young adults, and its risks in causing cardiovascular disease.

Psychometric Properties of the CAGE Questionnaire Amongst Middle-Aged and Older Adults in Khuzistan Province of Iran

The CAGE questionnaire is an instrument, proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The questionnaire has been more pervasive simple tool than AUDIT and LAST scales to screen in busy medical settings where limited time is considered for adult patient interviews. The present study aimed to determine the reliability and validity of the CAGE questionnaire in Khuzistan province, Iran and evaluate its role in detecting alcohol-related problems. For this purpose, 382 men with mean age of 65 ± 5 were sampled by cluster-random sampling method in convenience model from the medical centers in eight counties of Khuzistan province during 2019 and they responded to the CAGE questionnaire. The coefficients of Cronbach's alpha (α = 0.82), convergent validity (0.73), divergent validity (-0.06), and criterion validity (0.87) were estimated (ρ < 0.01). The exploratory factor analysis demonstrated that the four -items related to the CAGE for the aged samples are organized into one factor, which clarifies 94% of the variance. Based on the results of the second-order confirmatory factor analysis, all factors were matched up well into a principal factor. Finally, the one -factor model was appropriate for the data by using the fit index techniques for adjusting the scale (AGFI = 0.81, TLI = 0.91, GFI = 0.93, RMSEA = 0.006, IFI = 0.94, NFI = 0.91, CFI = 0.97).The results could prove the well-adjusted reliability and validity of the CAGE and its usefulness for the relevant studies.

Exploration factors on smoking among female adolescents based on the viewpoints of Iranian adolescent girls

Background

In recent years, the prevalence of smoking in women has increased significantly. This study aimed to explain the effective factors in the tendency to smoke in female adolescents, employing a qualitative method of content analysis in Mashhad, Iran.

Methods

The data for this conventional content analysis were obtained by conducting semi‑structured interviews with 20 female adolescent smokers. For open coding, integrating codes, creating main category and subcategories, and extracting quotation associated with codes and subcategories, MAXQDA software version 10 was used.

Results

Based on the results of the study, one main category and six subcategories were identified to influence the decision to smoke. The main category was interconnection of psychological and gender experiences. The subcategories included self-management weakness, ignoring the side effects, gender orientation, negative psychological experiences, the attraction of cigarettes, and positive psychological experiences.

Conclusion

Psychological and gender factors play an important role in initiating people's behavior and tendency to smoke and smoking prevention programs in educational settings need to focus efforts around what is known about young women smokers.

Exploration the role of social, cultural and environmental factors in tendency of female adolescents to smoking based on the qualitative content analysis

Background

The aim of this study was to explain the socio-cultural and environmental factors of smoking tendency in female adolescents.

Methods

This qualitative content analysis study was conducted among Iranian female adolescents in Mashhad, Iran. The data was collected through semi-structured interviews with 20 female smokers. The duration of each interview varies from 30 to 70 min. Data collection and management of data were done using MAXQADA software version 10.

Results

In exploration the effective socio-cultural and environmental factors in the tendency of female adolescents to smoking, six subcategories of role modeling of friends, membership in groups, parenting patterns, family modeling, the predisposing community, and the negative impact of the media were extracted.

Conclusions

The results obtained in this study indicated that there is a need to formulate policies and adopt environmental and social laws to reduce smoking. The results also showed the effective role of parents in improving personal skills, creating a stress-free environment in the family, and controlling adolescent behavior. Therefore, it is necessary to pay attention to all social and cultural aspects in order to make the smoking prevention programs.

Developing strategies to improve the community readiness level to prevent drug abuse in adolescents: Based on the community readiness model, Eghlid City, Iran, 2019

The aim of this study was to investigate the level of readiness of Eghlid city community for adolescents' substance abuse prevention programs, and to develop strategies to improve community readiness levels based on the community readiness model (CRM). In this two-stage qualitative study, a 36-item semi-structured CRM questionnaire, was used to interview 11 key informants in Eghlid city, Iran, 2019. The interviews were analyzed and scored by two independent researchers. Strategies for increasing the level of readiness were developed and prioritized by participants using the nominal group method. The readiness levels to prevent substance abuse in community efforts and leadership dimensions were at stabilization and preparation stage. In terms of community awareness of efforts, community space, and public awareness of the issue, the readiness level was at the pre-planning stage, and in the resources for prevention efforts dimension, it was at the vague awareness level. In the strategy development section, the key participants focused on using traditional methods such as holding face-to-face training programs and festivals, using IRIB platform, local media, and lectures. The general level of readiness is at a moderate level. It seems necessary to focus on resources and areas related to public information.